Piles (haemorrhoids) 

Introduction 

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Haemorrhoids, also known as piles, are swellings that contain enlarged blood vessels that are found inside or around the bottom (the rectum and anus).

Most haemorrhoids are mild and sometimes don't even cause symptoms. When there are symptoms, these usually include: 

  • bleeding after passing a stool (the blood will be bright red)
  • itchy bottom 
  • a lump hanging down outside of the anus, which may need to be pushed back in after passing a stool

Read more about the symptoms of haemorrhoids.

Should I see my GP?

The symptoms of haemorrhoids often clear up on their own or with simple treatments that can be bought from a pharmacy without a prescription (see below). However, you should speak to your GP if your symptoms don't get better, or if you experience pain or bleeding.

Haemorrhoids can be easily diagnosed by a simple internal examination of your back passage.

Some people with haemorrhoids are reluctant to see their GP. However, there’s no need to be embarrassed  all GPs are used to diagnosing and treating haemorrhoids.

Read more about diagnosing haemorrhoids.

What causes piles?

The exact cause of haemorrhoids is unclear, although they are associated with increased pressure in the blood vessels in and around your anus.

Most cases are thought to be caused by excessive straining on the toilet, due to prolonged constipation, often resulting from a lack of fibre in your diet.

Things that can increase your risk of haemorrhoids include:

  • being overweight
  • being over the age of 45
  • being pregnant (read more about piles in pregnancy)
  • having a family history of haemorrhoids

Read more about the causes of haemorrhoids.

Preventing and treating piles

Haemorrhoid symptoms often settle down after a few days without treatment. Haemorrhoids that occur due to pregnancy usually get better after you give birth.

However, making lifestyle changes to reduce the strain on the blood vessels in and around your anus is often recommended. These can include:

  • gradually increasing the amount of fibre in your diet  good sources of fibre include fruit, vegetables, wholegrain rice, wholewheat pasta and bread, seeds, nuts and oats
  • drinking plenty of fluid, particularly water, but avoiding or cutting down on caffeine and alcohol
  • not delaying going to the toilet – ignoring the urge to empty your bowels can make your stools harder and drier, which can lead to straining when you do go to the toilet
  • avoiding medication that causes constipation  such as painkillers that contain codeine
  • losing weight if you are overweight
  • exercising regularly  this can help prevent constipation, reduce your blood pressure and help you lose weight

These measures can also reduce the risk of haemorrhoids returning, or even developing in the first place.

Medication that you apply directly to your back passage (topical treatments) or tablets bought from a pharmacy or prescribed by your GP may ease your symptoms and make it easier for you to pass stools.

If your haemorrhoid symptoms are more severe, there are a number of treatment options available. For example, banding is a non-surgical procedure where a very tight elastic band is put around the base of the haemorrhoid to cut off its blood supply. The haemorrhoid should fall off after about a week.

Surgery under general anaesthetic (where you are asleep) is sometimes used to remove or shrink large or external haemorrhoids.

Read more about treating haemorrhoids and surgery for haemorrhoids.

Page last reviewed: 08/04/2014

Next review due: 08/04/2016

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Comments

The 16 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Leader said on 08 September 2014

My husband recently had surgery for haemorrhoids. Although not as painful as predicted, four weeks later he is still having a mucous discharge. Has anyone experienced this and if so how long does it last?

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JMS and B said on 05 September 2014

First the condition: at 56 years (female - no children) a 5mm pile appeared so I read up about medications and diets. Second, I applied Anusol as directed by a simply applying on top. Third, to help what seems to be part of the problem ie, a congested liver I started taking: 1 x cup of dandelion tea (to clear it) day; 15 drops daily of milk thistle (soften stools & cleanse liver); for breakfast added 15g insoluble high fiber (bran) to aid digestion and 'movement'; and generally ate more dark greens and less sugar although I always had eaten fairly healthily.
Result: within 3 months it had not only cleared up totally but what I had thought was a natural part of aging for years (very slightly bulbous around the anus) had also disappeared. Though no one might see it - its nice to know its now in top condition!
Hope this is helpful to someone.
NB if you have recurring problem you can pop the cream inside a little to tackle the problem there too.

