Haemorrhoids (Piles)

Haemorrhoids, also called piles, are a common medical condition in which blood vessels in and around the anus become enlarged or swollen. This often happens as a result of increased pressure in this area of the body, which can occur for a number of reasons.

There are many different types and stages of haemorrhoid. The symptoms you experience can vary considerably depending on this, as well as the severity of the condition.

This page will give you information on the various kinds of haemorrhoid, as well as some of the possible causes and piles symptoms you can expect.

It will also discuss some of the most effective options for haemorrhoid treatment. These include home remedies to ease pain and discomfort, plus hospital treatment for haemorrhoid removal.

Keep reading to the end to learn simple tips for ways you can prevent piles from developing in the first place.

Types and stages of haemorrhoid

Your anus is lined with blood vessels, and when these bulge or become swollen, they can develop into piles.

There are two main haemorrhoids type, distinguished by their location on the body:

Internal haemorrhoids – These develop inside the rectum or anal canal.
External haemorrhoids – These develop on the outside of the anus.

Internal haemorrhoids can be further subdivided into four types on a scale:

First degree or grade

These remain within the rectum and may bleed but have few or no other symptoms.

Second degree or grade

These may come out of the anus (prolapse), for example, during bowel movements, but go back inside the rectum on their own.

Third degree or grade

These also prolapse but only go back inside if you push them in manually.

Fourth degree or grade

These prolapse outside of the anus and cannot be pushed back in

Prolapsed, thrombosed haemorrhoids and sentinel pile

Prolapsed haemorrhoids are any that bulge or pop out of the anus, something that can happen with both internal and external piles.

Meanwhile, thrombosed piles are those which develop a blood clot inside them. This is more common with external haemorrhoids, but can happen to internal haemorrhoids too.

Lastly, a sentinel pile is a small and harmless skin tag leftover as an anal fissure heals.

It’s possible to have just one type of haemorrhoid or develop some or all of these varieties at the same time. The sort of piles you suffer from, as well as their severity, will have an impact on both your haemorrhoids symptoms and treatment options.

What causes haemorrhoids?

The question of what causes a haemorrhoid is a tricky one to answer. There are many different possible factors that can contribute to the development of piles, and it may be difficult to pinpoint the specific cause of your haemorrhoid.

As a general guide, pilesare normally caused by increased or excessive pressure in the lower rectum. Some of the activities and risk factors that might result in this are listed below.

Constipation

One of the more common haemorrhoids causes is constipation. This can be a contributing factor in piles for several reasons.

Firstly, both straining during bowel movements and spending a long time on the toilet can cause the veins in the anus to stretch because of the added pressure. This is true regardless of whether you are constipated or not.

In addition, a side effect of being constipated is that your stools may be larger, harder, and drier than usual. This, in turn, can cause damage to the anus when you defecate. At the other end of the spectrum, chronic diarrhoea can also cause or exacerbate a haemorrhoid.

A sedentary lifestyle

Leading an inactive lifestyle can contribute to a number of health conditions, including piles. If you spend a lot of time sitting down, it can put added pressure on the blood vessels in your anus and increase your risk of developing a haemorrhoid.

Similarly, being overweight or obese is linked with a higher risk of piles due to the added strain on your body.

A lack of exercise and movement can also slow down your digestive system, making it more likely you’ll suffer from constipation – another cause of haemorrhoids symptoms.

Heavy lifting

Another activity linked with the development of piles is lifting very heavy items. This could be anything from weights in the gym to furniture around the house or objects related to your job.

The problem happens when you don’t use the proper technique. For example, if you strain, grunt or hold your breath, it can put pressure on your abdomen and result in a haemorrhoid.

Pregnancy and childbirth

Haemorrhoids affect people of all genders, and what causes piles in males is largely the same as the causes of piles in females. The one main exception to this is that haemorrhoids can be caused by pregnancy.

This is both due to the extra weight and pressure of the baby, as well as an increase in the production of the hormone progesterone that causes veins to relax. In addition, straining during childbirth itself can both cause haemorrhoids and exacerbate existing ones.

