Internal piles have 4 developmental stages: grade 1, grade 2, grade 3 and grade 4.
It is very simple to tell, if your haemorrhoids are internal.
Internal haemorrhoids are painless. Only on very rare occasions are internal hemorrhoids ever painful.
Internal haemorrhoids occur inside the rectum. That is why they are labeled internal. You do not feel any pain because there are no pain receptors in this region. However, by the grade 2 developmental stage, internal hemorrhoids prolapse and protrude out of the anus. You might feel pain by the grade 2 developmental stage because your anus has pain receptors.
Prolapse is a medical term which describes the dislocation of tissues and organs from their normal positions.
You might also feel pain, if the piles are necrotic or thrombosed. Piles are necrotic, when the cells inside die, before maturity. In medicine, the term thrombosed describes the blockage of circulation due to the clotting of cells in blood vessels.
If your haemorrhoids are internal, you will see bright red blood on your stool. Blood will also be present on the toilet tissue and in the toilet bowl.
The presence of blood is a bit tricky. You cannot conclusively tell that, you have internal hemorrhoids, simply because, you found blood in your stool. Anal fissures might be responsible for the bleeding.
You can tell that, you are dealing with an anal fissure, if it is slightly painful.
On very rare occasions, colorectal cancer or anal cancer might be responsible for the bleeding.
The relevant point to remember is that, the absence of pain is the central indicator of internal haemorrhoids.
External hemorrhoids are labeled external because they occur on the realm of the anus.
Since they are visible externally, you can easily diagnose yourself with the help of a mirror.
Keep in mind that internal hemorrhoids are also visible externally. But external visibility occurs only after they have prolapsed, usually from grade 2 onwards.
If you are dealing with external hemorrhoids, peanut-shaped protrusions will be present on your anus. The anal region is richly served with nerve endings; hence, you will feel irritation, itching and pain.
The developmental stage of the piles directly affects the degree of pain and itching. You will feel more pain and irritation, if the haemorrhoids are thrombosed.