Piles (haemorrhoids)

Piles, also called haemorrhoids, are lumps that form inside and around your bottom (anus).

Many people with piles (haemorrhoids) have no symptoms at all, and some don't even realise they have them.

When symptoms do appear, they can include:

• bleeding after you poo (the blood is usually bright red)
• an itchy bottom
• a feeling that you still need to poo after you've been to the toilet
• mucus in your underwear or on toilet paper after you wipe your bottom
• lumps around your anus
• pain around your anus

You have piles (haemorrhoids) and:

• you're bleeding continuously
• there's a lot of blood or you see large blood clots
• you're in severe pain

Contact your doctor urgently if you have piles and any of these apply:

• you have a very high or low temperature, for example you feel either hot or cold to touch, or you're shivering
• you're bleeding from your anus
• pus is leaking from your piles

If you can't reach your doctor, call a doctor or the 16263 health line.

• you have symptoms of piles (haemorrhoids) and they're getting worse
• your symptoms are not getting better
• you keep getting piles
• you notice a change in how your anus looks

A doctor can diagnose piles (haemorrhoids) by examining your back passage to check for swollen blood vessels.

Some people with piles are reluctant to see a doctor. There's no need to be embarrassed, though. Doctors are used to diagnosing and treating piles.

Tell your doctor about all of your symptoms. Say so if:

• you've recently lost a lot of weight
• your bowel movements have changed
• your stools have become dark or sticky

Piles (haemorrhoids) often clear up by themselves after a few days. Even so, there are plenty of treatments that can ease the itching or discomfort while you wait.

Talk to a pharmacist about treatments for piles (haemorrhoids). They can suggest things like:

• creams to ease pain, itching and swelling
• laxatives to help with constipation and soften your poo
• cold packs to help with discomfort

Many pharmacies have a private room, so you don't have to worry about being overheard.

• If you can, gently push a haemorrhoid back inside
• If your piles hurt, take paracetamol
• Wrap an ice pack in a towel and use it to help ease the discomfort
• Drink lots of fluids and eat plenty of fibre, so your poo stays soft
• Take a warm bath to help with itching and pain
• Keep your bottom clean and dry, and pat it dry rather than rubbing
• Cut down on alcohol and caffeine to avoid constipation

• don't ignore the urge to poo
• don't push too hard when pooing
• don't take painkillers that contain codeine, as they can cause constipation
• don't take ibuprofen if your piles are bleeding
• don't spend more time than you need to on the toilet

If your piles don't get better with home treatment, your doctor may send you to hospital for treatment. The doctor can first confirm that it really is piles and then recommend the right treatment for you.

Common hospital treatments for piles include:

• rubber band ligation: a band is placed around the piles to cut off their blood supply, so they fall off
• sclerotherapy: a liquid is injected into the piles to make them shrink
• electrotherapy: a gentle electric current is applied to the piles to make them shrink
• infrared coagulation: an infrared light cuts off the blood supply to the piles, and this makes them shrink

You'll be awake during these treatments, though the area may be numbed. You should be able to go home on the same day.

If these treatments don't work, you may need surgery to remove the piles.

Surgery for piles (haemorrhoids) can be done in a few ways:

• haemorrhoidectomy, where the piles are cut out
• stapled haemorrhoidopexy, where the piles are stapled back inside your anus
• haemorrhoidal artery ligation, where stitches are used to cut off the blood supply to the piles so they shrink

You'll be asleep during these treatments. You may be able to go home on the same day as the procedure.

It's not clear what causes piles (haemorrhoids). But some things may raise your risk of getting them, including:

• constipation
• pushing too hard when pooing
• heavy lifting
• pregnancy
• getting older
• being overweight or obese