Hemorrhoids (also known as piles) is a condition where the blood vessels in and around the anus become swollen and inflamed. The anus is the opening of your back passage where stools are passed when you go to the toilet.

Hemorrhoids are caused by an increase pressure in the blood vessels in the anus and rectum (end part of the large bowel). This is often because of straining when trying to pass a stool.

Anyone at any age can be affected by hemorrhoids. They are very common, with about 50% of people experiencing them at some time in their life. However, it is usually more common in elderly people and during pregnancy.

Symptoms of hemorrhoids often begin with an itchy feeling around the anus, but can become painful and lead to bleeding. The condition is not very serious and can be successfully treated.

Types of hemorrhoids

There are two types of hemorrhoids - internal and external.

Internal hemorrhoids occur inside the anus. The swollen blood vessels remain inside your anus and do not usually cause pain. The size of internal hemorrhoids are classified using a grading system from 1 to 4.

• Grade 1 hemorrhoids are often small swellings inside the lining of your anus. They cannot be seen and are very common. In some cases they will enlarge to grade 2 hemorrhoids.
  
• Grade 2 hemorrhoids are larger in size but are still within your anus. In some instances they become pushed out when you pass a stool, but will return inside immediately after.
  
• Grade 3 hemorrhoids appear outside your anus. These are also referred to as prolapsed hemorrhoids. Grade 3 hemorrhoids protrude outside your anus and often decrease in size naturally. In most cases these hemorrhoids can be pushed back inside the anus with your fingers.
  
• Grade 4 hemorrhoids remain outside your anus permanently. They cannot be pushed back inside and will need to be treated by your doctor.

External hemorrhoids occur outside your anus. They are also known as perianal hematoma.

You may feel a small lump outside your anus that becomes increasingly itchy. This type of haemorrhoid is less common and will require immediate treatment.

It is possible to have both internal and external hemorrhoids at the same time, but this is rare.