Home > Piles Treatment > Hemorrhoids Size Chart

Grades of Hemorrhoids: Stages, Symptoms & Size Chart

Know the grades of hemorrhoids using an easy-to-read size chart. Learn symptoms, severity, and treatment options by grade.

Know the grades of hemorrhoids using an easy-to-read size chart. Learn symptoms, severity, ... and treatment options by grade. Read More

💯 No Booking Fees

Anup Soni - the voice of Pristyn Care pointing to download pristyncare mobile app

Name

Patient Name

Select Country

Phone

+91

Mobile Number

City

Select City

Call Us

We are Rated

3 M+ Happy Patients

200+ Hospitals

30+ Cities

3M+

Happy Patients

50+

Disease

200+

Hospitals

30+

Cities

Free Cab Facility

No-Cost EMI

Support in Insurance Claim

1-day Hospitalization

USFDA-Approved Procedure

Best Doctors for Piles

Choose Your City

It help us to find the best doctors near you.

Ahmedabad

Bangalore

Bhubaneswar

Chandigarh

Chennai

Coimbatore

Delhi

Hyderabad

Indore

Jaipur

Kochi

Kolkata

Kozhikode

Lucknow

Madurai

Mumbai

Patna

Pune

Raipur

Ranchi

Thiruvananthapuram

Vijayawada

Visakhapatnam

Delhi

Hyderabad

Pune

Mumbai

Bangalore

Doctor Not Found

Dr. Vipin Nagpal

MBBS, MS-General Surgery

31+ Yrs.Exp.

5.0/5

31+ Years Experience

Pristyn Care Elantis Hospital, Lajpat Nagar, Delhi

Call Us

080-6542-3711
Dr. Rakesh Shivhare

MBBS, MS(GI & General Surgeon)

30+ Yrs.Exp.

5.0/5

30+ Years Experience

Opp.Badwani Plaza, Manorama Ganj, Old Palasia, Indore, Madhya Pradesh 452003

Call Us

080-6542-3720
Dr. Apoorv Shrivastava

MBBS, DNB-General Surgery

25+ Yrs.Exp.

4.5/5

25+ Years Experience

Pristyn Care Eminent Hospital 6/1 Opp. Barwani Plaza, Manorama Ganj, Old Palasia, Indore - 452018

Call Us

080-6542-3720
Dr. Daipayan Ghosh

MBBS, DNB-General Surgery

23+ Yrs.Exp.

4.6/5

23+ Years Experience

Pristyn Care Sheetla Hospital, Sector 8, Gurgaon

Call Us

080-6542-3711

What are Hemorrhoids?

Hemorrhoids (also called piles) are swollen blood vessels in the rectal or anal area, often caused by straining, constipation, or prolonged sitting. They can be internal or external, and vary in size and severity.

Free Piles Surgery Cost Calculator

Fill details to get actual cost

Classification of hemorrhoids

Internal Hemorrhoids

Located inside the rectum
Painless bleeding
Classified by grades (I to IV)

External Hemorrhoids

Located under the skin around the anus
Painful, may form clots (thrombosed)
Not graded by size, but by symptoms

💯 No Booking Fees

Name

Patient Name

Select Country

Phone

+91

Mobile Number

City

Select City

Call Us

Internal Hemorrhoids Grading and Size Chart

Grade	Size	Prolapse Status	Symptoms	Common Treatment
Grade I	Small (≤0.5 cm)	No prolapse	Bleeding, discomfort	Diet changes, creams
Grade II	Moderate (0.5–1 cm)	Prolapse with straining, retracts on its own	Bleeding, itching	Rubber band ligation, sclerotherapy
Grade III	Large (1–2 cm)	Prolapse requires manual reduction	Pain, bleeding, swelling	Stapler surgery, banding
Grade IV	Very Large (>2 cm)	Permanent prolapse, cannot be pushed back	Severe pain, leakage, thrombosis	Hemorrhoidectomy, laser surgery

Key Differences in Internal Hemorrhoid Grades

Grade I: Only visible through endoscopy, usually painless.
Grade II: May protrude while passing stool but go back on their own.
Grade III: Needs manual push-back after prolapse.

Grade IV: Always outside, risk of clot formation (thrombosis).
Hemorrhoid Size Reference Table (Approx.)

