Symptoms, Differences & Ayurvedic Treatment Without Surgery
Many patients know they have piles, but they are unsure whether their piles are internal or external. This confusion often leads to improper treatment — using creams when tablets are needed, or delaying treatment until symptoms worsen.
In my 15+ years of Ayurvedic clinical experience, I have seen that understanding the type of piles is the first step toward correct and effective home treatment. This blog explains external vs internal piles, their symptoms, differences, and how each can be managed safely with Ayurvedic piles treatment at home without surgery.
What Are Internal Piles?
Location
Internal piles develop inside the rectum, above the anal opening. They are usually not visible from outside.
Common Symptoms of Internal Piles
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Bright red bleeding during or after stool
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Blood dripping into the toilet or on tissue
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Usually painless in early stages
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Mild discomfort or heaviness
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Mucus discharge (sometimes)
Pain is often absent initially because internal piles lie above pain-sensitive nerves.
What Are External Piles?
Location
External piles form outside the anal opening, under the skin around the anus.
Common Symptoms of External Piles
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Pain while sitting or walking
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Swelling or lump near anus
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Itching and irritation
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Burning sensation
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Pain increases after bowel movement
External piles are more painful because they are located in a nerve-rich area.
Key Differences: Internal vs External Piles
| Feature | Internal Piles | External Piles |
|---|---|---|
| Location | Inside rectum | Outside anus |
| Pain | Usually painless (early) | Painful |
| Bleeding | Common | Rare |
| Visible lump | No (early) | Yes |
| Itching | Less common | Common |
| Best relief focus | Bleeding control | Pain & swelling relief |
Understanding this difference helps in choosing the best home treatment without surgery.
Ayurvedic Understanding of Piles Types
According to Ayurveda:
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Internal piles are mainly linked to Pitta imbalance (bleeding, inflammation)
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External piles are mainly linked to Vata imbalance (pain, dryness, swelling)
However, constipation (Vata prakopa) is the root cause in both types.
Can Both Types Be Treated at Home?
Internal Piles
Grade 1 and Grade 2 internal piles respond very well to home treatment.
External Piles
Most external piles can be managed at home unless:
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Thrombosis occurs
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Severe infection develops
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Pain becomes unbearable
Early treatment gives the best results.
Home Treatment for Internal Piles (Ayurvedic Approach)
1. Control Bleeding (Primary Goal)
Best Ayurvedic support includes herbs that:
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Strengthen blood vessels
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Reduce inflammation
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Heal damaged tissue
Commonly used herbs:
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Nagkesar
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Lodhra
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Yashtimadhu
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Guggulu
Ayurvedic piles relief tablets work internally to stop bleeding naturally.
2. Constipation Management (Non-Negotiable)
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Warm water early morning
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Triphala or Isabgol at night (as advised)
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Fiber-rich diet
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Adequate hydration
Without correcting constipation, bleeding piles cannot heal permanently.
3. Diet for Internal Piles
Recommended
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Papaya, pear, figs
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Green vegetables
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Buttermilk
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Soft, warm meals
Avoid
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Spicy food
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Fried items
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Alcohol
Diet discipline is crucial for natural piles cure.
Home Treatment for External Piles (Ayurvedic Approach)
1. Pain & Swelling Relief (Primary Goal)
External piles need strong local care.
Ayurvedic Oils
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Reduce pain and burning
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Shrink swelling
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Heal cracks
Apply gently after cleaning and sitz bath.
2. Sitz Bath (Highly Effective)
Warm sitz bath:
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Relaxes anal muscles
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Improves circulation
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Reduces pain
10–15 minutes once or twice daily brings significant relief.
3. Sprays for Instant Relief
Ayurvedic sprays provide:
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Immediate cooling
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Fast pain relief
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Comfort after bowel movement
They support oils but do not replace internal treatment.
Combined Treatment for Mixed Piles
Many patients have both internal and external piles.
In such cases:
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Internal medicines control bleeding and constipation
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External oils and sprays relieve pain
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Diet and lifestyle prevent recurrence
This combined approach offers complete hemorrhoids relief at home.
How Long Do Internal and External Piles Take to Heal?
Internal Piles
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Bleeding reduces: 1–2 weeks
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Complete healing: 4–6 weeks
External Piles
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Pain relief: 5–7 days
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Swelling reduction: 2–3 weeks
Consistency determines success.
When Home Treatment Is Not Enough
Consult a doctor if:
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Bleeding is heavy or continuous
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Severe pain or fever develops
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Lump becomes hard and bluish (thrombosis)
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No improvement after 3–4 weeks
Early intervention prevents complications.
Common Mistakes Patients Make
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Using only creams for internal piles
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Ignoring constipation
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Stopping treatment early
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Continuing spicy food
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Sitting for long hours
Avoiding these mistakes speeds recovery.
Prevention Tips for Both Types of Piles
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Maintain regular bowel habits
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Drink enough water
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Eat fiber-rich diet
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Avoid prolonged sitting
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Walk daily
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Respond immediately to constipation
Prevention is easier than treatment.
Conclusion
Internal and external piles may look similar, but their symptoms, causes, and treatment focus are different. Understanding this difference helps you choose the right home treatment and avoid unnecessary suffering or surgery.
With the correct Ayurvedic approach — including internal medicines, external care, diet discipline, and lifestyle correction — both internal and external piles can be managed effectively at home without surgery, especially in early and moderate stages.
If you are unsure about your piles type, seek guidance early. Right treatment at the right time makes all the difference