What to do if you have piles
12 October 2022
Piles, or haemorrhoids, are a common health problem - especially among older people.
But these round, discoloured lumps that appear in and around your rectum and your anus are not something most of us want to discuss with our friends.
The good news is that, although they can be a source of stress and embarrassment, there are lots of ways to ease the symptoms.
These include making dietary changes, using treatments you can get over the counter at the pharmacy, and - in severe cases - undergoing a surgical procedure.
Here's everything you need to know.
Did you know?
A 'pile' is actually a swollen blood vessel in the back passage.
What are the symptoms of piles?
Not everyone with piles suffers from discomfort as a result. However, common symptoms include:
- Pain or swelling around your anus.
- Bleeding or mucus discharge after doing a poo.
- A lump in or around your anus.
- Discomfort when you go for a poo.
Given the nature of piles, many people also feel embarrassed or uncomfortable about having them, which can affect how they feel about going to the loo when away from home. Some people also find their sex drive is affected as a result.
Did you know?
Up to 50% of adults experience piles at some stage during their lives.1
How can I treat piles at home?
Most piles get better on their own after a few days of taking action to help them clear up, but if they recur or cause rectal bleeding you should contact your GP for further advice. Steps you can take at home to alleviate the symptoms include:
- Drink plenty of water.
- Add more fibre (fruit, vegetables, wholegrains) to your diet.
- Keep moving/exercising.
- Cut down on alcohol and caffeine.
- Wipe your bottom gently, using damp toilet paper.
- Have a warm bath or use an ice pack (wrapped in a clean cloth) to ease your symptoms.
- Take paracetamol if you are in pain.
- If you can feel a pile outside your anus, try to gently push it back in - you could use lubrication gel from the pharmacy to help.
- Practice good hygiene, keeping your bottom clean and dry and washing your hands well after home treatments.
Medical treatments designed to ease the discomfort caused by piles, such as creams, ointments, and suppositories, can also be found at your local pharmacy.
What causes piles?
It is not always clear what causes piles, but they are often linked to constipation, pregnancy, and heavy lifting. In some cases, they even appear alongside a bad cough or after a vomiting illness.
For that reason, doctors recommend that you should drink plenty of water and add extra fibre to your diet, which helps to keep your poo soft and avoids the need to strain when you are on the loo.
If you have piles, you should also avoid painkillers that can cause constipation, such as codeine, and try not to push too hard or sit for too long when on the loo.
Be gentle when wiping. And finally, go for a poo as soon as you can once you feel the urge.
Piles in pregnancy
In pregnancy, the change in your hormones can make your blood vessels relax, potentially causing piles to form.
If this happens, they will usually go away once you have given birth and can be generally treated in the same way as any other piles - although it's always sensible to check with your doctor or midwife before taking any new medication while pregnant.
Other things to try include avoiding standing for long periods of time and doing more walking or gentle exercising to improve circulation.
Did you know?
In medical terms, there are four 'degrees' of piles: 1st degree piles cannot be felt outside the anus and are the most common type; 2nd degree piles come out or 'prolapse' when you go for a poo, but go back in again on their own; 3rd degree piles need to be gently pushed back inside your anus after going to the loo; 4th degree piles cannot be pushed back in.
Do I need to see a doctor?
Piles can usually be treated at home and disappear within a week. But if you keep getting piles, or they don't go away despite treating them at home, it's a good idea to make an appointment with a GP.
As rectal bleeding can be a symptom of other, more serious medical conditions such as inflammatory bowel disease or even bowel cancer, it's also worth getting yourself checked out if you see blood when you go to the loo.
Your doctor will probably want to examine you during your appointment and will generally prescribe a treatment based on the type of symptoms you have, as well as the cause.
Steroid creams, for example, are effective at easing symptoms but should not be used on a long-term basis.
What if they get worse?
Fourth degree piles or internal piles that prolapse (hang down) can be very painful.
If you are in a lot of pain, you should therefore contact your doctor to discuss a different approach.
Taking paracetamol, using an ice pack, and having a warm bath are all ways to reduce the pain in the meantime.
Might I need surgery for piles?
Treatment options for severe cases of piles include:
- Using a tight plastic band to make the piles drop of.
- Shrinking your piles by injecting them with a liquid: "sclerotherapy".
- Applying a gentle electric current: "electrotherapy".
- Using an infrared light to cut off the blood supply.
These treatments can be carried out with local anaesthetic and shouldn't involve a hospital stay. If they don't work, however, you may require a general anaesthetic and one of the following procedures:
- A "haemorrhoidectomy" in which your piles are cut out.
- A "haemorrhoidopexy" that fixes your piles back inside.
- A stitching procedure to cut off the blood supply and shrink the piles.