Haemorrhoids (Piles)

Haemorrhoids, also known as piles, are swellings containing enlarged blood vessels found inside or around the bottom (the rectum and anus). Some people with haemorrhoids are reluctant to seek advice; your pharmacy will have a private room where they can provide confidential advice.

In many cases, haemorrhoids don’t cause symptoms and some people don’t even realise they have them.
But when symptoms do occur, they may include:

• Bleeding after passing a stool – the blood is usually bright red
• Itchy bottom
• A lump around the outside of the anus, which may need to be pushed back in after passing a stool
• A mucus discharge after passing a stool
• Soreness, redness and swelling around your anus

Haemorrhoids aren’t usually painful, unless their blood supply slows down or is interrupted.

How can I avoid triggers/ suggested lifestyle changes?

The exact cause of haemorrhoids is unclear, but they’re associated with increased pressure in the blood vessels in and around your anus.
This pressure can cause the blood vessels in your back passage to    become swollen and inflamed. 
Many cases are thought to be caused by too much straining on the toilet as a result of prolonged constipation. This is often caused by a lack of fibre in a person’s diet. Chronic (long-term) diarrhoea can
also make you more vulnerable to developing haemorrhoids.
Other factors that might increase your risk of developing haemorrhoids include:

• Being overweight or obese
• Age – as you get older, your body’s supporting tissues get weaker, increasing your risk of haemorrhoids
• Being pregnant – this can place increased pressure on your pelvic  blood vessels, causing them to enlarge
• Having a family history of haemorrhoids
• Regularly lifting heavy objects
• A persistent cough or repeated vomiting
• Sitting down for long periods of time

How do I manage my condition?

Haemorrhoid symptoms often settle down after a few days without needing treatment. Haemorrhoids that occur during pregnancy often get better after giving birth.

Making lifestyle changes to reduce the strain on the blood vessels in and around your anus is often recommended. These can include:

• Gradually increasing the amount of fibre in your diet – good sources of fibre include fruit,
  vegetables, wholegrain rice, whole-wheat pasta and bread, pulses and beans, seeds, nuts and oats
• Drinking plenty of fluid – particularly water, but avoiding or cutting down on caffeine and alcohol
• Not delaying going to the toilet – ignoring the urge to empty your bowels can make your stools
  harder and drier, which can lead to straining when you do go to the toilet
• Avoiding medication that causes constipation – such as painkillers that contain codeine
• Losing weight if you’re overweight
• Exercising regularly – this can help prevent constipation, reduce your blood pressure, and help you lose weight

These measures can also reduce the risk of haemorrhoids returning or even developing in the first place

How do I treat?

If the tips above haven’t improved your symptoms you may wish to try medication. There are a number of preparations available.

Creams, ointments and suppositories, which you insert into your bottom, are available from pharmacies without a prescription. They can be used to relieve any swelling and discomfort. There are various
treatment options for more severe haemorrhoids.

• Rub on relief – Over-the-counter wipes or creams can soothe pain and itch with no side effects. Don’t use one with hydrocortisone for more than a week unless your doctor says it’s OK.
• Ice – Put a small cold pack on the trouble spot several times a day. It can dull pain and bring down then swelling for a little while.
• Bath – take a warm bath to ease itching and pain
• Consider painkillers – An over-the-counter medicine, like paracetamol or ibuprofen, could help with
  soreness.
• Don’t scratch – You could damage the skin and make the irritation and the itching worse.
• Choose cotton – Wear loose, soft underwear. It keeps the area aired out and stops moisture from building up, which can bother your haemorrhoids.
• Speak to your pharmacist – for advice if you’re not sure which type of medicine is best for you and your symptoms.

When should I seek advice?

• If you have persistent or severe symptoms of haemorrhoids
• If your symptoms don’t get better or you experience pain or bleeding

Where can I get more information?

• NHS Choices
• Visit your local pharmacy for advice