Haemorrhoids
Haemorrhoids (piles) can cause itching, discomfort, a lump or bleeding, but these symptoms can have other causes. Treatment ranges from bowel habit measures and symptom relief to procedures or surgery, depending on the assessment. Bleeding should not automatically be attributed to piles.
In this guide
Overview
Haemorrhoids, also known as piles, are swollen blood vessels in the rectum or anus. They can cause discomfort, pain, itching, and sometimes bleeding. Haemorrhoids are a common condition, and several treatment options are available to manage the symptoms effectively.
Types of Haemorrhoids
- Internal Haemorrhoids: These develop inside the rectum and usually don’t cause pain. However, they can result in bleeding during bowel movements.
- External Haemorrhoids: These occur around the opening of the anus and may cause pain and itching. They can sometimes develop blood clots, leading to a condition called thrombosed haemorrhoids.
Non-Surgical Treatment
- Lifestyle Modifications
- Increasing dietary fibre intake to soften stools and promote regular bowel movements.
- Drinking plenty of water to prevent constipation.
- Avoiding straining during bowel movements.
- Engaging in regular physical activity.
- Topical Medications
- Over-the-counter creams, ointments, or suppositories containing hydrocortisone or witch hazel can help relieve pain, itching, and inflammation.
- Over-the-counter creams, ointments, or suppositories containing hydrocortisone or witch hazel can help relieve pain, itching, and inflammation.
Surgical Treatments
- THD Procedure
- THD is a procedure to reduce the size of haemorrhoids by suturing their blood-supplying arteries. It’s also sometimes called haemorrhoid ligation, haemorrhoidal artery ligation, or doppler-guided ligation.
- Discharge from the hospital will be the same day. You should expect to have your bowels open within 2 to 3 days, and this will be uncomfortable at first. A small amount of bleeding is expected.
- Haemorrhoidectomy
- Surgical removal of haemorrhoids. This procedure is usually recommended for severe cases or large external haemorrhoids.
- It may require a short hospital stay.
A little more clarity
Your questions, answered
Does bright red bleeding prove that I have piles?
No. Piles are one possible cause, but fissures and other bowel conditions can also cause bleeding. New, persistent or recurrent bleeding needs medical assessment, particularly if there is a change in bowel habit or unexplained weight loss. Do not assume a previous diagnosis explains every new episode.
Do piles always need an operation?
No. Measures to keep stools soft and avoid straining, together with advice from a pharmacist or clinician, may help. If symptoms persist, a hospital procedure may be considered. An operation is one option, not the starting point for everyone.
Is rubber band treatment the same as a haemorrhoidectomy?
No. Rubber band ligation places a band around a haemorrhoid to cut off its blood supply. Haemorrhoidectomy removes haemorrhoidal tissue surgically. They are different treatments with different suitability and aftercare; a clinician should explain which options fit the findings.
Can piles come back after treatment?
Yes. Treatment does not always prevent recurrence. Discuss what improvement to expect, the possibility of further treatment and how bowel habits may affect symptoms. After a procedure, follow your team's advice about pain relief, bowel care and review.
When do bleeding or painful piles need urgent help?
NHS advice is to go to A&E or call 999 for bleeding that does not stop, a large amount of blood or large clots, or severe pain. A high temperature with feeling unwell or pus leaking from the area needs urgent GP or NHS 111 advice. Do not wait for a routine consultation.
Patient information and guides
These leaflets provide general information and do not replace individual medical advice. Follow the instructions of your clinical team for your own care.
Haemorrhoidectomy (PDF, 5 pages)
Patient information about haemorrhoids and surgery to remove them.
Transanal haemorrhoidal dearterialisation (THD) (PDF, 6 pages)
Patient information about haemorrhoids and the THD procedure.
Sources & further reading
This guide provides general information, not an individual diagnosis or treatment plan. Your clinical team will advise what is appropriate for you.