Size in cm	Appearance	Grade Indicator
0.2 – 0.5 cm	Mild swelling, internal only	Grade I
0.5 – 1 cm	Mild prolapse with straining	Grade II
1 – 2 cm	Bulging, needs manual push	Grade III
2 – 3+ cm	Always prolapsed, visible	Grade IV

Pristyn Care’s Free Post-Operative Care

Diet & Lifestyle Consultation

Post-Surgery Recovery Follow up

Free Cab Facility

24*7 Patient Support

List of Top Health Insurance Provider for Piles Surgery

Insurance Providers FREE Quotes

Aditya Birla Health Insurance Co. Ltd.

National Insurance Co. Ltd.

Bajaj Allianz General Insurance Co. Ltd

Bharti AXA General Insurance Co. Ltd.

Future General India Insurance Co. Ltd.

HDFC ERGO General Insurance Co. Ltd.

Symptoms of Hemorrhoids by Grade

Degree of Piles	Symptoms
I	Light bleeding, discomfort, itching
II	Bright red blood, mild pain, mucous discharge
III	Swelling, persistent bleeding, sensation of incomplete evacuation
IV	Severe pain, difficulty sitting, fecal leakage, thrombosis

External hemorrhoids classification

Features	Thrombosed	Non-thrombosed
Color	Blue, purple, black	Similar to the color of your skin
Pain	Yes, usually very painful	Soft to touch
Blood clot	Forms in the vein	Do not have a blood clot

When to Seek Medical Help?

You should consult a proctologist if:

Bleeding lasts >1 week
Pain worsens while sitting or walking
Hemorrhoids protrude and don’t retract
There’s a noticeable lump or clot

Diagnostic Methods

Digital Rectal Examination (DRE)
Anoscopy
Proctoscopy
Colonoscopy (if bleeding origin is unclear)

Treatment Options Based on Grading

Grade I & II

High-fiber diet
Sitz bath
Topical creams (lidocaine, hydrocortisone)
OTC medications (Daflon)

Non-surgical methods

Rubber band ligation
Infrared coagulation (IRC)
Sclerotherapy

Grade III

May require:

Stapled Hemorrhoidopexy
Doppler-guided hemorrhoidal artery ligation (DG-HAL)
Minimally invasive laser surgery

Grade IV

Surgical options:

Conventional Hemorrhoidectomy (Milligan-Morgan)
Laser Hemorrhoidoplasty
Stapled Hemorrhoidopexy

When is Surgery Needed?

Surgery is recommended when:

Hemorrhoids are Grade III or IV
Recurrent bleeding despite treatment
Severe thrombosis (clot)
Non-surgical methods fail

Summary

Feature	Grade I	Grade II	Grade III	Grade IV
Visible Outside?	❌	❌ (temporarily)	✅ (manual push required)	✅ (permanently)
Bleeding	Mild	Moderate	Heavy	Severe
Pain Level	Low	Mild	Moderate	Severe
Treatment Type	Conservative	Non-surgical	Semi-surgical	Surgical

FAQs

What is the most severe grade of hemorrhoids?

Grade IV is the most severe and usually requires surgical removal due to permanent prolapse.

Can Grade I hemorrhoids go away on their own?

Yes. With lifestyle changes and topical medications, Grade I hemorrhoids often resolve without advanced treatment.

Is size the only indicator of hemorrhoid grade?

No. Grading is based on prolapse behavior, not just physical size.

Can hemorrhoid size increase with time?

Yes. If untreated, hemorrhoids may worsen from Grade I to IV, increasing in size and symptoms.

Are external hemorrhoids graded the same way?

No. External hemorrhoids are not graded but assessed based on pain, size, and clot formation.

MEDICALLY REVIEWED CONTENT

🔍 REVIEWED BY

Dr. Pankaj Sareen

MBBS, MS - General Surgery

24 yrs experience

✍️ WRITTEN BY

Pristyn Care Team

Healthcare Expert Editorial Policy

Updated On · October 28, 2026

What Our Patients Say

AY

Ashwani yadav

12 Oct, 2026

5/5

Recommends

5/5

Recommends

Dr. Digvijay is an excellent surgeon for piles and hemorrhoid treatment. He is very kind-hearted, caring, and professional. I am truly grateful to him for his exceptional care, support, and dedication throughout my treatment. My treatment was successful, and I sincerely appreciate his efforts. Thank you so much, Dr. Digvijay Sir, for everything. I highly recommend him to anyone seeking treatment for piles and hemorrhoids. 🙏❤️ He is a very kind-hearted and wonderful person. I am truly grateful to him for his care, support, and dedication in making my treatment successful. Thank you so much, sir, for everything. 🙏❤️

City : Delhi

Treated by : Dr. Digvijay Singh
JI

Jivesh

9 Oct, 2026

5/5

Recommends

5/5

Recommends

Treatment and care both provides. Very good human being.

