Piles is the common term for haemorrhoids, which are swollen veins in and around the back passage (anus). Many people will develop piles at some time or another and, although highly uncomfortable, they are rarely cause for concern.
The most frequent cause of piles is constipation, where you have difficulty going to the toilet. The straining puts extra pressure on the haemorrhoidal veins in the anus. Piles can also develop during pregnancy and after childbirth, if you are overweight, and as a result of lifting heavy weights or standing/sitting for long periods.
How Do I Know If I Have Piles?
The usual symptoms of piles are pain, itching or soreness around the anus, particularly when you go to the toilet, and bleeding after a bowel movement. You may be tipped off by blood on your toilet paper or in the lavatory pan. If haemorrhoids prolapse they may produce mucus around the opening to the anus.
External piles look a little like purple grapes and are felt as a soft lump or lumps around your anus. Prolapsing piles can be extremely painful if a clot forms inside the vein, making it hard for the growth to retreat back inside the anus.
What can I do immediately to make my piles better?
• If you are constipated, eat a varied, high-fibre diet (e.g., wholemeal bread, brown rice, bran cereals, pulses such as lentils, plenty of fruit and vegetables, pulses). Drinking lots of fluids (especially fruit juices) and taking regular exercise will also help your bowel movements.
• If you need to relieve the constipation straight away, you may want to use a 'bulk-forming' laxative, which will help soften your stools.
• Wear cool, loose-fitting clothing.
• Use soft toilet paper.
• Go to the toilet regularly if you can, and do not delay going when you get the urge.
• Try not to strain too much when you do go to the toilet.
• Do not scratch your piles as this will make them more uncomfortable.
• If the piles are protruding outside your anus, try to push them carefully back in (a warm bath and a lubricant will help).
• You can ease the pain, irritation and itching of piles with special creams, ointments and suppositories that you can buy in your local pharmacy.
• Applying an ice-pack to external piles will help relieve the pain and swelling. You can also soothe them by washing with warm water or using medicated wipes after going to the toilet. Make sure you then dry the affected area properly.
What Can I Do Generally To Avoid Piles?
• Take the steps recommended above to guard against constipation.
• Regular exercise will both aid digestion and lower pressure in the haemorrhoidal veins.
• Try to lose some weight if that is the problem.
What Treatments Can I Buy For Piles Without A Prescription?
Your pharmacy will have a variety of products for relieving the symptoms of piles. Many of them contain astringents or a local anaesthetic for soothing the pain and irritation of haemorrhoids and reducing the swelling.
A newer ingredient is the anti-inflammatory, hydrocortisone, which should not be used if you are pregnant, nor for more than seven days. Local anaesthetics can sometimes provoke an allergic reaction, so ask your pharmacist for advice.
You can buy these products as creams or ointments for rubbing into the affected area or as suppositories, which you insert into your anus. Suppositories are the best option for internal piles that cannot be reached with ointment or cream.
When Do I Need To See A Doctor?
• If your symptoms do not ease off despite treatment or are particularly painful.
• If you are not sure whether you have piles.
• If you are bleeding from your anus, especially if you also have stomach pain or have lost weight without knowing why.
• If your piles are particularly large.
• If you are over forty years old and have developed piles for the first time.
• Eat a high-fibre diet, exercise and drink plenty of fluids to overcome or prevent constipation.
• Go to the toilet regularly and do not hold back.
• Use an ice-pack or special creams, ointments and suppositories to relieve pain and irritation.
• Talk to a doctor if you are worried about your symptoms.