Piles (haemorrhoids): symptoms, treatment and how to get relief

The NHS says there are things you can do to treat and prevent piles. NHS inform says piles often clear up by themselves after a few days, but there are many treatments that can help with itching or discomfort. Treatment is stepped: self-care first, then pharmacy treatments, then a GP, and hospital treatment only if home treatments do not help.

NHS inform says a pharmacist can recommend creams to ease pain, itching and swelling, laxatives to help constipation and soften poo, and cold packs to help discomfort. Many pharmacies have private rooms if you do not want to be overheard.

The NHS adds that a GP may prescribe stronger medicines for piles or constipation and may check that your symptoms are not caused by something else.

NHS inform says that in many cases piles do not cause symptoms and some people do not realise they have them. When symptoms happen, the NHS lists the following. Piles can be small lumps about the size of a pea and can grow into larger lumps the size of grapes. They can be pink or purple.

• Bright red blood after you poo.

• An itchy bottom (anus).

• Feeling like you still need to poo after going to the toilet.

• Mucus in your underwear or on toilet paper after wiping.

• Lumps around your anus.

• Pain around your anus.

The NHS says piles often get better on their own after a few days. NHS inform says the same. The NHS says to see a GP if your symptoms are getting worse or there is no improvement after trying treatments at home, or if you keep getting piles.

Hospital treatment does not always stop piles coming back, according to the NHS. Looking after your bowel habits, as described below, is the main way to reduce the chance of a recurrence.

NHS inform gives a list of things you can do to relieve symptoms. Fibre and fluids are the core of it, because constipation and straining are among the things that make piles more likely.

• Drink lots of fluids and eat plenty of fibre to keep poo soft.

• Gently push a haemorrhoid back inside if you can.

• Take paracetamol if piles hurt.

• Use an ice pack wrapped in a towel to ease discomfort.

• Take a warm bath to help with itching and pain.

• Keep your bottom clean and dry: pat it dry rather than rub.

• Cut down on alcohol and caffeine to avoid constipation.

• Do not ignore the urge to poo, and do not push too hard when pooing.

• Do not spend more time than you need to on the toilet.

• Do not take painkillers containing codeine, as they can cause constipation.

• Do not take ibuprofen if your piles are bleeding.

The NHS says piles are swollen blood vessels and that it is not clear what causes them. It lists things that make them more likely: constipation, pushing too hard when pooing, heavy lifting, pregnancy, getting older and being overweight.

No. The NHS describes piles as swollen blood vessels, and the factors it lists are things like constipation, straining, pregnancy, age and weight, not an infection, so there is nothing to pass on to someone else.

The NHS says anyone can get piles and they do not just happen in pregnancy, but pregnancy makes them more likely. Symptoms in pregnancy include itching, aching, soreness or swelling around the anus, pain when passing a stool and a mucus discharge afterwards, a lump hanging outside the anus, and bleeding after passing a stool, usually bright red.

The NHS pregnancy guide says that constipation can cause piles, so try to keep stools soft and regular by eating plenty of fibre-rich food such as wholemeal bread, fruit and vegetables and drinking plenty of water. It also suggests avoiding standing or sitting for long periods, taking regular exercise, using a cloth wrung out in iced water held gently against the piles, avoiding straining, cleaning with moist toilet paper instead of dry paper, and patting rather than rubbing the area.

Medicines can soothe the inflammation, treating the symptoms but not the cause. The NHS says to ask your doctor, midwife or pharmacist for a suitable treatment and not to use a cream or medicine without checking with them first.

NHS inform says a GP can diagnose piles by examining your back passage to check for swollen blood vessels. There is no need to be embarrassed, as all GPs are used to diagnosing and treating piles. It is important to tell the GP about all of your symptoms, including if you have recently lost a lot of weight, your bowel movements have changed or your stools have become dark or sticky.

Bleeding from the bottom can have other causes. The NHS says to ask for an urgent GP appointment or call NHS 111 if you have painless bleeding from the bottom, so bleeding should always be mentioned to a GP rather than assumed to be piles.

The NHS and NHS inform give three levels of advice.

On the NHS you can start with a pharmacist or a GP. The GP can examine you and, if home treatments have not helped, refer you for hospital treatment. NHS inform says the hospital can confirm whether you have piles and recommend appropriate treatment.

You can also arrange a private colorectal consultation and some of the same office-based treatments, such as banding, privately. The procedures are broadly the same. Whichever route you choose, ask what the follow-up is and whether bleeding has been properly investigated.