Stages of hemorrhoids … understanding grades 1 to 4

More than half of adults will experience hemorrhoids at some point in their lives. These swollen veins in the rectum or anus can cause itching, pain and bleeding. Doctors grade hemorrhoids by severity, from stage 1 to stage 4. Understanding each stage helps you choose the right care and prevent complications.

Stage 1 … small hemorrhoids that stay inside
Stage 1 hemorrhoids remain inside the anal canal. Symptoms include minor itching, occasional discomfort and small amounts of bright-red blood on the toilet paper. These early hemorrhoids usually shrink with at-home care such as eating more fiber, drinking water, exercising and avoiding straining during bowel movements. Over-the-counter creams and witch-hazel pads can relieve itchiness.

Stage 2 … hemorrhoids that prolapse and retract
Stage 2 hemorrhoids slip out during bowel movements but retract on their own. They may cause pain while passing stool, along with bleeding and irritation. At this stage, home remedies may still work, but your doctor might also recommend non-surgical treatments like rubber-band ligation or sclerotherapy. Early intervention helps prevent progression to more severe stages.

Stage 3 … hemorrhoids that require manual repositioning
Stage 3 hemorrhoids prolapse and must be pushed back in manually. They often cause significant pain, swelling, itching and discomfort when sitting. Treatments may include rubber-band ligation, sclerotherapy or a newer procedure called hemorrhoid artery embolization. See a doctor promptly if you experience these symptoms to avoid complications like blood clots.

Stage 4 … permanently prolapsed hemorrhoids
Stage 4 hemorrhoids remain outside the anus and cannot be pushed back in. They cause persistent pain, bleeding and swelling. Surgical removal, known as a hemorrhoidectomy, is usually necessary. Do not ignore these symptoms … prompt medical care helps prevent complications such as clotting or infection.

At-home care & prevention
Even if your hemorrhoids are mild, adopting healthy habits can ease symptoms and stop them from getting worse:

• Eat a high-fiber diet with fruits, vegetables, whole grains and beans.
• Drink plenty of water to soften stools.
• Exercise regularly to promote good bowel function.
• Don’t strain or sit too long on the toilet … limit each trip to a few minutes.
• Respond to the urge to go rather than delaying.

When to see a doctor
Consult a healthcare professional if you experience severe pain, heavy rectal bleeding, protruding hemorrhoids that won’t retract, or symptoms that last more than a week. Persistent or advanced hemorrhoids may require procedures to provide relief. Bleeding can also be a sign of other digestive problems, so it’s important to get an evaluation.

Conclusion
Hemorrhoids progress from stage 1 (mild discomfort and occasional bleeding) to stage 4 (constant prolapse and severe pain). Early treatment and lifestyle changes often relieve stage 1 and 2 hemorrhoids, while stages 3 and 4 may require medical procedures. By eating fiber, staying hydrated, exercising and avoiding straining, you can prevent hemorrhoids from worsening. Don’t hesitate to seek professional advice if symptoms persist or you notice bleeding … prompt care helps you feel better faster and protects your health.