Piles, also known as haemorrhoids, are swollen and inflamed veins around your anus or in your anal canal.
Piles are round swellings on the inside of or just outside your anal canal. The anal canal is the short, muscular tube that connects your rectum (back passage) with your anus. Piles develop in areas known as the haemorrhoidal cushions, which can become swollen, often as a result of straining when you go to the toilet.
You can get piles at any age, but they are most common in people aged between 45 and 65. It’s difficult to know exactly how many people get piles, but in the UK the condition is thought to affect between four and 25 people in every 100. Piles aren’t cancerous and you can’t catch them from someone else.
Piles are common during pregnancy. They develop as a result of changes in the hormones (chemicals) in your body and the increased pressure in your abdomen (tummy. They usually get better once your baby is born.
Internal piles develop inside your anal canal, but they can hang down outside your anus. Internal piles can be graded according to how far they protrude, if at all, from your anus.
External piles are swellings that develop further down your anal canal, closer to your anus. They can be more painful than internal types of piles.
Common symptoms of piles include:
These symptoms may be caused by problems other than piles. If you have any of these symptoms, see your GP for advice.
Piles develop when the veins in your anal canal become swollen. This can happen for a number of reasons, including:
It isn’t true that you can get piles by sitting on cold, hard surfaces.
Your GP will ask about your symptoms and examine you. He or she is likely to examine your rectum by gently inserting a gloved finger into your anus. Your GP may also use a proctoscope to look inside your rectum. A proctoscope is a short, narrow, tube-like instrument with a light source. Air can be blown through the tube to open up your bowel so it can be seen more clearly. This test should not be painful but it may be uncomfortable and make you feel as though you want to have a bowel movement.
Piles are often mild and get better with simple lifestyle changes. There are a number of things that you can do to help to relieve the symptoms.
Diet and lifestyle changes can often help to relieve your symptoms. For example, eating a high-fibre diet will make your stools softer and easier to pass. This is important for reducing the increased pressure on the veins in your anus caused by straining when you have a bowel movement. Drink enough fluids to keep hydrated and don’t have too much caffeine.
Try not to strain when you’re passing a bowel movement and gently clean around your anus with baby wipes afterwards. Regular warm baths may relieve any irritation and help to keep your anal area clean. See our frequently asked questions for more information.
If you still have symptoms after about seven to 10 days despite using self-help measures, you may wish to consider taking a medicine or seeing your GP for advice.
There are a range of medicines that can help relieve the symptoms of piles.
Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your GP or pharmacist for advice. See our frequently asked questions for more information.
It’s important to be aware that it can take several weeks for some of these medicines to have an effect. If after this time your symptoms haven’t improved and are troublesome, or your haemorrhoids are severe, your GP may refer you to see a specialist for treatment.
There are certain treatments that you will need to go into hospital for, but you won't have to stay overnight. These include the following.
Surgical treatments for piles are an option if you have severe piles and other treatments haven't worked. There are different types of surgery, including haemorrhoidectomy or stapled haemorrhoidopexy. The type that is recommended for you will depend on the size and number of piles you have.
If you have daily bowel movements that are solid but soft and you don't need to strain, faeces will pass easily and won't put pressure on the veins in your anal area. This can help to prevent piles.
The following lifestyle measures can help to keep your bowel movements soft and prevent constipation, and therefore piles.
Reviewed by Polly Kerr, Bupa Health Information Team, June 2013.
For answers to frequently asked questions on this topic, see FAQs.
For sources and links to further information, see Resources.
This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.