Haemorrhoids (Piles): 5 Common Signs and When to See a Doctor

Haemorrhoids (Piles): 5 Common Signs and When to See a Doctor

Hemorrhoids, commonly known as piles, are swollen veins in the lower rectum and anus. They are incredibly common—affecting nearly 75% of adults at some point in their lives.

Whistl they can be uncomfortable and distressing, most cases can be managed with simple lifestyle changes or minimally invasive treatments.

To understand piles, think of them like “varicose veins” of the bottom. They are classified as internal (inside the rectum) or external (under the skin around the anus).

5 Common Signs of Piles

Recognizing the symptoms early can help you avoid more invasive procedures later.

1. Painless Bleeding During Bowel Movements: You might notice small amounts of bright red blood on the toilet tissue or in the bowl. This is often the first sign of internal piles.

2. Itching or Irritation: The anal region may feel chronically itchy (pruritus ani). This is often caused by mucus discharge from internal piles or difficulty cleaning the area properly.

3. Pain or Discomfort: While internal piles are usually painless, external piles or a thrombosed haemorrhoid (a blood clot within the pile) can cause sharp, severe pain and swelling.

4. A Lump Near the Anus: You may feel a sensitive or painful lump near the anal opening. These can sometimes “prolapse” (push through the opening) during a bowel movement.

5. Swelling and Inflammation: The area around the anus may feel tender, swollen, or “full,” even after you have finished using the bathroom.

What Causes Piles?

Piles develop when there is increased pressure in the lower rectum. Common triggers include:

• Straining during bowel movements: This is the #1 cause, often linked to a low-fiber diet.

• Chronic constipation or diarrhoea: Frequent “heavy lifting” by the rectal muscles.

• Pregnancy: The weight of the baby and hormonal changes increase pressure on pelvic veins.

• Sitting for long periods: Especially sitting on the toilet for a long time (put the phone away!).

• Aging: The tissues that support the veins in your rectum and anus can weaken and stretch over time.

Treatment Options in 2026

Treatment has evolved to be faster and less painful than in previous decades.

Home Remedies (The “First Line”)

• High-Fibre Diet: Aim for 25–35 grams of fiber daily to soften stools.

• Sitz Baths: Soaking the area in warm water for 10–15 minutes, two to three times a day.

• Topical Treatments: Over-the-counter creams containing hydrocortisone or witch hazel.

Medical Procedures

If home care doesn’t work, your doctor may suggest:

• Rubber Band Ligation: A small band is placed around the base of an internal pile to cut off circulation.

• Sclerotherapy: A chemical solution is injected to shrink the haemorrhoid.

• Laser Therapy (LHP): A modern, precise way to shrink piles with minimal recovery time.

• Haemorrhoidectomy: Surgery to remove severe or recurring piles.

When to See a Doctor

While piles are rarely “dangerous,” they share symptoms with more serious conditions like colorectal cancer or IBD.

Schedule a GP Appointment If:

• Your symptoms do not improve after one week of home treatment.
• You are experiencing chronic constipation despite increasing fiber.
• You are over the age of 45 and experiencing rectal bleeding for the first time.

Seek Emergency Care If:

• You experience excessive rectal bleeding or lightheadedness.
• You have a “thrombosed” external pile (a hard, purple, intensely painful lump) that requires immediate draining.
• You have a fever or pus-like discharge, which could indicate an abscess.