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Elaine0303 said on 01 September 2014

I can highly recommend ligation with the THD method. After years of suffering I finally got rid of my hemorrhoids with this procedure. If diet changes, cremes, sitzbaths and so on don't help anymore those minimal invasive procedures are a great alternative as you don't have to get general aesthetics. So you can go home afterwards. Also the healing time is faster and it is apparently less painful.

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G3MA said on 01 September 2014

On Friday I attended what I thought was a consultation appointment. On very brief discussion with the doctor he explained he would do an examination and do banding if required without fully explaining banding. He banded 3 and said if I experienced some discomfort to take some paracetamol.
This was the worst pain I have ever experienced in my life, giving birth was less painful than this treatment. I am a 32 year old female, who other than a heavy bleed in July had not experienced any ongoing problems with pile, they were so far up that my gp and this doctor couldn't find them at 1st. An hour after the treatment and for 48hrs I have been in excruciating pain, crying, counting down to the next dose of painkillers and even thought he had done it wrong and I was going to die. I was unable to work the following day and only today (Monday) do I feel better. Iam going back in 8weeks for a check up where he said they would band again. . .if I have any say there is no way I am putting myself through it all again. I am grateful to the comments on here as it reassred me I wasn't dying but other than that a poor job from the NHS for explanation and realistic expectations being given.
**consider all your options 1st and if you are having this done stock up on pain relief.

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Phartosis said on 18 August 2014

I used to suffer with these terribly. In the end I was very depressed. I had tried everything. I was rubbing the well known potions onto the affected area, I was using that moist toilet paper stuff you can buy, washing the area every time I went for a poo. I changed my diet and took out as much unnecessary stress from my life as possible.

Nothing worked. I had a very puffy sore red ringer and it took the edge off the enjoyment I normally feel about life. I was in despair. Anyhow, I was sitting at a bus stop and this old boy came and sat next to me. We began chatting and after a while and I don't know how, the topic came round to bottoms and basically things going wrong with them and I happened to mention I suffered with piles.

He looked at me for a short while, cocked his head to one side and asked me seriously if I genuinely wanted to be rid of them, I said that I did, why wouldn't I? He told me to switch to raw cane sugar and cut out white (refined) sugar completely out of my diet. I thought the guy was mad but I had bled heavily that day and my anus was very itchy and sore and I was desperate to scratch it so I thought it was worth a go. I got rid of the bag of white sugar I had, gave to it to a neighbour. Then I switched to raw cane unrefined sugar and within 3 weeks my piles had fled.

I thought it simply a coincidence so I began using white sugar again and the piles came back with a vengeance. I did this several times. White sugar brought back the ass-goblins, raw cane sugar took them away. I swear by it. It may work for others. I have been pile-free for 3 years. I do however still suffer with terrible wind and loose stools, I guess there has to be a trade-off somewhere!

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MidlandsGal said on 17 August 2014

I'm sure that increased fibre and water is exactly what is needed for some people, especially if they're constipated or straining. However in my case, the doctor prescribed exactly that, even though I was neither constipated nor straining (he seemed to make an assumption that that was the cause of my problem, without actually asking me). I already drank a lot of water, and already ate a lot of fruit & vegetables. I started eating more whole grains in a bid to follow the doctor's advice, and my problem just got worse and worse. Eventually I discovered that my problems went away COMPLETELY when I cut out gluten and dairy from my diet. This may not be the case for everyone, but I thought it was worth mentioning in case it helps someone!

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Patiencehope said on 18 July 2014

I have suffered periodically with piles throughout my adult life. I am recovering from them now. I now know that I must change my diet dramatically I.e. much more fruit and veg and lots of water. I went to the Dr in agony after 3 days of being in quite a lot of pain. The pain has been unbearable at times and paracetamol, Tramadol and ibuprofen havent touched it. After 10 days I was able to look and 2 were obviously thrombosed an internal one possibly strangulated. I am in bed 24/7 in a bid for them heal. Creams don't really help at this level but when you're desperate you will try everything. I can see light at the end of the tunnel. I have asked to be referred to a specialist consultant and will take heed of his advice but I will not have any incision or stapling. If necessary I will opt for HALO. I only wish more knowledge was available for sufferers. Sometimes Drs don't fully understand the symptoms or pain levels.My advice is Check your diet, fibre fruit and veg,lots of water limited alcohol and exercise. Ask lots of questions before any treatment. Good luck

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Worcester69 said on 14 April 2014

I have 3 large lumps outside my anus about the size of 50ps no cream is Helping, There very hard and very painful..should i bother my Gp?

