The term pile refers to a collection of swollen and inflamed tissue in the anal area. They may be internal or external and can come in a range of sizes. Discomfort is a common symptom, especially during bowel movements or when sitting. Other symptoms include itching and bleeding. An internal pile is usually found between 2 and 4 centimeters (cm) above the opening of the anus, and it is the most commonly found type. An external pile is located outside the anus.