Haemorrhoids (piles) are enlarged blood vessels that you can get inside or around your anus (the opening of your bottom). It’s completely normal to have blood vessels in your anus, as they play an important role in continence. But piles can develop if these blood vessels become enlarged, which can cause symptoms.
Your anus is lined with spongy tissue supplied with blood vessels – the anal cushions – and they help your anus to close. These are perfectly normal but sometimes they can develop into piles. Piles usually look like small, round, discoloured lumps. You might be able to feel them on your anus or hanging down from your anal canal. Your anal canal is the short, muscular tube with blood vessels that connects your rectum (back passage) with your anus.
Internal piles start inside your anal canal, but they might hang down and come out your anus. They’re graded according to whether they come out, and if so, how far they come out.
External piles are swellings that develop further down your anal canal, closer to your anus. They can be really painful, especially if they have a blood clot in them.
It’s possible to have both internal and external piles at the same time.
Piles develop when the veins in your anal canal become swollen, which may happen for a number of reasons, such as:
Piles are also common during pregnancy. They may develop due to the higher pressure in your tummy (abdomen) when you’re pregnant. They usually get better after you give birth.
Some people believe there’s a link between stress and piles but there’s no evidence to support this. But having piles can be potentially stressful.
Another theory is that you’re more likely to get piles around the time of your period. But there’s currently no evidence to support this.
Piles don’t always cause pain or other symptoms, but if you do have symptoms, they might include:
These symptoms can vary a lot between individuals. They may also be caused by problems other than piles, such as inflammatory bowel disease, anal cancer, bowel cancer and an anal fissure (tear). So, if you have any of these symptoms, contact your doctor for advice – don’t just assume they’re caused by piles.
Your doctor will ask about your symptoms and examine you. They may gently put their finger into your anus to feel your rectum – they’ll wear gloves and use some gel to make it more comfortable. If necessary, your doctor may refer you to a specialist doctor to look inside your rectum, using a short, rigid tube-like instrument called a proctoscope.
You might need to have a blood test to check if you have anaemia if you have a lot of bleeding. Anaemia is when you have a low number of red blood cells in your blood or haemoglobin (the oxygen-carrying component of your blood).
If your symptoms, examinations or test results suggest your symptoms might be caused by something else, your doctor may refer you to hospital for more tests. These can rule out other conditions, such as bowel cancer.
If you make a few changes to your diet and lifestyle it can help with the symptoms of piles.
You won’t need to cut things out of your diet unless your doctor advises you to.
If you have piles, it can be uncomfortable, and it’s understandable if they make you feel a bit self-conscious. They might have an effect on other areas of your life, such as your sex life if your piles hang out or you have some discharge. But try not to worry – piles usually last less than a month and then shrink back, although they might come back.
In the meantime, there are plenty of treatments that can relieve your symptoms. If you have mild bleeding from piles every now and then, change your diet and lifestyle to prevent constipation – this may be all you need for things to get better. See our Self-help section above for more information.
Medicines for treating piles
There’s a range of medicines that can help to relieve the symptoms of piles. Always read the patient information leaflet that comes with your medicine and ask your pharmacist for advice if you have any questions.
It can sometimes take up to a month for self-help measures and medicines to work. If your symptoms don’t improve after this time, contact your doctor. They may refer you to a specialist.
Non-surgical treatments for piles
Piles will usually go away on their own but, if they don’t, you might need to have a procedure to deal with the problem. There are some treatments that you’ll need to go into hospital for as an out-patient. This means you can have the treatment and go home the same day.
Your doctor will let you know the benefits and risks of each procedure and which is the best option for you.
Surgery for piles
Most people don’t need an operation to treat piles. But if you still have symptoms of piles and other treatments haven’t worked, or your piles keep bleeding, it might be an appropriate option for you. There are different types of surgery for piles, which include the following.
Haemorrhoidal artery ligation operation (known as HALO). During this procedure, arteries in your anal canal are closed to limit the blood supply to your piles. Sometimes an ultrasound probe will be used to help find your arteries and guide your surgeon during the procedure.
Piles rarely cause any serious problems but sometimes they can lead to the following.
If you eat a healthy diet and lead a healthy lifestyle, it can help to keep your poo soft and prevent constipation, which will help to prevent piles.
Piles usually look like small, round, discoloured lumps. You might be able to feel them on your anus or hanging down from your anal canal.
Piles develop when the veins in your anal canal become swollen, which may happen for a number of reasons, including straining when you go to the toilet, getting older, a persistent cough and lifting heavy objects. They are also common during pregnancy. See ‘Causes of piles’ for more information.
No, skin tags aren't the same as piles. But you may get them if you have external piles (swellings that develop on the outside edge of your anus). Blood clots can sometimes form in external piles and this will stretch your skin over the area. As the pile heals, it will gradually shrink and leave behind a small tag of extra skin. You can also get skin tags without having piles or a blood clot.
Some complementary therapies are promoted as a way to reduce the inflammation and pain you might experience with piles. But there haven’t been enough studies or studies of good quality to provide proof that they work. It’s important to consider that not all complementary therapies are safe to use, so ask your doctor for advice before using them.
Itching is a common symptom of piles, and it can be caused by mucus, skin tags or unclean skin. If you have internal piles, mucus from your rectum can leak out, which can make the surrounding area itchy. You may also find that poo occasionally leaks out too, which can make it worse.
If you have external piles, skin tags can develop, which can be itchy because they trap moisture near your skin. They can also make it difficult to clean yourself properly after you go to the toilet, causing further itching and discomfort.
The information and/or article is solely the contribution of Bupa, (hereinafter referred to as “Bupa UK”) a United Kingdom (UK) based healthcare services expert and is based on their experiences and medical practices prevalent in UK. All the efforts to ensure accuracy and relevance of the content is undertaken by Bupa UK. The content of the article should not be construed as a statement of law or used for any legal purpsoe or otherwise. Niva Bupa Health Insurance Company Limited (formerly known as Max Bupa Health Insurance Company Limited) (hereinafter referred to as “the Company”) hereby expressly disown and repudiated any claims (including but not limited to any third party claims or liability, of any nature, whatsoever) in relation to the accuracy, completeness, usefulness and real-time of any information and contents available in this article, and against any intended purposes (of any kind whatsoever) by use thereof, by the user/s (whether used by user/s directly or indirectly). Users are advised to obtain appropriate professional advice and/or medical opinion, before acting on the information provided, from time to time, in the article(s).
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