Piles are literally a pain in the bum!


Piles are swollen veins (a bit like varicose veins in the legs), which swell out of the wall of the anal canal.  They can swell so much that they appear down outside the anus (external haemorrhoids).  They produce symptoms of itching, burning, pain, swelling and discomfort especially when defecating.


Haemorrhoids can bleed, and this fresh blood appears on the surface of stools (but not mixed with the stool) or splashed in the toilet or on toilet paper. Piles are caused by inadequate fibre or fluid intake, leading to constipation that causes the patient to strain or use a lot of pressure when defecating.  Certain drugs can cause constipation, hence piles.


Internal piles cannot be seen as they are too small to hang down outside.  External piles are more advanced, and hang down during defecating.  Some remain permanently hung down. (1st, 2nd, 3rd degree piles respectively).  Pain is usually a dull ache, worsening on bowel movement.  Itching is usually very troublesome and is the main symptom referred to by patients.


Causes of Piles


Piles are often associated with bad diet, pregnancy or a sedentary occupation.


Symptoms of Piles


Symptoms may include the dull ache, itch, swelling, soreness, and constipation.  The symptoms all tend to stay around the anus.  You should talk to your local pharmacist if there is abdominal pain, stretching or nausea and vomiting.


Treatment of Piles:


You can treat piles that have been present up to 3 weeks.  Have you had haemorrhoids before, and if so, did you seek medical advice at that time?  If you have suffered with haemorrhoids before what did you use?  What, if anything, have you been using until now? Certain drugs cause constipation, which can cause piles, so inform the pharmacist about any such medication, prescription or over the counter.


The underlying cause of constipation must be addressed.  Seek advice on diet and lifestyle at your local pharmacy.


Creams, ointments and suppositories are available to relieve the symptoms.


Practical Points:


  • Hygiene alone can do a lot for the itch of haemorrhoids, as small amounts of faeces often cause the itching.  The area should be washed as frequently as possible (ideally after each bowel movement).
  • Soap dries the skin so a soap substitute is generally a better idea.
  • Drying should be with a patting rather than a rubbing motion (which might tear the piles) and with soft tissue paper.
  • A warm bath often helps with the discomfort.