Hemorrhoid Grades: Understanding the Levels, Symptoms, and Natural Ayurvedic Solutions

Hemorrhoids—commonly known as piles—are a prevalent yet often unspoken health concern that affects a large portion of the adult population, especially those over 30. These swollen veins in the lower rectum or anus can be painful, itchy, and, in more severe cases, disruptive to daily life. But did you know that internal hemorrhoids are categorized into grades based on how advanced they are?

In this blog, we’ll explore:

  • What each hemorrhoid grade means
  • The symptoms and causes
  • Conventional vs Ayurvedic approaches
  • Natural remedies for every stage

Let’s dive deep into understanding hemorrhoids through both modern and Ayurvedic lenses.

🔍 What Are Hemorrhoids?

Hemorrhoids are swollen or inflamed veins in the rectum or anus. They are broadly categorized into:

  • Internal Hemorrhoids – Located inside the rectum

  • External Hemorrhoids – Found beneath the skin around the anus

Internal hemorrhoids are usually painless but may cause bleeding. External ones are often painful, especially when irritated. When internal hemorrhoids enlarge and start to protrude from the anus, their severity is measured using a grading system (Grade 1 to Grade 4).

📊 Hemorrhoid Grading System: 4 Stages of Severity

➤ Grade 1 Hemorrhoids – Mild and Internal

What happens:
Hemorrhoids are present but do not protrude outside the anus. You may not even know you have them unless they cause bleeding.

Symptoms:

  • Bright red blood during bowel movements

  • Mild discomfort or itching

Natural/Ayurvedic Relief:

  • Triphala churna at night for soft stool passage

  • Include fiber-rich foods like papaya, figs, and whole grains

  • Warm sitz baths with neem or turmeric

➤ Grade 2 Hemorrhoids – Prolapse During Strain, Retract Naturally

What happens:
These hemorrhoids bulge outside the anus while straining but return inside without needing assistance.

Symptoms:

  • Bleeding with a feeling of incomplete evacuation

  • Occasional pain or itching

  • Slight mucous discharge

Ayurvedic Relief:

  • Use of herbal formulations like Arshoghni Vati

  • Warm water intake first thing in the morning

  • Avoid constipation-triggering foods like refined flour, meat, or processed snacks

  • Gentle yoga poses like Malasana and Pavanmuktasana

➤ Grade 3 Hemorrhoids – Manual Retraction Required

What happens:
These hemorrhoids prolapse with bowel movements or even walking, and don’t go back in on their own. They must be pushed back manually.

Symptoms:

  • Persistent swelling and pain

  • Bleeding during or after defecation

  • Irritation while sitting

Ayurvedic Relief:

  • Local application of Jatyadi Tailam or Nirgundi Oil

  • Herbal decoctions made with Triphala, Haritaki, and Daruharidra

  • Buttermilk mixed with roasted cumin and black salt post-meals

  • Triphala Guggulu for internal detox

➤ Grade 4 Hemorrhoids – Permanently Prolapsed

What happens:
The most severe stage. The hemorrhoids are permanently outside and cannot be pushed back in. They can cause complications like blood clots (thrombosed hemorrhoids).

Symptoms:

  • Severe pain, swelling, and inflammation

  • Risk of infections or ulcers

  • Constant difficulty sitting or walking

Ayurvedic & Medical Relief:

  • Surgical procedures (hemorrhoidectomy) may be necessary

  • Post-operative support with Haridra (turmeric), Aloe Vera, and Yashtimadhu

  • Panchakarma therapies like Basti (enema) for detox and dosha balance

Here’s a simplified comparison of all four hemorrhoid grades along with symptoms and Ayurvedic management strategies:

Grade Description Symptoms Ayurvedic Management
Grade 1 Internal hemorrhoids that do not protrude Mild bleeding, itching, irritation Triphala churna, fiber-rich diet, neem/turmeric sitz baths
Grade 2 Prolapse during straining, retracts on its own Bleeding, mucous discharge, discomfort Arshoghni Vati, avoid spicy food, yoga (Malasana)
Grade 3 Prolapsed, needs manual retraction Persistent swelling, pain, itching Jatyadi Tailam, Abhayarishta, Triphala Guggulu
Grade 4 Permanently prolapsed, cannot be pushed back Severe pain, bleeding, risk of infection May need surgery, post-care with turmeric, Panchakarma

Let’s now explore each grade in more detail with symptoms and home remedies tailored for Ayurvedic healing:

🔎 Common Causes of Hemorrhoids

Understanding the root causes can help prevent them:

  • Straining during bowel movements
  • Chronic constipation or diarrhea
  • Pregnancy-related pressure on pelvic veins
  • Low-fiber diet
  • Prolonged sitting or sedentary lifestyle

In Ayurvedic terms, hemorrhoids are called Arsha and result from an imbalance in Vata, Pitta, or Kapha doshas, often linked to poor digestion (Agni dushti), suppressed natural urges, or poor dietary habits.

🌿 Ayurvedic View on Hemorrhoids (Arsha)

According to Ayurveda:

  • Vata Arsha: Causes dryness, pain, and hard stools
  • Pitta Arsha: Associated with burning, inflammation, and bleeding
  • Kapha Arsha: Leads to swelling, heaviness, and mucous discharge

Treatment focuses on:

  • Pacifying the aggravated dosha
  • Supporting digestion and detoxification
  • Healing the tissues with herbs and oils

✅ Ayurvedic Remedies for All Hemorrhoid Grades

Here are some natural solutions tailored to hemorrhoid grade and dosha imbalance:

🍃 Herbal Remedies

  • Triphala: Gentle laxative and colon cleanser

  • Arshoghni Vati: Targets hemorrhoidal tissue and reduces swelling

  • Kankayan Vati: Works on digestive fire and relieves constipation

  • Abhayarishta: Fermented tonic for digestion and bowel regulation

🛁 Sitz Bath with Herbs

  • Add neem leaves, triphala, or turmeric powder to warm water

  • Soak the affected area for 15–20 minutes, twice a day

🥗 Diet & Lifestyle Tips

  • Eat a fiber-rich diet: Whole grains, leafy greens, flaxseeds, raisins

  • Stay hydrated: Aim for 2–3 liters of water daily

  • Avoid spicy, oily, fermented, or heavy-to-digest foods

  • Exercise regularly—preferably yoga or brisk walking

🧘‍♂️ Effective Yoga Poses

  • Malasana (Squat pose)

  • Pavanmuktasana (Wind-relieving pose)

  • Viparita Karani (Legs-up-the-wall pose)

⚠️ When to See a Doctor

If you experience:

  • Heavy or continuous rectal bleeding

  • Unmanageable pain or discomfort

  • Signs of infection like pus or fever

  • Prolapse that cannot be pushed back

It’s time to consult a medical professional or Ayurvedic expert for deeper diagnosis and treatment planning.

🌿 Final Thoughts: Early Detection, Holistic Healing

Understanding the grade of hemorrhoids is crucial to choosing the right treatment—whether it’s self-care at home or medical intervention. At The Natural Ayurved, we promote healing that begins from within, using nature’s wisdom and time-tested Ayurvedic practices.

🌱 From Grade 1 prevention to Grade 4 support, Ayurveda offers a gentle, yet effective approach. Restore your gut health, reduce inflammation naturally, and support your body’s healing with holistic practices.

Looking for natural Ayurvedic remedies for piles and related issues?

👉 Explore our product range or consult our Ayurvedic experts at The Natural Ayurved.