|Piles, also referred to as piles, are protrusions of varicose veins and connective tissue around the canal extending to inside the rectum. Symptoms are itching, discomfort, bleeding, and swelling. The primary cause is genetics (an absence of valves within the hemorrhoidal veins), followed by irregular bowel routines (constipation or diarrhea), and any activity that causes increased intra-abdominal pressure (prolonged straining, lifting, etc.).Piles are classified as external or internal, and can be staged or graded 1 to 4. Classification of Piles page and or view the Hemorrhoid Surgical treatment Video to see and hear the differences in the Goligher pile category system, and to learn the fundamentals of Pile surgery.