Piles are swellings that develop inside your back passage (rectum) or around your bottom (anus) which can cause bleeding and pain. Piles are also known as haemorrhoids.

By Wallace Health I Medically reviewed by Adrian Roberts.
Page last reviewed: October 2018 I Next review due: October 2021

What are piles?

Piles form when pressure builds in the small blood vessels in your rectum or anus, so that the tissue round them enlarges and forms a lump.

Piles are very common and anyone can get them. Some piles are small, internal and cause no symptoms. However, sometimes you can have symptoms such as itching, sore skin, constipation, bleeding and pain, anal discharge or a lump you can feel on the outside of your anus. On rare occasions, chronic blood loss from haemorrhoids may cause anaemia.

Piles often get better on their own or with over-the-counter treatments like a haemorrhoid cream. Easing constipation can help too, as straining on the toilet to pass stools (faeces) can make piles worse.

If these piles treatments don’t work, there are several types of surgery that have a high success rate in removing piles.

How to tell if you have piles

The most common symptom of piles is bleeding – bright red blood you can see after you’ve passed a stool.

Other piles symptoms are:

Talk to your doctor if you’re concerned about symptoms

You can book an appointment with a Spire private GP today.

Diagnosis and tests for piles

See your GP about any bleeding from your bottom. They’ll be able confirm if it’s piles and rule out other causes, such as an anal fissure or bowel polyps.

Your GP will usually be able to diagnose piles by asking about your symptoms and medical history and by examining your bottom.

They may refer you for a proctoscopy, an examination to check the inside of your rectum using a tool called a proctoscope.

Causes of piles

It isn’t always clear why pressure builds up in the blood vessels in your rectum and anus and forms a swelling. Piles are more common if you’re:

  • Aged 45 and over
  • Overweight or obese
  • Pregnant or have recently given birth

Other factors that can increase your risk of piles, or make them worse, include:

Common treatments for piles

Piles often go away on their own, although this can take time. Treatments for small piles include:

  • Corticosteroid creams to reduce inflammation
  • Haemorrhoid creams to relieve itching and pain
  • Over-the-counter painkillers
  • Relieving constipation by changing your diet or taking medication

For larger piles, your doctor may recommend a non-surgical treatment such as:

  • Banding – cuts off the piles’ blood supply by fitting a tight band around their base
  • Sclerotherapy – shrivels piles by injecting phenol into their base

One in 10 people with piles eventually need an operation. There are several procedures that use different techniques to shrink piles by blocking their blood supply. They include:

  • HALO (haemorrhoid artery ligation operation)
  • Rafaelo procedure (radio frequency treatment under local anaesthetic)
  • Stapling (circular stapled haemorrhoidectomy)
  • THD (transanal haemorrhoidal de-arterialisation)

You and your doctor can discuss which option would be best for you.