Haemorrhoids (Piles): Symptoms, Causes, and Treatment

Haemorrhoids are swollen veins in the rectum or anus that can cause pain, itching, and bleeding. They're often caused by straining during bowel movements and are common in pregnancy. Most cases can be managed with simple at-home treatments like sitz baths and fiber supplements. If symptoms persist, several medical procedures can provide relief.

In plain words

Haemorrhoids, also called piles, are swollen veins in the rectum or anus. They are common, especially as people get older. Many people have them by age 50. Internal haemorrhoids are inside the rectum. External haemorrhoids are under the skin around the anus. They can cause pain, itching, and bleeding. Haemorrhoids often happen from straining during bowel movements. Pregnancy, sitting too long on the toilet, and chronic constipation or diarrhea can also cause them. Most cases improve with simple home treatments like warm baths and fiber supplements. If symptoms don’t get better, doctors can use procedures to help.

What is Haemorrhoids (Piles): Symptoms, Causes, and Treatment?

Haemorrhoids are swollen veins in the rectum or anus that can cause pain, itching, and bleeding. They're often caused by straining during bowel movements and are common in pregnancy. Most cases can be managed with simple at-home treatments like sitz baths and fiber supplements. If symptoms persist, several medical procedures can provide relief.

Symptoms

Early symptoms

  • Painless rectal bleeding: Bright red blood on toilet paper or in the toilet bowl after a bowel movement. The bleeding is usually small in amount but can be alarming. (2) (6)
  • Anal itching or irritation: Discomfort or itchiness around the anal area, often caused by mucus secretion from internal haemorrhoids. (2) (8)
  • Discomfort after bowel movements: A lingering feeling as if you still need to have a bowel movement, caused by swollen haemorrhoids. (2) (6)
  • Small lump near the anus: A soft tissue growth that may be painful or sensitive to touch, indicating an external haemorrhoid. (2) (6)
  • Mild pain when sitting: Discomfort that increases when sitting for long periods and improves when standing or lying down. (2) (8)

Serious or emergency symptoms

  • Severe rectal pain: Intense pain that may indicate a thrombosed haemorrhoid (blood clot in an external haemorrhoid) or strangulated haemorrhoid (loss of blood supply to an internal haemorrhoid). Seek medical attention, especially if pain persists for more than a week. (2) (6)
  • Heavy rectal bleeding: Large amounts of bright red blood or passage of dark, tarry stools which could indicate bleeding higher in the digestive tract. Seek immediate medical care if bleeding is heavy or makes you feel lightheaded. (6) (8)
  • Prolapsed haemorrhoid that cannot be pushed back inside: When an internal haemorrhoid protrudes from the anus and becomes stuck outside, potentially cutting off its blood supply. Seek prompt medical attention to prevent tissue damage. (2) (8)

Causes

Primary causes

  • Increased pressure in rectal veins: Pressure from straining during bowel movements (often due to constipation) can cause veins to swell and stretch. (1) (4)
  • Sitting too long on the toilet: Prolonged sitting increases pressure in the anal area and can contribute to haemorrhoid development. (1) (4)
  • Pregnancy: The growing uterus and hormonal changes increase pressure on pelvic veins, making haemorrhoids common during pregnancy. (1) (4)
  • Chronic diarrhea or constipation: Both conditions can lead to straining and increased pressure on rectal veins over time. (1) (4)

Risk factors

Age

Most common between ages 45-65 as supporting tissues weaken over time. (4) (6)

Pregnancy

About 50% of pregnant women develop haemorrhoids, especially in the third trimester. (4) (6)

Chronic constipation or diarrhea

Both conditions increase straining and pressure on rectal veins. (4) (6)

Obesity

Excess weight increases pressure on pelvic veins. (4) (6)

Sedentary lifestyle

Sitting for long periods increases pressure on anal veins. (4) (6)

Diagnosis

Doctors typically diagnose haemorrhoids by examining the anal area. For external haemorrhoids, visual inspection is usually sufficient. For suspected internal haemorrhoids, your doctor may perform a digital rectal exam (inserting a gloved, lubricated finger) or use an anoscope (a short lighted tube) to view the rectal canal. If there's concern about other digestive issues causing symptoms, further tests like colonoscopy may be recommended, especially for patients over 50 or those with risk factors for colorectal cancer.

