Piles

What are piles?

Piles (also called haemorrhoids) are lumps inside the rectum and around your anus (the opening of your bottom) caused by swollen blood vessels.

They are very common and are often not serious, clearing up on their own within a few days or with home treatment and lifestyle changes. In some cases, hospital treatment may be needed.

What causes piles?

When the veins in your anus become stretched under pressure, it can cause them to swell or bulge, creating small, round lumps that you may be able to feel around your anus.

This pressure on the veins can be caused by:

• Severe diarrhoea or constipation

• Straining during bowel movements

• Pregnancy

• Heavy lifting

• Not enough fibre in your diet

• Anal intercourse

• Older age

• Persistent coughing

Piles symptoms

Piles can develop inside the rectum (known as internal haemorrhoids) or under the skin around the anus (called external haemorrhoids).

You may not experience any symptoms when you have piles, but some of the more common symptoms include:

• Pain, discomfort or itching around the anus

• Bumps in or around the anus

• Swelling around the anus

• Bleeding when you poo

• Mucus after wiping your bottom

• Feeling like your bowels haven’t fully emptied after pooing

Piles diagnosis

It’s not always necessary to get piles diagnosed, but if you have bleeding when you poo or your symptoms don’t go away after a few days, you should see a doctor.

Your doctor will examine your anus and rectum wearing gloves, ask you about your symptoms, and they may take a blood test. If they want to rule out other conditions, they may refer you for more tests.

Piles treatment

Often, it’s possible to treat the symptoms of piles with a few changes to your diet and lifestyle, for example:

• Drinking plenty of water

• Increasing your fibre intake to make your poo softer

• Avoiding straining when you go to the toilet

• Staying active

• Keeping your bottom clean and avoid wiping it too hard when you go to the toilet

Piles medication

Speak to your pharmacist about over-the-counter medication, like painkillers, creams to ease itching and swelling, constipation medication and cold packs.

Hospital treatment

If home treatments don’t improve your symptoms, hospital treatment may be recommended. This might include:

• Banding – Elastic bands are tied around the piles to cut off the blood supply and cause them to fall off.

• Sclerotherapy – Injecting a liquid into the piles to make them shrivel up.

• Infrared coagulation – Shrinking the piles with an infrared light that cuts off the blood supply

• Electrotherapy – Shrinking the piles with an electric current

In rare cases, surgery may be needed to treat the piles. Procedures include:

• Haemorrhoidectomy – Surgically removing the piles
  -Stapled haemorrhoidopexy – Stapling the piles into place inside the anus

• Haemorrhoidal artery ligation operation (HALO) – Stitching up the arteries in your anal canal to cut the blood supply to your piles

Piles prevention

It’s a good idea to follow a healthy diet and lifestyle to help keep your poo soft and easy to pass. You can do this by:

• Eating a fibre-rich diet – Choose wholemeal bread, wholewheat pasta and rice, keep potato skins on and include plenty of pulses and vegetables in your meals

• Drink plenty of fluids – Make water your priority and limit caffeine to three cups a day

• Exercise regularly

Piles complications

Piles aren’t usually serious, but in rare cases, they can cause complications like:

• Anaemia – In rare cases, severe blood loss from piles may cause anaemia

• Strangulated haemorrhoid – This is when the blood supply to an internal haemorrhoid is cut off, causing extreme pain

• Blood clot – Clots can sometimes form in the haemorrhoid – it’s not dangerous, but it can be painful