Piles (haemorrhoids) are enlarged blood vessels that you can get inside or around your anus. They’re usually small, round, discoloured lumps. You might be able to feel them on your anus or hanging down from your anal canal. Your anal canal is the short, muscular tube with blood vessels that connects your rectum (back passage) with your anus.
It’s completely normal to have blood vessels in your anus – they have an important role to play incontinence. But piles are when they get enlarged, which can cause symptoms.
Anyone can get piles, but they are more common as you get older. They are also more common if you often get constipated, or find you are spending long periods of time in the toilet, straining to open your bowels.
It’s difficult to know exactly how many people get piles as many people don’t go and see their doctor about them.
Piles are also common during and after pregnancy. They may develop due to changes in your hormones and the higher pressure in your tummy (abdomen) when you’re pregnant. They usually get better once your baby is born.
Types of Piles
Internal piles start inside your anal canal, but they might hang down and come out your anus. They’re graded according to whether they come out, and if so, how far they come out – this is a general classification and the symptoms can vary between individuals.
- First degree piles may bleed but don’t come out of your anus.
- Second-degree piles come out of your anus when you have a bowel movement but go back inside on their own afterwards.
- Third-degree piles come out of your anus and only go back inside if you physically push them back in.
- Fourth-degree piles always hang down from your anus and you can’t push them back in. They can become very swollen and painful if the blood inside them clots.
External piles are swellings that develop further down your anal canal, closer to your anus. They can be really painful, especially if they have a blood clot in them.
It’s possible to have both internal and external piles at the same time.
Symptoms of piles
Piles don’t always cause pain or other symptoms, but if you do have symptoms, they might include:
- Bleeding when you have a bowel movement – you may see blood (usually bright red) on toilet paper or drips in the toilet or on the surface of your poo
- A lump in or around your anus
- A slimy discharge of mucus from your anus
- A feeling of ‘fullness’ and discomfort in your anus, or a feeling that your bowels haven’t completely emptied after going to the toilet
- Itchy or sore skin around your anus
- Pain and discomfort after you go to the toilet
These symptoms can vary a lot between individuals. They may also be caused by problems other than piles, such as inflammatory bowel disease, anal cancer, bowel cancer and an anal fissure (tear). So if you have any of these symptoms, contact your GP for advice – don’t just assume they’re being caused by piles.
Diagnosis of Piles
If you go and see your GP, they’ll ask about your symptoms and examine you. They may gently put their finger into your anus to feel your rectum (they’ll wear gloves). If needed, your GP may refer you to a specialist to look inside your rectum. They’ll do this using a short, rigid tube-like instrument called a proctoscope.
You might need to have a blood test to check if you have anaemia if you have a lot of bleeding. Anaemia is when you have a low number of red blood cells in your blood. Anaemia can be a sign that you have a more serious condition.
If your symptoms, examinations or test results suggest your symptoms might be caused by something else, your GP may refer you to hospital for more tests. These can rule out other conditions, such as bowel cancer.
Self-help for piles
Sometimes piles can be improved by making a few changes to your diet and lifestyle. There are a number of things that you can do to help.
Eat a high-fibre diet to help make your poo softer and easier to pass. This will help to reduce the pressure on the veins in your anus caused by straining when you have a bowel movement. Learn more about fibre and which foods to eat to up your fibre intake.
Drink enough fluids to keep hydrated but don’t have too many caffeinated ones like tea and coffee.
Try not to strain when you’re going to the toilet. Afterwards, gently clean around your anus with water and pat the area dry.
Diet changes such as increasing fibre and drinking enough fluids are known to help. Lots of people wonder if eating spicy foods makes their symptoms worse. However, there isn’t any scientific evidence to suggest this is the case, so you shouldn’t need to start cutting things out of your diet unless your doctor advises you to.
It’s good to keep active and get your recommended amount of physical activity each day. There might be some activities that may make your symptoms more noticeable such as cycling; so, you may want to switch to something else for a while if you notice this. Generally, though, physical activity is good for your health and shouldn’t make your piles worse.
Treatment of Piles
It can be uncomfortable if you have piles and it’s understandable if they make you feel a bit self-conscious. They might have an effect on other areas of your life, such as your sex life if your piles hang out or you have some discharge. But try not to worry – the symptoms usually get better within a month and the piles shrink back, although they might come back. In the meantime, there are plenty of treatments that can relieve your symptoms. If you have mild intermittent bleeding from piles, changing your diet and lifestyle to prevent constipation may be all that you need for things to get better. See our Self-help section above for more information. Source: bupa.co.uk