City : Delhi

Treated by : Dr. Rakesh Kumar
TA

tarun

8 Oct, 2026

5/5

Recommends

5/5

Recommends

Dr pankaj sareen, One of the best doctor in Delhi I met so far. Better understanding

City : Delhi

Treated by : Dr. Pankaj Sareen
JA

Jay

8 Oct, 2026

5/5

Recommends

5/5

Recommends

Very good, Best doctor so far 👌

City : Chandigarh

Treated by : Dr. Vipul Parmar
SS

SAI SANDEEP

5 Oct, 2026

5/5

Recommends

5/5

Recommends

Nice doctor explained everything clearly. Overall Satisfied

City : Hyderabad

Treated by : Dr. P. Thrivikrama Rao
JM

Jitendra Mohapatra

5 Oct, 2026

5/5

Recommends

5/5

Recommends

He a very talented and beautiful person..GREAT 👍 MY GOD..

City : Bhubaneswar

Treated by : Dr. Ravi Sharma

Piles Treatment in Top cities

Piles Surgery Cost in Top Cities

💯 No Booking Fees

Name

Patient Name

Select Country

Phone

+91

Mobile Number

City

Select City

Call Us

We are Rated

3 M+ Happy Patients

200+ Hospitals

30+ Cities

Appointment With

Consultation With Expert Doctors

Patient Detail

Patient Name

Mobile Number

Select City

Select Disease

Proctology

","

Pilonidal Sinus

","

Piles

","

Rectal Prolapse

","

Fissure

","

Fistula

","

Fecal Incontinence

","

Constipation

","

Hemorrhoids

","

Laparoscopy

","

Umbilical Hernia

","

Hydrocele

","

Inguinal Hernia

","

Incisional Hernia

","

Appendicitis

","

Gallstone

","

Hernia

","

Achalasia Cardia

","

Acid Reflux Surgery

","

Large Intestine

","

Indirect Hernia

","

Small Intestine

","

Colonoscopy

","

Gastric Bypass Surgery

","

Gynaecology

","

Pain During Intercourse

","

Vaginoplasty

","

Labiaplasty

","

Vaginal Discharge

","

Laser Vaginal Tightening

","

Vaginal Dryness

","

Ovarian Cyst

","

Hysterectomy

","

Hymenoplasty

","

Clitoral Hoodoplasty

","

Abortion

","

Hysteroscopy

","

Pap Smear

","

Vaginal Rejuvenation

","

Ectopic Pregnancy

","

Laser Vaginal Rejuvenation

","

Vaginal Recurrent Infection

","

Pelvic Pain

","

Female Urinary Problems

","

Lichen Sclerosus

","

Menstrual Disorders

","

Preconception Care

","

Uterine Fibroid

","

Pcos Pcod

","

Pregnancy Care

","

Medical Termination Of Pregnancy

","

Laser Vaginal Bleaching

","

Anal Bleaching

","

Vaginal Wart

","

Molar Pregnancy

","

Bartholin Cyst

","

Miscarriage

","

Endometriosis

","

Adenomyosis

","

Myomectomy

","

Dilation And Evacuation (D&E)

","

Polypectomy

","

ENT

","

Turbinate Reduction

","

Uvulopalatopharyngoplasty

","

Adenoidectomy

","

Myringotomy

","

Microlaryngeal

","

Mastoidectomy

","

Tongue Base Reduction

","

Tonsils Removal

","

Deviated Nasal Septum

","

Eardrum Surgery

","

Sinus Surgery

","

Thyroidectomy

","

Tonsillectomy

","

Ear Surgery

","

Sinusitis

","

Tympanoplasty

","

Fess Surgery

","

Stapedectomy

","

Septoplasty

","

Tonsillitis

","

Adenoids

","

Hearing Problem

","

Thyroid Infection

","

Chronic Sinusitis

","

Recurrent Sinusitis

","

Subacute Sinusitis

","

Mastoiditis

","

Parotidectomy

","

Nose Surgery

","

Vocal Cord Polyps

","

Adenotonsillectomy

","

Otitis Media

","

Nasal Polyps

","