Digital rectal examination

Allows the doctor to feel for abnormalities inside the rectum using a gloved, lubricated finger. (5) (7)

Anoscopy

A short, lighted tube (anoscope) is inserted a few inches into the anus to examine the anal canal and lower rectum. (5) (7)

Additional tests if needed

For patients with bleeding symptoms and risk factors for colorectal cancer, tests like colonoscopy may be recommended to rule out other conditions. (7)

Treatment

Medication options

Topical treatments

Reduce inflammation, pain, and itching. Available over-the-counter or in stronger prescription forms. (3) (7)

Oral pain relievers

Help manage pain and discomfort. Acetaminophen is preferred for bleeding haemorrhoids as NSAIDs may increase bleeding risk. (3) (7)

Stool softeners

Make stools softer to reduce straining during bowel movements. (3) (7)

Lifestyle and self-care

  • Increase fiber intake: Eat 25率lintroller30 grams of fiber daily from fruits, vegetables, and whole grains to soften stools and prevent straining. (3) (8)
  • Stay hydrated: Drink plenty of fluids (mostly water) to help prevent constipation and keep stools soft. (3) (8)
  • Sitz baths: Soak the anal area in warm (not hot) water for 15厂玲20 minutes 2 Array3 times daily, especially after bowel movements. (3) (8)
  • Exercise regularly: Moderate physical activity helps prevent constipation and reduce pressure on rectal veins. (3) (8)
  • Don't delay bowel movements: Go when you feel the urge to avoid stool hardening from water absorption in the colon. (3) (8)

Always discuss dosing and treatment changes with your own prescriber.

Possible complications

  • Anemia: Chronic blood loss from haemorrhoids can rarely lead to iron deficiency anemia if severe and untreated. (8)
  • Strangulated haemorrhoid: When the blood supply to an internal haemorrhoid is cut off, causing extreme pain and requiring immediate medical attention. (8)
  • Blood clot (thrombosis): Can form in external haemorrhoids, causing severe pain and swelling. (8)
  • Skin tags: Excess skin may remain after an external haemorrhoid heals, which can be bothersome but are harmless. (8)

When to see a doctor

Routine follow-up

  • If you notice rectal bleeding for the first time, especially if you're over 40, to rule out more serious conditions. (6)
  • If symptoms don't improve after a week of home treatment or worsen despite self-care measures. (6)

Seek emergency care

  • Seek emergency care for heavy rectal bleeding, severe pain, fever, or signs of infection (increasing pain, swelling, foul discharge). (6)
  • If you pass dark or tarry stools, which could indicate bleeding higher in the digestive tract. (6)

Frequently asked questions

What are the differences between internal and external haemorrhoids?

Internal haemorrhoids develop inside the rectum and usually can't be seen or felt unless they prolapse (bulge outside the anus). They rarely cause pain but may bleed. External haemorrhoids form under the skin around the anus and can be felt as lumps. They're more likely to cause pain, itching and discomfort. Some people have both types simultaneously. (1) (6)

How long do haemorrhoid symptoms typically last?

Most mild cases improve within a week with proper self-care. Thrombosed external haemorrhoids may take 1-3 weeks to resolve. Chronic haemorrhoids can persist for months if underlying causes (like constipation) aren't addressed. Symptoms often come and go, especially when lifestyle factors fluctuate. (3) (6)

Are haemorrhoids permanent?

While haemorrhoids themselves don't go away completely (as they're swollen veins), symptoms can be effectively managed and often resolve with proper treatment. Many people experience occasional flare-ups throughout their lives. Maintaining good bowel habits and a high-fiber diet helps prevent recurrent symptoms. (1) (6)

Can spicy foods cause haemorrhoids?

No, spicy foods don't cause haemorrhoids, though they may irritate existing haemorrhoids during bowel movements. The main dietary factor is fiber intake — low-fiber diets contribute to constipation, which is a primary cause of haemorrhoids. (1) (4)

What surgical options are available for severe haemorrhoids?

For persistent or severe cases, options include rubber band ligation (small elastic cuts off circulation to shrink the haemorrhoid), sclerotherapy (injection to shrink tissue), infrared coagulation, haemorrhoidectomy (surgical removal), or stapled haemorrhoidopexy. Your doctor can recommend the best approach based on your specific case. (7) (3)

References

  1. NHS — Piles (haemorrhoids) source 1
  2. NHS — Piles (haemorrhoids) - Symptoms source 2
  3. NHS — Piles (haemorrhoids) - Treatment source 3
  4. MedlinePlus — Hemorrhoids source 4
  5. MedlinePlus — Hemorrhoids Diagnosis source 5
  6. Mayo Clinic — Hemorrhoids source 6
  7. Mayo Clinic — Hemorrhoids - Diagnosis & treatment source 7
  8. Cleveland Clinic — Hemorrhoids: Symptoms, Causes & Treatment source 8