Piles (haemorrhoids)

Piles are lumps inside and around your bottom (anus). They often get better on their own after a few days.

There are things you can do to treat and prevent piles. But if piles are causing you bleeding or pain, contact your GP.

Piles are more common in pregnancy.

Symptoms of piles

You may be suffering from piles if you have:

  • bright red blood after you poo
  • an itchy anus
  • a feeling like you still need to poo straight after you’ve been
  • slimy mucus in your underwear or on toilet paper after wiping your bottom
  • lumps around your anus
  • pain around your anus
See what piles look like
They can be small lumps, around the size of a pea.
They can be small lumps, around the size of a pea.
They can be pink or purple.
They can be pink or purple.
They can grow into larger lumps, the size of grapes.
They can grow into larger lumps, the size of grapes.

Treating and preventing piles

Do

  • drink lots of fluid and eat plenty of fibre to keep your poo soft and easy to pass

  • wipe your bottom with damp toilet paper

  • take paracetamol if your piles hurt

  • have a warm bath to ease itching and pain

  • use an ice pack wrapped in a towel to ease discomfort

  • gently push a pile back inside

  • keep your bottom clean and dry

  • exercise regularly to help prevent constipation

  • cut down on alcohol and caffeine, such as tea, coffee and cola, to avoid constipation

Don't

  • do not wipe your bottom too hard after you poo

  • do not ignore the urge to poo

  • do not push too hard when pooing

  • do not take painkillers that contain codeine, as they cause constipation

  • do not take ibuprofen if your piles are bleeding

  • do not spend more time than you need to on the toilet

Ask a pharmacist about treatment for piles

Talk to a pharmacist to get advice on:

  • creams to ease the pain, itching and swelling
  • treatment to help constipation and soften poo
  • cold packs to ease discomfort

You can ask the pharmacist to talk to you in a private area if you do not want to be overheard.

It can feel embarrassing to talk to your pharmacist or GP about your piles. But piles are very common. Your GP is used to diagnosing and treating piles.

Non-urgent advice: See a GP if:

  • you have any bleeding from your bottom
  • there's no improvement after 7 days of treatment at home
  • you keep getting piles

Your GP may prescribe stronger medicines for piles or constipation. They can also check for more serious conditions.

Urgent advice: Ask for an urgent GP appointment if you have:

  • piles and your temperature is very high or you feel hot and shivery and generally unwell
  • pus leaking from your piles

Hospital treatment for piles

You might need hospital treatment if your piles do not improve after home treatments. If so, talk to your GP about the best treatment for you.

Treatment does not always prevent piles from coming back.

Treatment without surgery

Common hospital treatments for piles include:

  • rubber band ligation - a band is placed around the piles to make them drop off
  • sclerotherapy - a liquid is injected into the piles to make them shrink
  • electrotherapy - a gentle electric current is applied to make the piles shrink
  • infrared coagulation - infrared light is used to cut the blood supply and make the piles shrink

You'll be awake for this type of treatment, but the area will be numbed. You can usually go home on the same day.

You may need surgery to remove your piles if these treatments do not work.

Surgery

Surgical treatments include:

  • haemorrhoidectomy - the piles are cut out
  • stapled haemorrhoidopexy - the piles are stapled back inside your anus
  • haemorrhoidal artery ligation - the piles are stitched to cut the blood supply and make them shrink

You'll usually be asleep for the surgery. You may need to stay in hospital for more than a day.

Immediate action required: Phone 999 or 112 or go to your nearest emergency department (ED) if you have piles and you’re:

  • bleeding non-stop
  • bleeding heavily – for example, the toilet water turns red or you see large blood clots
  • in severe pain

Causes of piles

Piles are swollen blood vessels. It's not clear what causes them.

You’re more likely to get piles if you:

  • are constipated
  • push too hard when pooing
  • are pregnant
  • lift heavy objects

Piles during pregnancy

Piles are more common during pregnancy but they can also happen to anyone. You're more likely to get piles if you’re constipated (having trouble pooing).

Ask your GP or obstetrician for a stool softener (medicine to soften your poo) if you are constipated during your pregnancy.

Read more about constipation in pregnancy

Preventing constipation

To avoid becoming constipated:

  • drink lots of fluids - you need 2 extra glasses of water a day when you're pregnant
  • eat plenty of fibre in your diet, such as fruit, vegetables and wholegrains

Read drinks advice to keep hydrated on safefood.net

Read more about healthy eating and active living


Content supplied by the NHS and adapted for Ireland by the HSE

Slaintecare logo
This project has received funding from the Government of Ireland’s Sláintecare Integration Fund 2019 under Grant Agreement Number 123.

Page last reviewed: 29 April 2021
Next review due: 29 April 2024