About the piles

Haemorrhoids (=piles) are the most common anal disease. Haemorrhoids are areas in the anal canal where tissue containing blood vessels have become stretched or swollen. This can occur due to increased pressure in the veins of the anus, as a result of childbirth, chronic constipation, obesity, diarrhoea, heavy lifting, family history or for no obvious reason at all. Haemorrhoids can be present in healthy individuals. When the normal vascular cushions within the anus cause symptoms, they are referred to as haemorrhoids. Haemorrhoids generally cause symptoms when they become enlarged, inflamed, thrombosed, or prolapsed. Symptomatic haemorrhoids are very common and one in two people in the UK will deal with them at some point in their lives.

The first step is to get the diagnosis

Internal piles

Internal haemorrhoids - these are not visible, but usually cause dull pain

  • Pain, bleeding, itching and anal discomfort are the most common symptoms.

  • Blood on the toilet paper after you have been on the toilet.

  • A lumpy feeling inside your back passage or protruding from your bottom.

If you experience any of these symptoms suggested to contact your GP or our Clinic. 

Thorough investigations are required to establish the proper diagnosis and rule out other conditions, including anal fissures, fistulas, polyps or rectal cancer.

The suggested treatment depends on the severity (Grade I-IV) of your piles, but could be the piles banding, injection or more advanced treatments (laser or RF ablation).

External piles

External haemorrhoids - a visible lump around your back passage. If not thrombosed, external haemorrhoids may cause few problems, these are the itching and irritating.  However, when thrombosed, haemorrhoids may be very painful. Nevertheless this pain typically resolves in 6 days. The swelling however may take a few weeks to disappear. A skin tag may remain after healing. If haemorrhoids are large and cause issues with hygiene, they may produce irritation of the surrounding skin and thus itchiness around the anus.

The suggested treatment is to perform an emergency anal thrombectomy, which is minor procedure, performed under local anaesthesia and could cause quick symptom resolution. It is the recommended to perform this procedure within 96 hours.

Other symptoms

Anal fissure or rectal fissure is a break or tear in the skin of the anal canal. Anal fissures may be noticed by bright red anal bleeding on toilet paper, sometimes in the toilet. If acute they may usually cause sharp pain during and after defecation.

Fistula is a painful lump around the anus, associated with redness and sometimes with purulent discharge. Usually the patient has high temperature, fever and chills. Requires and operation and further assessment of the area to check the underlying condition. 

Neoplasia is a change in bowel habits, a lump near the anus, rectal bleeding, itching or discharge. If you experience these symptoms, you need to see your GP or a specialist, who will examine you and decide about the further course of action.