When should I see a doctor about haemorrhoids (piles)?
What are piles?
Piles (haemorrhoids) are lumps inside and around your bottom (anus). They are swollen blood vessels (veins). It’s not clear what causes them. They often get better on their own after a few days.
There are things you can do to treat and prevent piles. Avoiding constipation is important in preventing and treating piles.
What are the symptoms of piles?
- Bright red blood after you poo
- An itchy anus
- Feeling like you still need to poo after going to the toilet
- Mucus (clear jelly) in your underwear or on toilet paper after wiping your bottom
- Lumps around your anus
- Pain around your anus.
Piles may be inside or outside the anus.
Tell me more about piles, their causes, treatment and when to see a doctor.
Causes of piles
- If you strain when you go to the toilet, for example if you have constipation
- Getting older – your anal canal weakens with age, which makes piles more likely
- Having a persistent cough
- Lifting heavy objects
- Pregnancy.
How you can treat or prevent piles
Do’s
- Drink lots of fluid and eat plenty of fibre to keep your poo soft
- Take paracetamol if piles hurt
- Take a warm bath to ease itching and pain
- Gently push a pile back inside
- Keep your bottom clean and dry
- Exercise regularly and keep your weight down.
Don’ts
- Do not wipe your bottom too hard after you poo
- Do not ignore the urge to poo, or push too hard when pooing
- Do not take painkillers that contain codeine, as they can cause constipation
- Do not take aspirin or ibuprofen if your piles are bleeding
- Do not spend more time than you need to on the toilet.
You may want to start with a pharmacist
- Creams to ease the pain, itching and swelling
- Treatment to help constipation and soften poo
- Cold packs to ease discomfort.
Note. Many pharmacies have private areas if you do not want to be overheard.
So. When should I see a doctor about haemorrhoids (piles)?
- If your piles are getting worse or there’s no improvement after 7 days of treatment at home
- You keep getting piles
- You notice a change around your anus that is not normal for you.
Your GP 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.
The GP may prescribe stronger medicines for piles or constipation. They may also check your symptoms are not being caused by something else.
Procedures at hospital
If necessary, your GP may refer you to a consultant surgeon at the hospital to look inside your rectum, using a short, rigid tube, with a light, called a proctoscope. If confirmed, they may offer one of these treatments:
- Rubber band ligation – a band is placed around your piles to make them drop off
- Sclerotherapy – a liquid is injected into your piles to make them shrink
- Electrotherapy – a gentle electric current is applied to your piles to make them shrink
- Infrared coagulation – an infrared light is used to cut the blood supply to your piles to make them shrink.
You will be awake for this type of treatment, but the area will be numbed. You will be able to go home on the same day. If these treatments do not work, you may need surgery to remove your piles.
Operations for piles
- Haemorrhoidectomy – your piles are cut out
- Stapled haemorrhoidopexy – your piles are stapled or stitched back inside your anus
- Haemorrhoidal artery ligation – stitches are used to cut the blood supply to your piles to make them shrink.
You will be asleep for this type of treatment and usually need to stay in hospital for more than 1 day.
Go to A&E or call 999
If you have piles and:
- Are bleeding non-stop
- Are in severe pain
- Your temperature is very high or you feel hot and shivery and generally unwell
- You have pus leaking from your piles.
Summary
We have described when should I see a doctor about haemorrhoids (piles). We hope you understand them better now.