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foysal 2412 said on 17 March 2014

Now a days because of our food habit almost 1of every 2person suffering from piles. Basically its getting worse if your diet chart contains red meat like beef, lamb, and pork. Whatever Avril said i do agree with that but i knew my mom used this therapies but it wont help for cure just short term remedies from pain. My mom had three times operation for piles. So my suggestion is keep enough vegetable and salad will help more and will be a prevention method as well as minimum 3litres of water each day. Thanks

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Avril Elaine said on 01 August 2013

I have a simple method for treating external piles which does not require ointment or an operation, merely water. When you have a shower, direct the water jet at the pile. You will feel a sharp pain when you have found the correct place. Continue to direct the water at the sore spot until the pain subsides. This will take a few seconds. That is it. It is so simple and it has worked for me every time so far. I hope that this will help you.

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petuna said on 18 April 2013

I wondwr if piles can be caused by stress. I have been under stress for about 8 years and have suffer withthem increasingly during that time

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MissPickle said on 13 October 2012

I think I suffered from internal piles for 21/2months. For me this was a dull, achy, constant pain and feeling full at the base of the bottom which came on quite suddenly one day. Reading all the literature and testimonials on-line, I conclude that the causes and symptoms differ widely and one needs to find the cause of the irritation to the bowel which is making it too hard (constipation) or too easy (diohorrea) to pass poos. Then if you can make it stop, you will get chance of getting better (gradually). If it helps anyone; I had a bout of IBS caused be eating too much fibre i.e. watery fruit such as melon and pineapple causing me chronic diohorrea. When I realised this was causing me the problem, I stopped eating it. But it still took 11/2 months for the irritation to really go away especially if I indulged in something fibourous. But all symptoms are completely gone now. I hope this helps someone as I was so distracted and grumpy all the time when I had piles. My doctor was no help at all with the piles symptoms but did point out I had IBS which led me to help myself.

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MissPickle said on 29 August 2012

Does anyone know if piles can start as a result of a strain to the lower back?

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sweedlepipe said on 10 August 2012

Hi Moonpig,

I've heard it said that: 'A GP's job is to stand between you and treatment'. Your husband's GP sounds to be doing her job well. Fortunately, not all GP's do their job to such a high standard, so I would suggest you ask your husband to see a different one or insist on some proper treatment. He deserves it because hemorrhoids can taint your quality of life. Good luck!

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moonpig2011 said on 08 October 2011

My husband just visited his GP and complained of probable haemorrhoids which he has suffered in silence for some time. Worried that in the absence of a proper diagnosis he might be suffering from something more serious, he sought reassurance and some practical advice. He has already tried losing weight, adding fibre to his diet etc., but because he does heavy lifting in the construction industry, these measures have helped not one bit. His GP did not deem it necessary to examine him and told him that surgery was 'a waste of time as the haemorrhoids just come back'. She prescribed the sort of cream which can be bought over the counter at any pharmacy.
I therefore sought advice here and at BUPA's site. What a marked contrast!

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NHSC Super User said on 17 May 2011

Pretty generic content about piles. I suffered a few ago with them my doctor recommended surgery to remove them (I'm a male 35). At the same time I was having heart palpitations, the nurse at my ECG scan asked if I drank lots of tea, coffee or soft drinks. Yes, I was drinking up to ten cups of tea a day plus a can of coke or two. That's why your having palpitations she said too much caffeine! Within months of cutting out caffeine in my diet and having more fibre at breakfast my piles and palpitations went. I felt 99% sure the caffeine was triggering my piles. Drink decafe now, and haven't had piles in 4-5 years. My doctor never really advised me to change my diet! Maybe of help to sufferers, a painful condition.

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