Piles means balls or mass. This is caused by downward sliding of anal coushins due to straining. Anal Cushion is aggregation of blood vessels, smooth muscles and elastic tissue in submucosa at the night times.

Types of Piles Internal : Above the dentale live covered with mucus membrane. External : Below the dentale live covered with skin. Type 3: Internal & External together occurs. .

Grades in Piles:

First Degree : Hemorrhoids that bleed, but do not Comeout. These are slightly enlarged hemorrhoids, but they do not protrude outside the anus.
Second Degree : Comes out during deafaction These may come out of the anus during certain activities like passing stool, and then return back inside the body.
Third Degree : Comes out during daefesation Hemorrhoids that prolapse and must be pushed back in by a finger.
Fourth Degree : Completely comes out of the anus.

Causes of Piles:

• Heredrity
• Straining, Constipation, Hard stools
• Low Fibre diet, Pregnancy
• holding your breath while straining to do physical labor