Haemorrhoids, also called piles, are swollen blood vessels and supporting tissues in and around the anus. They are common and often improve within a few days, but they can cause bleeding, itching, discomfort or lumps around the anus.
Most cases can be managed with simple measures that help keep stools soft and reduce straining. Pharmacy treatments can also help with symptoms.
However, bleeding from the bottom should not automatically be assumed to be haemorrhoids. Persistent, heavy or unusual bleeding needs medical assessment.
What Are Haemorrhoids?
Haemorrhoids are swollen tissues containing blood vessels around the lower rectum and anus.
They can occur inside the anus or under the skin around the opening.
Some haemorrhoids cause no symptoms at all. When they do cause problems, the symptoms can vary depending on their size and position.
What Do Haemorrhoids Feel Like?
Common symptoms include:
- bright red blood after passing stool
- itching around the anus
- pain or discomfort
- a lump or swelling around the anus
- a feeling that you still need to empty your bowel after going to the toilet
- mucus on toilet paper or in your underwear
Bleeding is often bright red and may appear on toilet paper, on the outside of the stool or in the toilet bowl.
Although these symptoms are common with haemorrhoids, other conditions can cause similar symptoms. Do not assume that every episode of rectal bleeding is caused by piles.
What Causes Haemorrhoids?
There is not always one obvious cause.
Several things can make haemorrhoids more likely, including:
- constipation
- repeatedly straining when passing stool
- spending a long time on the toilet
- pregnancy
- getting older
- being overweight
- heavy lifting
Anything that increases pressure around the veins and tissues of the lower rectum and anus may contribute.
The good news is that many of the factors you can influence are related to keeping bowel movements regular and avoiding unnecessary straining.
What Can You Do at Home?
Small or uncomplicated haemorrhoids often settle with self-care.
Keep Your Stools Soft
One of the most useful things you can do is make bowel movements easier to pass.
Aim to drink plenty of fluids and eat enough fibre. Fibre is found in foods such as vegetables, fruit, beans, pulses, wholegrains, nuts and seeds.
Increasing fibre gradually can help if your current diet is low in fibre.
If constipation is a problem, a pharmacist can also advise you about a suitable laxative or stool-softening treatment.
Don’t Strain
Try not to push hard when you are on the toilet.
Ignoring the urge to have a bowel movement can also make constipation worse, so go when your body tells you it is time.
Avoid sitting on the toilet for longer than necessary. Taking your phone with you and settling in for a long session is not a great habit for haemorrhoids.
Keep the Area Clean and Dry
Gently clean the area after a bowel movement and pat it dry rather than rubbing.
Avoid heavily fragranced soaps or other products that may irritate sensitive skin.
A warm bath can also help relieve itching and discomfort.
Try a Cold Pack
For swelling and discomfort, an ice pack or cold pack wrapped in a towel can provide temporary relief.
Never place ice directly against your skin.
Take Suitable Pain Relief
Paracetamol may help with pain.
The NHS advises avoiding painkillers containing codeine because they can cause constipation. It also advises not taking ibuprofen if your haemorrhoids are bleeding.
Can a Pharmacist Help?
Yes.
A pharmacist can recommend treatments for haemorrhoid symptoms and can help you decide whether you should see a GP.
Depending on your symptoms, they may suggest:
- creams or ointments to reduce pain, itching or swelling
- suppositories for some internal haemorrhoids
- treatments to help with constipation and soften stools
- cold packs or other measures for discomfort
Many pharmacies have a private consultation area if you would rather discuss the problem away from the main counter.
What About Haemorrhoid Creams?
Over-the-counter creams and ointments can help relieve symptoms, but they do not necessarily remove the underlying cause.
Different products are designed for different symptoms, so ask a pharmacist which treatment is appropriate for you.
Do not assume that a product is better simply because it is labelled natural.
There is also no good reason to treat haemorrhoids with kitchen ingredients such as coconut oil when better-established options are available.
What About Bleeding?
Bright red bleeding after a bowel movement is a common symptom of haemorrhoids.