Turbinoplasty

","

Ear Infection

","

Ear Hole

","

Throat Infection

","

Middle Ear Perforation

","

Urology

","

Urinary Tract Infection

","

Urinary Incontinence

","

Erectile Dysfunction

","

Urethral Stricture

","

Stress Urinary Incontinence

","

Circumcision

","

Kidney Stones

","

Male Urinary Tract Infection

","

Prostate Enlargement

","

Phimosis

","

Paraphimosis

","

Foreskin Infection

","

Balanoposthitis

","

Balanitis

","

Frenuloplasty

","

Cystoscopy

","

Cystolithotripsy

","

DJ Stent

","

cystolithotomy

","

Urethral Stricture

","

pyeloplasty

","

nephrostomy

","

Corn Removal

","

Vasectomy

","

Toenail treatment

","

Testicular Torsion

","

Epididymal Cyst

","

Vascular

","

Varicose Veins

","

Varicocele

","

Diabetic Foot Ulcer

","

AV Fistula For Dialysis

","

Deep Vein Thrombosis

","

Spider Veins

","

Toe Amputations

","

Finger Amputations

","

Aesthetics

","

Gynecomastia

","

Liposuction

","

Lipoma

","

Sebaceous Cyst

","

Breast Lift

","

Rhinoplasty

","

Breast Reduction

","

Breast Augmentation

","

Breast Lump

","

Hair Loss

","

Breast Surgery

","

Axillary Breast

","

Abdominoplasty

","

Double Chin

","

Buccal Fat

","

Earlobe Repair

","

Blepharoplasty

","

Hair Fall PRP

","

Orthopedics

","

Carpal Tunnel Syndrome

","

Knee Replacement

","

Spine Surgery

","

Hip Replacement

","

Arthroscopy

","

ACL Tear

","

Rotator Cuff Repair

","

Bankart Surgery

","

Bankart Repair

","

Meniscus Repair Surgery

","

Shoulder Replacement Surgery

","

Discectomy

","

Laminectomy

","

Acdf Surgery

","

Spinal Fusion

","

Ligament Injury

","

Knee Arthroscopy

","

Shoulder Arthroscopy

","

Femur Fracture

","

Stem Cell

","

Ophthalmology

","

Lasik

","

Cataract

","

Squint Surgery

","

Glaucoma Surgery

","

Retinal Detachment Surgery

","

Diabetic Retinopathy Treatment

","

Intravitreal Injections

","

Vitrectomy

","

Monofocal Lens

","

Multifocal Lens

","

Toric Lens

","

PRK Lasik

","

Smile Lasik Surgery

","

Femto Lasik Surgery

","

ICL Surgery

","

Macular Edema

","

Retinal Surgery

","

Contoura Vision

","

Phaco Surgery

","

Pterygium

","

Dentistry

","

Teeth Alignment (Fix)

","

Dental Others

","

Crossbite Teeth

","

Overbite Teeth

","

Openbite Teeth

","

Weight Loss

","

Bariatric Surgery

","

SPATZ Intragastric Balloon

","

Intragastric Balloon

","

Weight Loss Surgery

","

Weight Loss

","

Cool Sculpting

","

Dermatology

","

Scar Removal

","

Beard Transplant

","

Face Threadlift

","

Botox

","

Derma Fillers

","

Vampire Facial with Dermaroller

","

Hair Transplant

","

Hair Reduction

","

Fat Loss

","

Allergan for Double Chin

","

Allergan for Arms

","

Allergan for Underarm Fat

","

Allergan for Tummy

","

Allergan for Inner Thigh

","

Allergan for Outer Thigh

","

Anti Aging

","

Uneven Skin Tone

","

Acne & Scar

","

Pigmentation

","

Tattoo removal

","

Hair Treatment

","

Vitiligo for Face

","

Roascea (Gold Toning laser)

","

Dark Circle & Puffy Eyes

","

Foundation full Face

","

Acne Scar

","

Fertility

","

Male Infertility

","

Female Infertility

","

Ivf

","

Iui

","

Embryo Transfer

","

ICSI Treatment

","

Neurology

","

Headache or migraine

","

Neurology-Others

","

Nephrology

","

Chronic kidney disease (CKD) follow-up

","

Pulmonology

","

Chest pain or tightness

","

Oncology

","

Oncology

","

General Physician

","

General Physician-Others

","

Diabetes

"]" data-all-dropdown-items-arr="[]">