Haemorrhoids, also known as piles, are swellings that contain enlarged blood vessels that are found inside or around the bottom (the rectum and anus).

Most haemorrhoids are mild and sometimes don't even cause symptoms. When there are symptoms, these usually include: 

• bleeding after passing a stool (the blood will be bright red)
• itchy bottom 
• a lump hanging down outside of the anus, which may need to be pushed back in after passing a stool

Read more about the symptoms of haemorrhoids.

Should I see my GP?

The symptoms of haemorrhoids often clear up on their own or with simple treatments that can be bought from a pharmacy without a prescription (see below). However, you should speak to your GP if your symptoms don't get better, or if you experience pain or bleeding.

Haemorrhoids can be easily diagnosed by a simple internal examination of your back passage.

Some people with haemorrhoids are reluctant to see their GP. However, there’s no need to be embarrassed – all GPs are used to diagnosing and treating haemorrhoids.

Read more about diagnosing haemorrhoids.

What causes piles?

The exact cause of haemorrhoids is unclear, although they are associated with increased pressure in the blood vessels in and around your anus.

Most cases are thought to be caused by excessive straining on the toilet, due to prolonged constipation, often resulting from a lack of fibre in your diet.

Things that can increase your risk of haemorrhoids include:

• being overweight
• being over the age of 45
• being pregnant (read more about piles in pregnancy)
• having a family history of haemorrhoids

Read more about the causes of haemorrhoids.

Preventing and treating piles

Haemorrhoid symptoms often settle down after a few days without treatment. Haemorrhoids that occur due to pregnancy usually get better after you give birth.

However, making lifestyle changes to reduce the strain on the blood vessels in and around your anus is often recommended. These can include:

• gradually increasing the amount of fibre in your diet – good sources of fibre include fruit, vegetables, wholegrain rice, wholewheat pasta and bread, seeds, nuts and oats
• drinking plenty of fluid, particularly water, but avoiding or cutting down on caffeine and alcohol
• not delaying going to the toilet – ignoring the urge to empty your bowels can make your stools harder and drier, which can lead to straining when you do go to the toilet
• avoiding medication that causes constipation – such as painkillers that contain codeine
• losing weight if you are overweight
• exercising regularly – this can help prevent constipation, reduce your blood pressure and help you lose weight

These measures can also reduce the risk of haemorrhoids returning, or even developing in the first place.

Medication that you apply directly to your back passage (topical treatments) or tablets bought from a pharmacy or prescribed by your GP may ease your symptoms and make it easier for you to pass stools.

If your haemorrhoid symptoms are more severe, there are a number of treatment options available. For example, banding is a non-surgical procedure where a very tight elastic band is put around the base of the haemorrhoid to cut off its blood supply. The haemorrhoid should fall off after about a week.

Surgery under general anaesthetic (where you are asleep) is sometimes used to remove or shrink large or external haemorrhoids.

Read more about treating haemorrhoids and surgery for haemorrhoids.