However, rectal bleeding has many possible causes, including anal fissures, bowel conditions and, less commonly, bowel cancer.
That means you should not automatically diagnose yourself with haemorrhoids simply because you notice blood.
Speak to a GP if you have bleeding from the bottom, especially if the bleeding persists, keeps returning or is accompanied by other symptoms.
When Should You See a Doctor?
Make an appointment with your GP if:
- your symptoms are getting worse
- there is no improvement after treating the problem at home
- you keep getting haemorrhoids
- you notice a change around your anus that is unusual for you
- you have rectal bleeding and are worried about it
Your doctor may examine the area and may recommend stronger medication, treatment for constipation or further investigations if necessary.
There is no reason to feel embarrassed. Haemorrhoids are common and healthcare professionals are used to discussing them.
When Is Urgent Help Needed?
Seek urgent medical advice if you have haemorrhoid symptoms together with a very high temperature, feel hot, cold or shivery and generally unwell, have painless bleeding from the bottom, or notice pus coming from the affected area.
Go to an emergency department or seek emergency help if:
- bleeding will not stop
- there is a large amount of blood
- you see large blood clots
- you are in severe pain
Heavy or persistent rectal bleeding should never simply be put down to haemorrhoids.
What Treatments Are Available if Haemorrhoids Don’t Improve?
Most haemorrhoids do not need an operation.
If symptoms persist despite self-care and other treatments, a doctor may discuss procedures that treat the haemorrhoid directly.
Depending on the type and severity, treatments can include:
Rubber Band Ligation
A small band is placed around an internal haemorrhoid to cut off its blood supply. The haemorrhoid then shrinks and eventually falls away.
This is a commonly used treatment for suitable internal haemorrhoids.
Sclerotherapy
A solution is injected into the haemorrhoid to help it shrink.
Electrotherapy or Infrared Treatment
Some haemorrhoids can be treated by applying a controlled source of heat or electrical energy to reduce their blood supply and make them shrink.
Surgery
Large or persistent haemorrhoids may sometimes require surgery.
Options can include haemorrhoidectomy, stapled haemorrhoidopexy or haemorrhoidal artery ligation.
Your doctor or specialist will advise which approach is appropriate for your particular situation.
How Can You Help Prevent Haemorrhoids Coming Back?
There is no way to guarantee that haemorrhoids will never return, but reducing constipation and straining can lower the risk of recurrence.
Useful habits include:
- eat enough fibre
- drink plenty of fluids
- stay physically active
- go to the toilet when you need to
- avoid straining
- don’t spend longer than necessary on the toilet
- work towards a healthy weight if appropriate
These habits are also useful for general digestive and cardiovascular health.
Are Natural Remedies Worth Trying?
The internet contains countless claims about natural cures for haemorrhoids.
You will find recommendations for oils, herbs, supplements and homemade treatments.
Some may provide a feeling of temporary comfort, but that does not mean they have been shown to treat haemorrhoids or prevent complications.
Be especially cautious about products that promise to make haemorrhoids disappear quickly or claim that a single ingredient can cure them.
For a common problem such as haemorrhoids, sensible bowel habits and established treatments are usually a better starting point than experimenting with unproven remedies.
The Bottom Line (No that is not a pun)
Haemorrhoids are common and, in many cases, temporary.
The most useful first steps are surprisingly simple:
Keep your stools soft.
Eat enough fibre.
Drink plenty of fluids.
Avoid straining.
Don’t spend unnecessary time on the toilet.
Use appropriate pharmacy treatments when needed.
And remember that rectal bleeding should not automatically be blamed on piles.
If symptoms persist, keep returning, become severe or seem unusual, get medical advice.
There is nothing embarrassing about asking for help. Haemorrhoids are common, and getting the right diagnosis is much more important than suffering in silence.
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Medical Disclaimer
This article is for general educational purposes and is not a substitute for personalised medical advice, diagnosis or treatment. If you have rectal bleeding, severe pain, persistent symptoms or any concern about your health, speak with an appropriately qualified healthcare professional.