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Piles are inflamed and swollen collections of tissue in the anal area. They can have a range of sizes, and they may be internal or external.
Internal piles are normally located between 2 and 4 centimeters (cm) above the opening of the anus, and they are the more common type. External piles occur on the outside edge of the anus.
1. Grade I: There are small inflammations, usually inside the lining of the anus. They are not visible.
2. Grade II: Grade II piles are larger than grade I piles, but also remain inside the anus. They may get pushed out during the passing of stool, but they will return unaided.
3. Grade III: These are also known as prolapsed hemorrhoids, and appear outside the anus. The individual may feel them hanging from the rectum, but they can be easily re-inserted.
4. Grade IV: These cannot be pushed back in and need treatment. They are large and remain outside of the anus.