Hello there. I can understand your concern. I hope you are not in too much pain. There is no staging of piles for getting surgical treatment. Initially it can be managed by medical line of treatment and certain lifestyle changes like having high fiber foods, losing weight if overweight, avoiding oily and spicy foods etc. Sometimes the haemorrhoids can prolapse, which is a absolute indication of surgery. To sum it up, a physical examination of the patient by a surgeon can help determine if the patient needs surgery or not. Best regards. Dr. Anil Kumar Jain.