Haemorrhoides (piles)


What are haemorrhoids?

Haemorrhoids, also known as 'piles', are often described as the 'varicose veins of the anal passage'. They're lumps in the anus that contain swollen and enlarged blood vessels. This is a relatively common condition that's generally associated with constipation.

The difference between internal & external haemorrhoids

Haemorrhoids may occur internally or externally.

External haemorrhoids develop under the skin around the anus. They may cause discomfort because the overlying skin gets irritated. A blood clot can form inside the external haemorrhoids and can cause sudden and severe pain. The clot generally dissolves, leaving excess skin (a 'skin tag') that may become irritated and itchy.

Internal haemorrhoids occur in the lower rectum. They're often painless, even when bleeding. Internal haemorrhoids can sometimes prolapse, or push out of the anus during a bowel movement. Wipe gently and as few times as possible after you move your bowels to avoid irritating the skin more.

The symptoms of haemorrhoids

• Bright red blood on the toilet paper or in the toilet after passing a stool

• Itchiness or discomfort around the anus

• A discharge of mucus after a bowel movement

Haemorrhoids can be embarrassing and some people are hesitant to talk to their pharmacist or GP about them. There’s no need to be self-conscious, however, as medical professionals are accustomed to treating people with this condition. Rectal bleeding (bleeding from the anus) should always be looked at by a GP, as it may indicate a more serious condition.

What causes haemorrhoids?

The exact cause of haemorrhoids isn't clear. They’re associated with the blood vessels in and around the anus experiencing increased pressure, sometimes due to straining when moving the bowels, which can happen when you're constipated. This extra pressure can cause the anal passage to become swollen and inflamed. Long-term diarrhoea may also be a cause.

Other factors that could heighten your risk of developing haemorrhoids include:

• Being pregnant

• Being overweight

• Ageing (the risk increases as you get older)

• Frequent coughing

• Repeated vomiting

• Being in a sitting position for extended periods of time

• Having a family history of haemorrhoids

• Lifting heavy items on a regular basis

How are haemorrhoids treated or prevented?

• Drinking plenty of fluids, especially water

• Reducing your intake of alcohol and caffeine

• Eating more fibre-rich foods (such as fruit and vegetables)

• Doing regular exercise

• Going to the toilet as soon as you feel the need

• Using creams, ointments and suppositories – ask your pharmacist for advice

• Avoiding medication that causes constipation wherever possible – talk to your pharmacist or GP if you're concerned that a medication you're taking is causing this

Next steps

• Include enough fibre in your diet by eating fruit, vegetables and other high-fibre foods. Also make sure you’re drinking enough fluids, exercising regularly and not delaying bowel movements

• If you have haemorrhoids, ask your pharmacist which medicines may be appropriate for you

• If you experience rectal bleeding, persistent or severe symptoms, visit your GP