Haemorrhoids (piles)

Symptoms of haemorrhoids 

In many cases, haemorrhoids don't cause symptoms.

Some people don't even realise they have them.

However, when symptoms do occur, they may include:

• bleeding after passing a stool (poo) -  the blood is usually bright red
• itchy bottom
• a lump hanging down outside the anus, which may need to be pushed back in after passing a stool
• a mucus discharge after passing a stool
• soreness, redness and swelling around your anus (bottom)

Haemorrhoids aren't usually painful, unless their blood supply slows down or is interrupted.

When to seek medical advice 

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

You should see your GP if you have persistent or severe symptoms of haemorrhoids.

You should always get any rectal bleeding checked out, just in case there is something more serious causing the bleeding.

The symptoms of haemorrhoids often clear up on their own or with simple treatments. These can be bought from a pharmacy without a prescription.

However, speak to your GP if your symptoms don't get better or if you experience pain or bleeding.

Your GP can often diagnose haemorrhoids using a simple internal examination of your back passage. Although, they may need to refer you to a hospital doctor for further examination and treatment.

Treating haemorrhoids 

Haemorrhoids (piles) often clear up by themselves after a few days. However, there are many treatments that can reduce itching and discomfort.

You can ask your pharmacist for advice about which product is most suitable for you.

Making simple dietary changes and not straining on the toilet are often recommended first.

If your symptoms do not get any better, you should see your GP.

Causes of haemorrhoids

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

This pressure can cause the blood vessels in your back passage to become swollen and inflamed.

Many cases are thought to be caused by too much straining on the toilet, due to long periods of constipation. This is often due to a lack of fibre in a person's diet.

Chronic (long-term) diarrhoea can also make you more vulnerable to getting haemorrhoids.

Other factors that might increase your risk of developing haemorrhoids include:

• being overweight or obese
• age – as you get older, your body's supporting tissues get weaker, increasing your risk of haemorrhoids
• being pregnant – which can place increased pressure on your pelvic blood vessels, causing them to enlarge
• having a family history of haemorrhoids
• regularly lifting heavy objects
• a persistent cough or repeated vomiting
• sitting down for long periods of time

Preventing haemorrhoids 

Making lifestyle changes to reduce the strain on the blood vessels in and around your anus is often recommended to help prevent haemorrhoids.

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, pulses and beans, 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 need to poo (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're overweight)
• exercising regularly – 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.

• Haemorrhoids

More useful links

• How to use your health services