Haemorrhoids

Piles, also called haemorrhoids, are swollen lumps that form inside and around your bottom. They're very common and usually get better on their own within a few days.

What Do Piles Look Like?

Piles can appear as:

• Small lumps about the size of a pea
• Pink or purple bumps around your bottom
• Larger lumps that can grow to grape size

Common Signs of Piles

You might notice:

• Bright red blood when you go to the toilet
• Your bottom feeling itchy
• Feeling like you still need to go to the toilet even after you've been
• Clear fluid (mucus) in your underwear or on toilet paper
• Lumps around your bottom that may be painful
• Pain around your bottom area

How to Help Yourself at Home

Things that can help:

• Drink plenty of water and eat foods with fibre (like fruits, vegetables, and wholemeal bread) to keep your poo soft
• Use damp toilet paper to gently clean your bottom
• Take paracetamol if piles are painful
• Have a warm bath to ease itching and pain
• Use an ice pack wrapped in a towel on the area for comfort
• Gently push piles back inside if they stick out
• Keep your bottom clean and dry
• Exercise regularly
• Cut down on alcohol, tea, coffee, and fizzy drinks to prevent being unable to poo (constipation)

Things to avoid:

• Don't wipe your bottom too hard
• Don't ignore the urge to go to the toilet
• Don't push too hard when going to the toilet
• Don't take painkillers with codeine as these can cause constipation
• Don't take ibuprofen if your piles are bleeding
• Don't spend longer than needed on the toilet

Getting Help from Your Pharmacist

Your pharmacist can suggest:

• Creams to reduce pain, itching, and swelling
• Treatments to help with constipation and soften poo
• Cold packs for comfort

Many pharmacies have private areas if you prefer not to be overheard.

When to See Your GP

Speak to your GP if:

• Your piles are getting worse or not better after 7 days of home treatment
• You keep getting piles
• You notice unusual changes around your bottom

Your GP might prescribe stronger medicines or check if something else is causing your symptoms.

When to Get Urgent Help

Get urgent help from your GP or call NHS 111 if:

• You have a very high temperature or feel hot, cold, or shivery
• Pus is coming from your piles

When to Call 999 or Go to A&E

Call 999 or go to A&E immediately if:

• You're bleeding and it won't stop
• There's lots of blood (the toilet water turns red or you see large blood clots)
• You're in severe pain that's so bad you can't think, talk, or sleep

Don't drive yourself to A&E - ask someone to drive you or call 999 for an ambulance.

What Causes Piles?

Piles happen when blood vessels around your bottom become swollen. We don't know exactly why this happens, but these things make them more likely:

• Being unable to poo easily (constipation)
• Pushing too hard when going to the toilet
• Heavy lifting
• Being pregnant

Most piles get better with simple home treatments, but speak to your GP if you're worried or they're not improving.

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Based on NHS.uk guidance. Written by Dr Krishnan Pasupathi, NHS GP.