Piles (haemorrhoids)
Updated: 03.08.2023
Approved by: General Practitioner, Alice Pan
Piles, also known as haemorrhoids, are lumps that develop inside and around the anus. In most cases, piles improve on their own within a few days. However, there are steps you can take to treat and prevent them.
Identifying piles
Symptoms of piles include:
- bright red blood after a bowel movement
- itchy anus
- the feeling of incomplete bowel evacuation
- presence of mucus on underwear or toilet paper after wiping
- lumps around the anus
- pain or discomfort around the anus
Causes
The exact cause of the piles is not clear. However, factors that increase the likelihood of developing piles include:
- constipation
- straining during bowel movements
- heavy lifting
- pregnancy
By understanding the symptoms, taking preventive measures, and seeking appropriate medical advice, individuals can effectively manage piles and minimize their impact on daily life.
Treating and preventing piles
Effective measures to manage and prevent piles include:
- adequate fluid intake and a high-fibre diet to maintain soft stools
- use damp toilet paper for gentle wiping
- taking paracetamol to alleviate pain
- soaking in a warm bath to ease itching and discomfort
- applying an ice pack wrapped in a towel for relief
- gently pushing a prolapsed pile back inside the anus
- maintaining cleanliness and dryness of the anal area
- regular exercise to promote healthy bowel movements
- limiting alcohol and caffeine consumption to prevent constipation
Important Don'ts
To avoid worsening the condition or causing additional discomfort, it is advised to:
- Avoid wiping the anus too vigorously after a bowel movement
- Respond promptly to the urge to have a bowel movement
- Avoid straining during bowel movements
- Refrain from taking painkillers containing codeine, as they may cause constipation
- Avoid taking ibuprofen if piles are bleeding
- Minimize excessive time spent on the toilet
Pharmacist Assistance
Pharmacists can provide over-the-counter recommendations to address piles, including creams to alleviate pain, itching, and swelling. They may also suggest treatments for constipation and the softening of stools, as well as cold packs for relief.
When to seek medical advice
If symptoms persist or worsen after 7 days of home treatment, or if you experience recurrent piles, it is advisable to consult a GP. Additionally, if you notice any abnormal changes around the anus or have concerns about your symptoms, seek medical advice. Urgent GP appointments or assistance from NHS 111 are recommended in cases where the individual has a high temperature, pus leakage from piles, or severe pain.
Hospital treatment for piles
If home treatments do not yield improvement, hospital treatment may be necessary. Common non-surgical options include:
- Rubber band ligation: Placing a band around the base of the piles to cause them to fall off
- Sclerotherapy: Injecting a solution into the piles to shrink them
- Electrotherapy: Applying a gentle electric current to shrink the piles
- Infrared coagulation: Using infrared light to cut off the blood supply to the piles and make them shrink
These treatments are typically performed under local anaesthesia, and patients can usually return home on the same day. In cases where non-surgical treatments are ineffective, surgical options such as haemorrhoidectomy (removal of piles), stapled haemorrhoidopexy (stapling piles back inside the anus), or haemorrhoidal artery ligation (cutting off blood supply to shrink piles) may be considered. These surgeries may require general anaesthesia, and hospital stays of more than one day may be necessary.
Immediate action required
Seek immediate medical attention by visiting A&E or calling 999 if you experience non-stop bleeding, excessive bleeding (e.g., toilet water turns red or the presence of large blood clots), or severe pain.
