Piles (haemorrhoids) usually settle down in a few days without any treatment. However, there are a number of treatments that will reduce the itching and discomfort that haemorrhoids can cause. Lifestyle changes are usually the first step of treatment.
Dietary changes
If your haemorrhoids are a result of constipation (being unable to empty your bowels), try to keep your stools soft and regular. By making changes to your diet, you can avoid straining while on the toilet:
- Increase the amount of fibre in your diet. Aim to eat 25-30g of insoluble fibre every day (insoluble fibre is fibre that the body cannot digest, so it passes through the bowels and helps other food and waste move through more easily), such as wholegrain bread and cereal, and raw fruits and vegetables.
- Drink lots of water. Aim to drink six to eight glasses of fluid every day and avoid too much caffeine (which is found in tea, coffee and coca-cola).
See the Health A-Z topic on Constipation - treatment for more information on how to treat constipation, as this is what often causes haemorrhoids.
Self care
Follow the advice below when passing stools:
- Avoid straining to pass a stool as this may make your haemorrhoids worse.
- After passing a stool, clean your anus (the opening where solid waste leaves the body) with moist toilet paper instead of dry toilet paper.
- Using baby wipes can ease any discomfort that occurs after passing a stool.
- Pat, rather than rubbing, the area.
Creams, ointments and suppositories
Over-the-counter (OTC) creams and medicines can be used to soothe any inflammation (swelling and redness) around your anus. These will only treat the symptoms of haemorrhoids, and will not cure the haemorrhoids themselves.
These products should only be used for five to seven days at a time. If they are used for longer than this, they may irritate the sensitive skin around your anus. Combine taking any medication with the diet and self-care advice above.
There is no evidence to show that one preparation is more effective than another. Ask your pharmacist about which product may suit you best, and always read the patient information leaflet that comes with your medicine before using it.
Do not use more than one product at the same time, as they may contain similar ingredients. Your pharmacist should be able to advise you about which products you can safely use.
Corticosteroids
Creams containing corticosteroids (medication that contains powerful hormones called steroids) can also be prescribed to reduce the inflammation around your anus. These should not be used for longer than a week as they can make the skin around your anus thinner.
See the Health A-Z topic on Corticosteroid preparations (topical) for more information.
Painkilling medication
Painkillers, such as paracetamol, can be taken to relieve the pain caused by haemorrhoids. Some are available OTC, or they may be prescribed by your GP.
Products containing local anaesthetic (a painkilling medication) may also be prescribed to treat the pain that haemorrhoids cause. They should only be used for a few days, as they can make the skin around the anus more sensitive.
Laxatives
If you are constipated, your GP may prescribe a laxative (a type of medicine that can help you to empty your bowels). This could either be:
- a bulk-forming laxative, which contains fibre to make your stools heavier and softer
- an osmotic laxative, which increases the amount of water in your bowels to make your stools softer
See the Health A-Z topic about Laxatives for more information.
Banding
Banding involves your GP putting a very tight elastic band around the base of the haemorrhoid inside your anus. This cuts off the blood supply. Within seven days of having the treatment, the haemorrhoids should fall off.
This is a common treatment for grade two or three internal haemorrhoids. See Haemorrhoids - symptoms for an explanation of the different types and grades of haemorrhoids.
Banding is usually done as a day procedure and you can return to work the following day. However, you may feel some pain or discomfort for a day or so. Normal painkillers are usually effective, but your GP can prescribe something stronger if necessary.
You may not notice that the haemorrhoids have fallen off as they should pass out of your body with a bowel movement. Some people notice some mucus discharge within a week of the procedure, which usually means the haemorrhoid has fallen off.
Directly after the procedure, it is normal to see some blood on the toilet paper, but you should not bleed a lot. If you start to pass a lot of bright red blood or pass clots (solid lumps of blood), go to your nearest accident and emergency (A&E) department immediately.
Infections or ulcers (open sores) can also occur where the banding took place. However, these complications are rare and can be easily treated.
Injections (sclerotherapy)
Sclerotherapy is a common treatment for grade two or three internal haemorrhoids. It is often used as an alternative to banding.
A chemical solution can be injected around the blood vessels in your anus. This relieves pain by numbing the sensory nerve endings at the site of the injection. It also hardens the tissue of the haemorrhoid so that a scar is formed. After about four to six weeks, the haemorrhoid should decrease in size or shrivel up.
After the injection, avoid strenuous exercise for the rest of the day. You can resume your normal activities, including work, the day after. You may experience some minor pain for a while and may bleed a little.
Infrared coagulation
Infrared coagulation (also know as infrared light) can also be used to treat your haemorrhoids. A special device is used to burn the tissue of the haemorrhoid. One or two bursts of infrared light can cut off the circulation to small internal haemorrhoids, such as grade one or two haemorrhoids.
Surgery
Surgery is often used to treat internal haemorrhoids that are either very large or are grade three or four. See Haemorrhoids - surgery for more information on surgical procedures to treat haemorrhoids.
