Haemorrhoids
Sources consulted
This article is original patient-education content.
- WHO—Health topics A–Z(2024)
- NHS—Health A to Z(2024)
- CDC—Health topics(2024)
Based on international clinical guidelines
Overview
Haemorrhoids, also called piles, are swollen blood vessels inside or around the bottom (anus). They can cause discomfort, itching, and bleeding, but they are usually not serious.
Key facts
- Haemorrhoids are very common, especially in adults over 50.
- They are often caused by straining during bowel movements or chronic constipation.
- Most cases improve with simple home care, such as eating more fibre and drinking plenty of water.
Yes, haemorrhoids are one of the most common reasons people visit a doctor for bowel-related problems. About 3 in 4 adults will experience them at some point.
Haemorrhoids can affect people of all ages, but they are more common in adults over 50, pregnant women, and people with a family history of haemorrhoids or chronic constipation.
Symptoms
- Passing a large amount of blood from the rectum (more than a few streaks)
- Feeling faint, dizzy, or weak when you have rectal bleeding
- Severe pain in the anal area that does not go away
- ⚠Rectal bleeding that lasts for more than a day or two
- ⚠A change in your bowel habits that you cannot explain
- ⚠A lump near the anus that does not go back inside after a bowel movement
- ⚠Fever along with swelling or pain in the anal area
Common symptoms
- Itching or irritation around the anus
- Pain or discomfort, especially when sitting
- Bright red blood on toilet paper or in the toilet bowl after a bowel movement
- A lump near the anus that may be sensitive or painful
- Swelling around the anus
- Leakage of stool (faeces)
Symptoms in children
- Haemorrhoids are rare in children but can occur with severe constipation. Symptoms may include pain during bowel movements, blood-streaked stool, or a small lump outside the anus. If you notice these, consult your child's doctor.
Symptoms in older adults
- In older adults, haemorrhoids are more common due to weaker tissues and chronic constipation. Symptoms are similar but may include more frequent rectal bleeding or a prolapsed haemorrhoid (one that sticks out). Always get any rectal bleeding checked by a doctor, as it can have other causes.
Causes
Main causes
- Straining during bowel movements
- Sitting on the toilet for long periods
- Chronic constipation or diarrhoea
- Being overweight or obese
- Pregnancy (due to increased pressure on the veins)
- A low-fibre diet
- Heavy lifting or other activities that increase pressure in the abdomen
Risk factors
- Age over 50
- Family history of haemorrhoids
- Obesity
- Pregnancy and childbirth
- Chronic constipation
- Prolonged sitting (e.g., desk jobs)
- Anal intercourse
- Cirrhosis of the liver (causes increased pressure in the veins around the anus)
When to see a doctor
See a doctor urgently if:
- Heavy rectal bleeding
- Severe pain that does not go away
- Dizziness or fainting along with bleeding
- A lump that is extremely painful (possible thrombosis)
Book a routine appointment if:
- Rectal bleeding for more than a few days (even if just a small amount)
- Itching or discomfort that does not improve with home care after a week
- A lump near the anus that concerns you or does not go away
- A change in your bowel habits that lasts more than a few weeks
Diagnosis
A doctor will usually diagnose haemorrhoids by asking about your symptoms and performing a physical exam. This may include a digital rectal exam (gently feeling inside the back passage with a gloved finger).
Tests that may be done
- Anoscopy (a small, lighted tube to look inside the anal canal)
- Sigmoidoscopy (a flexible tube with a camera to examine the lower part of the bowel)
- Colonoscopy (a longer tube to examine the entire colon) – especially if there is bleeding or other concerns
What to expect at your appointment
The examinations are quick and usually cause only mild discomfort. Your doctor will explain each step. In most cases, no special preparation is needed, but for a colonoscopy you may need to follow a specific diet and take laxatives beforehand.
Treatment
Treatment focuses on relieving symptoms and preventing haemorrhoids from getting worse. Many cases improve with self-care alone. If symptoms persist, there are several medical treatments available. Surgery is rarely needed.
Self-care at home
- Eat more high-fibre foods (fruits, vegetables, whole grains) to soften stools
- Drink plenty of water (6-8 glasses a day)
- Avoid straining during bowel movements
- Use moist wipes (alcohol-free) instead of dry toilet paper
- Take warm baths (sitz baths) for 10-15 minutes a few times a day to soothe the area
- Apply ice packs wrapped in a cloth to reduce swelling
- Over-the-counter creams or suppositories (use short-term only, as directed on the pack)
- Try not to sit for long periods; take breaks to walk around
Medical treatments
If self-care is not enough, doctors may recommend procedures done in their office, such as rubber band ligation (placing a small band around the haemorrhoid to cut off its blood supply), sclerotherapy (injection of a chemical to shrink it), or infrared coagulation (using heat). These treatments are effective for many people. Always follow your doctor's advice about which option is best for you.
When is surgery considered?
Surgery (haemorrhoidectomy) is usually only considered for large, prolapsed, or thrombosed haemorrhoids that have not responded to other treatments. Your doctor will discuss the risks and benefits with you.
Living with this condition
Most people with haemorrhoids can manage them at home. Keep the area clean and dry. Avoid sitting for too long, especially on the toilet. If you have a flare-up, use warm baths and rest. Do not force a bowel movement – go only when you feel the urge.
Lifestyle tips
- Include plenty of fibre in your diet every day
- Stay well hydrated
- Exercise regularly (e.g., walking) to help keep your bowels regular
- Avoid heavy lifting if it causes straining
- Maintain a healthy weight
- Try not to delay bowel movements – go when you feel the urge
Diet and exercise
A high-fibre diet is key. Aim for 25–30 grams of fibre per day from foods like oats, beans, broccoli, apples, and wholemeal bread. Drink at least 6-8 glasses of water daily. Gentle exercise like brisk walking for 30 minutes most days can help prevent constipation. Avoid prolonged sitting or standing.
Mental health and emotional wellbeing
Haemorrhoids can be embarrassing or uncomfortable, but they are very common. Do not let embarrassment stop you from seeking help. Talking to a doctor can relieve anxiety. Stress can worsen constipation, so it is important to find relaxation techniques that work for you.
Prevention
Yes, in many cases haemorrhoids can be prevented by avoiding constipation and straining. Eat a high-fibre diet, drink plenty of fluids, exercise regularly, and go to the toilet as soon as you feel the urge. Avoid sitting on the toilet for more than a few minutes.
Complications
If left untreated
- Anaemia (low red blood cells) from chronic blood loss (rare)
- Strangulated haemorrhoid (blood supply to a prolapsed haemorrhoid is cut off, causing severe pain)
- Thrombosed haemorrhoid (a blood clot forms inside, causing sudden, intense pain and swelling)
- Infection in the surrounding area (uncommon)
Long-term outlook
The outlook is excellent. Most haemorrhoids get better with simple lifestyle changes and home care. If you need medical treatment, there are safe and effective options. Haemorrhoids do not lead to cancer, but always see a doctor to rule out other causes of bleeding. With proper management, you can keep symptoms under control and live a normal life.
Find support
International organisations
- International Foundation for Gastrointestinal Disorders (IFFGD) ↗
- World Gastroenterology Organisation (WGO) ↗
Local organisations
- NHS (UK) ↗ · United Kingdom
- Bowel Cancer UK (for information about rectal bleeding) ↗ · United Kingdom
Helplines
External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.
Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.