Haemorrhoids symptoms

The haemorrhoids, or piles symptoms you experience can vary quite a lot depending on the type, location, and severity of your piles. For example, internal haemorrhoids symptoms are often not as intense or obvious as those of external piles. In fact, many people don’t even realise they have them.

Just as with the causes of haemorrhoids, the symptoms of piles in males are much the same as the symptoms of piles in females.

Some of the most frequently reported piles symptoms include:

Lumps in and around the anus
An itchy anus
Small amounts of bright red blood after bowel movements (this might be on the toilet paper, in the toilet itself, or in your stool)
Pain around the anus, for example, when using the toilet
A feeling like you still need to poo after defecating
Slimy mucus on the toilet paper or in your underwear
General discomfort in the anal region
Swelling around the anus
A particularly swollen haemorrhoid may obstruct your bowel movements

Prolapsed Haemorrhoids

If you have internal haemorrhoids, these may prolapse (pop out of your anus, for example, during bowel movements). In some cases, you can push them back inside, but this isn’t always possible depending on the haemorrhoids type you have.

If you suffer from prolapsed piles, these can be painful when sitting down and feel tender if touched.

Symptoms of thrombosed piles

In addition to the symptoms above, those who suffer from thrombosed piles might experience severe pain, swelling, or inflammation and feel a hard haemorrhoid around the anus.

They also tend to be a bluish colour due to the blood clot inside – similar to a bruise – which is one way to tell them apart from regular piles.

You may also have heard of a popping thrombosed haemorrhoid. Due to the buildup of pressure and blood inside, sometimes thrombosed piles can burst. This may result in more intense pain and bleeding, which lasts anywhere from a few seconds to several minutes.

It might sound scary, but in most cases is nothing to worry about. Having said that, if you experience heavy bleeding or it doesn’t stop after 10 minutes, you should seek immediate medical care.

Other complications

Complications with piles are rare but can occur. For example, they may become infected or develop into a more serious condition such as an anal fistula.

It’s also possible for a haemorrhoid skin tag to form. This usually occurs as a result of the excess skin that’s produced by piles and left behind as they shrink. Anal skin tags are normally painless and don’t bleed, though they may be uncomfortable and have to be removed surgically.

One potential complication of prolapsed haemorrhoids is that they can become strangulated. This means that the blood supply to them has been cut off, which can result in severe pain and may require haemorrhoids surgery.

Haemorrhoids treatment

For most people, a haemorrhoid will go away on its own without the need for medical piles treatment. This is particularly true for small piles and those with only minor symptoms.

By using simple home remedies and over-the-counter medicine for piles like haemorrhoid cream or suppositories – tablets that you insert inside the rectum – you can soothe your haemorrhoids symptoms and get rid of piles fast.

Home remedies for haemorrhoids

If you are experiencing painful or irritating piles symptoms, try the following recommendations:

Soak your anal region (or your whole body) in a warm bath to help relieve itchiness and soreness.
Press a clean cloth wrung in ice water (or an ice pack wrapped in a clean cloth) against the affected area to ease haemorrhoid symptoms.
After defecating, use wet wipes rather than dry toilet paper to wipe your bottom. This will cause less agitation to the area.
When wiping your bottom, use a patting motion rather than rubbing. This will cause less irritation to the skin.
Use a haemorrhoid cream directly on the skin to provide relief from pain, itching, and other piles symptoms.
Use haemorrhoid suppositories – tablets that you insert inside the rectum to provide relief from piles symptoms.
Consider other medicine for piles if necessary, for example, painkillers.
Other tactics for easing constipation include eating a high-fibre diet, staying hydrated, not ignoring the urge to defecate, and keeping physically active. Laxatives can be helpful if dietary and lifestyle measures won’t help.
You can ease the pressure on the veins in your anus by not spending too long on the toilet or straining when defecating.

Medical procedures for haemorrhoid removal

In cases of severe piles or a chronic haemorrhoid, the above recommendations might not be sufficient to treat the condition. Don’t worry, though, as there are a number of both non-surgical and surgical hospital procedures available. Your doctor will be able to advise you on the most appropriate external or internal haemorrhoids treatment for your condition.

