Piles (haemorrhoids) are swollen blood vessels inside or around the anus. They often cause bright red blood after a bowel movement, itching, discomfort or a lump around the anus. Most piles improve within days with more fibre, more fluids and not straining. Bleeding from the bottom should still be checked by a health worker, because other conditions, including bowel cancer, can cause similar symptoms.
Symptoms
- Bright red blood on toilet paper or in the toilet after passing stool
- Itchy bottom
- A lump hanging outside the anus that may need pushing back
- Mucus in underwear or on paper
- Feeling that you still need to pass stool after going
- Pain, especially if a clot forms in an external pile (thrombosed haemorrhoid)
Common causes
- Constipation and straining
- Low-fibre diet and low fluid intake
- Pregnancy
- Sitting on the toilet for long periods (including scrolling on your phone)
- Heavy lifting and long periods of standing or sitting
- Obesity
- Persistent diarrhoea
Home treatment
- Fibre: fruits, vegetables, beans, oats, whole grains; increase gradually
- Fluids: plenty of water
- Don’t strain and don’t delay going when you need to
- Limit toilet time to a few minutes
- Warm sitz baths for 10–15 minutes can soothe
- Keep the area clean and dry; use moist unscented wipes or water
- Pharmacy creams or suppositories can ease pain and itching (steroid creams for a short time only)
- Pain relief: paracetamol; avoid codeine, which causes constipation
Medical treatments
If piles don’t improve, a healthcare provider may offer banding (rubber band ligation), sclerotherapy, or surgery (haemorrhoidectomy or stapled procedures) for large or persistent piles.
Piles in pregnancy
Piles are common in pregnancy due to pressure and constipation. Fibre, fluids and gentle activity help. Ask a midwife or healthcare provider before using any cream.
Red flags: see a healthcare provider
- Dark red or black stool, or blood mixed in the stool
- Change in bowel habit lasting more than 3 weeks
- Unexplained weight loss or tiredness
- Heavy bleeding or feeling faint
- Severe pain or a pile that won’t go back in
- Age over 50 with new rectal bleeding
- Family history of bowel cancer
Frequently asked questions
Can piles go away on their own?
Yes, small piles often settle in a few days with fibre, fluids and avoiding straining.
Is “pile” caused by sitting on hot surfaces or eating sweet food?
These are common myths. Piles are mainly linked to constipation, straining and pressure.
Related reading: Constipation assessment and laxatives · Common pregnancy complaints
Checked against NHS guidance on piles. Updated 5 November 2026.
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