Although piles develop from inside the anal canal, they can hang down out of their normal place.
- Piles can be described as follows.First degree piles are swellings on the inside lining of the anal canal (dental line). They bleed but can’t be seen from outside the anus.
- Second degree piles are larger and can stick out (or prolapse) from the anus when someone open his/her bowels, but return on their own afterwards.
- Third degree piles are similar, but hang out from the anus and only return inside when pushed back in.
- Fourth degree piles permanently hang down from the anus and can’t push them back inside. They may become extremely swollen and painful if the blood in them clots.