When I enquired about the rational behind his thinking of piles in 4th stage, he very confidently tried to establish that as his suffering is for more than 5 to 7 years that is why is in 4th stage.
Actually, assigning a degree to piles or haemorrhoid has nothing do do with the duration of suffering; rather the classification of degree done seeing other features of piles.
Piles (Latin: Pila=a ball) or Haemorrhoids (Greek: haima= blood, rhoos= flowing) is a bunch of dilated veins present in anal canal or external to it. likewise, those are termed as either external or internal piles. Another term, sentinel pile is used in case of a fissure-in-ano, to guard the fissure as sentry (Sentinel= Sentry, to guard).
Internal piles starts from the inside the anal canal, so first degree piles are those which can not be seen or felt out side; but can only bleed to show its presence.
Second degree piles are those which come out of anal opening during defecation and reduce automatically; whereas third degree piles does not reduce, remain prolapsed or may show up at any other time besides during defecation; to be reduced manually.
External piles are those which remain outside the anal margin and can be readily seen and felt.
Another variety of piles named interno-external piles, where both external and internal components of piles co-exist.
Piles as such is not painful, unless thrombosed; and so also not felt on digital examination, unless otherwise thrombosed.
Commonly, piles are located in at 3, 7 or 11 O’clock position; where the branches of superior rectal vein are present. Ancillary positions are 5 and 9 O’clock positions.
Haemorrhoids may be a manifestation of a colorectal cancer inside. Digital and sigmoidoscopic examination rectum and colon is a must to rule out the possibility of colorectal cancer.