Piles, also referred to as stacks, are protrusions of varicose veins and connective tissue around the canal extending to inside the rectum. Signs are itching, pain, bleeding, and swelling. The primary cause is genes (a lack of valves within the hemorrhoidal veins), followed by irregular bowel practices (constipation or diarrhea), and any activity that triggers increased intra-abdominal pressure (extended straining, lifting, and so on).Piles are classified as external or internal, and can be staged or graded 1 to 4. Classification of Hemorrhoids page and or view the Hemorrhoid Surgical treatment Video to see and hear the differences in the Goligher hemorrhoid category system, and to discover the fundamentals of Hemorrhoid surgery.