This section contains answers to frequently asked questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.
Itching is often a symptom of piles. It can happen if your piles are internal or external, but each type has a different underlying cause.
Your rectum is lined with a thin film called the rectal mucosa. It produces mucus to keep the area lubricated and to help faeces pass through your anus. Internal piles can cause the rectal mucosa to slip down out of place. The mucus then passes onto the skin around your anus causing it to become irritated and itchy. If this happens, you may also experience soiling, which may increase the itching.
If you have external piles, the itching may be caused by skin tags, which can develop as a result of piles. These can hold moisture around the skin of your anus, which irritates the area. Skin tags can also make it difficult to clean yourself properly after you have had a bowel movement, which can lead to further itching and discomfort.
There are many different creams, ointments and suppositories that may help to ease any pain and itchiness. Some contain a local anaesthetic such as lidocaine. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your GP or pharmacist for advice.
It's important to remember that although these treatments may give you short-term relief from your symptoms, they won’t treat or cure your piles.
No, skin tags aren’t the same as piles but you may have them if you get piles. Anal skin tags are folds of skin that develop in your anal area, sometimes as a result of an underlying condition.
Skin tags are common and you may develop them if you get external piles. External piles are swellings that develop on the outside edge of your anus. Blood clots can sometimes form in external piles and this will stretch your skin over the area. As an external pile heals it will gradually shrink and leave behind a small skin tag made up of the excess skin.
You can get skin tags without having piles, and they are sometimes associated with other anal conditions, such as inflammatory bowel disease or an anal fissure (a small tear in the skin lining your anus). You may develop a type of skin tag called a sentinel tag if you have an anal fissure.
Skin tags can make it difficult to clean yourself after you have a bowel movement, which can lead to itching, discomfort and sometimes infection. Usually you won’t need any treatment for skin tags, but if they are causing severe problems or discomfort, you may be able to have an operation to remove them.
A number of natural and herbal remedies have been suggested as treatments for piles, including traditional Chinese or Indian medicine and homeopathic treatments. However, in general there isn't enough evidence to show that they are effective. The best way to reduce your symptoms without taking conventional medicines is to eat a healthy diet with plenty of fibre, drink enough water and take care to clean yourself after every bowel movement.
You may have heard of sitz baths being recommended for piles. A sitz bath is when you sit in a bath or basin filled with warm water so that only your hips and buttocks are covered. It's thought that the warm water may encourage blood flow to the area and relax the sphincter muscle (which controls the opening and closing of your anus). This may help to relieve pain and itching. Sitz baths may also be helpful in keeping your anal area clean.
However, although sitz baths are often recommended, there is little evidence to show that they are effective. There is uncertainty over whether you should use warm or cold water and how long you should sit in it for.
Other remedies that have been suggested for piles include flavonoid supplements. Flavonoids are plant pigments found in some foods, including apples and onions. It's thought that flavonoids have an anti-inflammatory effect but there is little evidence to show that they work and they aren't licensed for use in the UK.
You may also have heard the herbal extract euphorbia prostrata suggested as a treatment for piles. Again, there is very little evidence to support its use and it’s not recommended for piles.
Speak to your GP if you’re thinking about using any herbal or homeopathic remedies. It’s important to remember that natural remedies aren’t necessarily harmless or safer than conventional medicines. They also won’t have been tested as thoroughly.
There is a range of different creams, ointments and suppositories for piles that you can buy over the counter from your pharmacy. However, it's important to remember that these treatments will only relieve your symptoms and they won't cure piles.
The aim of creams, ointments and suppositories is to soothe and relieve your symptoms. They all contain different ingredients, which work in different ways to reduce pain, swelling and itching.
It’s important not to use medicines that contain an anaesthetic, such as lidocaine, for longer than a few days as your skin can become sensitive to them. Don’t use medicines that contain corticosteroids for more than a week. If you use them for longer than this, they may damage your skin. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.
If you’re pregnant, ask your GP or midwife for advice about what medicines are safe for you to use.
Painkillers, such as paracetamol, may help to relieve any pain from piles. However, don't take painkillers that contain opioids, such as codeine, as they can cause constipation. Also, non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, aren't suitable if you’re bleeding from your rectum.
If your symptoms continue to get worse despite using medicines, or if you have any questions or concerns, see your GP.
It’s possible that piles may affect your sex life as they can make it painful or difficult, particularly if they are severe. They may also make you feel self-conscious. However, there is no medical reason why you can’t have sex if you have piles.
Piles can affect your sex life both emotionally and physically. It depends on how severe your piles are as to how much they will affect you.
If your piles are quite minor, they are very unlikely to interfere with sex. However, if you have more severe piles, especially if they hang down from your anus and you can't push them back inside, they may make you feel self-conscious and not want to have sex. If the piles become very swollen and painful, you may feel too much pain to have sex, particularly if you have anal sex, and this may be a good reason to get them treated.
If you have surgery to remove piles, it’s important to wait until the area has healed before you have sex. If you have any questions or concerns about having sex after an operation to remove piles, ask your GP or surgeon for advice.
Reviewed by Polly Kerr, Bupa Health Information, June 2013.
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