Piles or Haemorrhoids

Doctors will often tell patients with symptoms around the bottom that they have 'piles' or haemorrhoids to reassure them they have nothing serious. However bleeding from the bottom, the most common symptom attributed to 'piles' is so common that it can almost be called normal especially in younger patients - women having a baby and in young men - almost natural for some of us

Although doctors think it is reassuring to be told that bleeding is just from piles many people don’t like the thought of having ‘piles’, believing they must have done something wrong (bad diet, bad habits, straining etc) Bleeding affects one in five of us in any year and can continue on and off throughout our lives

The bleeding, usually short bursts for a few days at a time, comes from ‘venous cushions’ just underneath the skin in and around the anus - natural spongy bulges of tissue and blood vessels which close the anal canal to hold in gases - most bleeding from the bottom is therefore from normal structures - pass a hard motion or strain and they can bleed easily, especially when we’re younger - it mostly goes away without treatment

Other symptoms can be attributed to 'piles' like itching, soreness, pain, pressure feelings, soft grape-like little lumps which appear when you strain to have your bowel open and can thrombose -  when they are called a thrombosed pile or perianal haematoma - however the term 'piles' should really be kept for patients whose ‘venous cushions’ are so large they come down through the anal canal when having the bowels open and the patient has to push them back (prolapsed piles). This is more likely to happen as we get older and may need surgical treatment   

 What can be done to control bleeding and 'pile' symptoms?

 If you are worried about the bleeding click on 'Rectal bleeding' in the symptom checker to see if your pattern of bleeding could be something more serious particularly if you are over 50 years of age

 

• Change your diet - to more fibre/more fluids so that the motions are softer and easier to pass

• Avoid excessive straining - straining a lot is an important cause of bleeding or 'piles' - some straining to start the bowels working is normal but try not to strain too much

• Suppositories/creams - get advice from your local pharmacist - as bleeding tends to come and go, it can be hard to know if the product has worked!

• Injections or rubber banding -  if bleeding is a nuisance and you are referred to hospital these simple safe procedures can reduce the size of the 'venous cushions'/piles and make them less likely to bleed - at least in the short term but because they can't completely get rid of the normal 'venous cushions' it is often impossible to stop the bleeding permanently  


Really large 'true prolapsing piles' - usually require surgery but should only be as the last resort. Recovery can be painful for a couple of weeks, especially when going to the toilet. Laser, infra-red and cryotherapy treatments have been tried in the past but are not usual treatments at the moment.

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