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Diseases & conditions
Stomach & bowel

Haemorrhoids (piles)

Haemorrhoids, also called piles, are swollen veins in and around the anus. They are very common, especially in pregnancy, after childbirth and in people with constipation. They are usually not serious and often improve with simple measures, but some people need a small procedure.

Symptoms

  • Bright red blood on the toilet paper or in the toilet after passing stool
  • Itching or irritation around the anus
  • A soft lump near the anus
  • Pain or discomfort, especially when sitting
  • Mucus discharge

When to see a doctor

Get medical help quickly if you notice any of these:

  • Heavy bleeding, dark blood, or blood mixed into the stool
  • Bleeding from the back passage for the first time after the age of 40
  • Severe pain or a hard, very painful lump
  • Losing weight or a change in bowel habits
  • Dizziness or weakness from blood loss
  • No improvement after one week of home care

In an emergency, go to the nearest hospital or clinic straight away.

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Causes

  • Straining because of constipation
  • Sitting on the toilet for a long time
  • Pregnancy and childbirth
  • Heavy lifting
  • Long-lasting diarrhoea
  • Being overweight

Prevention

  • Eat plenty of fibre and drink enough water to keep stools soft
  • Do not strain or sit on the toilet for long
  • Go to the toilet when you feel the urge
  • Stay active and keep a healthy weight

Treatment

  • More fibre and fluids to soften the stool
  • Sitting in a basin of warm water for 10 to 15 minutes a few times a day
  • Creams or suppositories from the pharmacy for a short time
  • Paracetamol for pain; avoid codeine because it causes constipation
  • Small procedures (such as banding) or surgery for large or long-lasting piles
  • Do not start prescription medicines without a doctor

Common questions

Is bleeding from the back passage always piles?

No. Piles are the most common cause, but bleeding can also come from other conditions, including bowel cancer. Bleeding should be checked by a doctor, especially if you are over 40.

Will piles from pregnancy go away?

Piles in pregnancy often improve on their own after the baby is born. Avoiding constipation helps. Ask your doctor or midwife before using any cream.

General information onlyThis guide does not replace an examination by a doctor. Do not start or stop a medicine without a doctor's advice.