Non-surgical piles treatment includes:

Rubber band ligation

Rubber band ligation is where a band is placed around the base of your piles. This cuts the blood supply so that the haemorrhoid falls off.

Infrared coagulation

This uses infrared light on certain parts of the haemorrhoid to cut the blood supply and make it shrink.

Sclerotherapy

Medicine is injected into your piles, causing them to shrivel up.

Electrotherapy

Electrotherapy is where a gentle electric current is applied to a haemorrhoid to make it shrink.

Thrombectomy

This treatment for thrombosed piles involves making a small cut in the clot so it can be drained.

During these procedures, you will be awake, but the area will be anaesthetised so that you don’t feel pain. In most instances, you’ll be able to go home on the same day.

Surgical haemorrhoid treatment

Surgical haemorrhoid treatment includes:

Haemorrhoidectomy

A form of haemorrhoid removal where your piles are cut out

Haemorrhoidal artery ligation

This uses stitches to cut off the blood supply to a haemorrhoid and make it shrink.

Stapled haemorrhoidopexy

Your piles are stapled back inside your anus, so they will no longer prolapse but instead will shrink.

Surgery for piles can be very effective, but there is some risk involved, and there’s no guarantee the haemorrhoid won’t come back. You’ll be asleep for the procedure and normally need to stay in hospital for a few days to recover.

Haemorrhoid prevention

Prevention is generally better than a cure, and the good news is that there are lots of diet and lifestyle changes you can make to reduce your chances of developing piles.

Prevent Constipation

Some of the most effective suggestions include ways to prevent constipation, such as:

Eat a diet that’s rich in high-fibre foods. These include wholewheat pasta, brown rice, wholemeal bread, nuts, fruits, and vegetables.
Drink six to eight glasses of water every day to have good levels of hydration (and avoid dehydrating beverages such as coffee, coke, and alcohol).
Live an active lifestyle to keep your digestive system moving.
Do not ignore the need to defecate when you feel it.

Prevent veins and rectum pressure

There are also ways in which you can avoid piles by not putting too much pressure on the veins in your rectum and anus. For example:

Avoid sitting down for prolonged periods of time. If you work at a desk all day, try to make sure you get up and move around for a few minutes every hour.
Do not spend too long on the toilet (don’t take your phone or anything else that can distract you in the bathroom).
Use good technique when lifting something heavy, and breathe steadily throughout.
Maintain a healthy body weight.

Haemorrhoids FAQs

Will haemoorhoids go away on their own?

Yes, haemoorhoids will generally disappear on their own. However, this can take some time, so seeking out treatment is advisable.

How do you get rid of haemorrhoids?

Speed up the process of getting rid of haemorrhoids by eating a high-fibre diet, staying hydrated, keeping active, and practicing good toilet habits.

These include not straining too hard, spending too long on the toilet, or ignoring the need to defecate. To help ease piles symptoms, take warm baths, use a cold compress on the affected area, treat your anal region gently, and use a topical haemorrhoid cream.

What happens if you let haemorrhoids go untreated?

In the majority of cases, leaving a haemorrhoid untreated won’t cause any problems. You may simply find that it takes longer to heal, or your symptoms are more severe compared to if you had used home remedies.

However, in some instances, complications with piles can develop. As such, it’s important to seek treatment if your haemorrhoid symptoms don’t improve within a few days

When should you go to the doctor for haemorrhoids?

Although piles are usually nothing to be concerned about, you should still see a GP about them if your symptoms don’t clear up in a couple of days or if they appear to be getting worse.

This is because there are certainly more serious health conditions that can present with similar symptoms. Getting an accurate diagnosis helps you to rule those out or seek early treatment for them if necessary. Likewise, it’s wise to book an appointment if you have a recurring or chronic haemorrhoid.

Additionally, if you have a haemorrhoid and suffer from any of the following, you should see a doctor immediately:

Heavy or constant bleeding
Pus leaking from your piles
Fever or chills
Severe pain