Haemorrhoids (Piles): Symptoms, Causes and Treatment

Last updated: 5 Nov 2026

Noticing bright red blood on the toilet paper, or feeling a small lump around your bottom, can be worrying and a little embarrassing to talk about. Very often the cause is haemorrhoids, also called piles. They are common, especially as we get older, and many people find their symptoms settle with simple changes at home.[1][2] Bleeding from the back passage can also have other causes, though, so it's worth knowing which symptoms are typical of piles and which ones need a doctor's review. This guide explains piles symptoms, causes, self-care and the haemorrhoids treatment options a doctor may discuss.

What are haemorrhoids?

Haemorrhoids are swollen blood vessels in and around the anus and lower rectum. Everyone has these vessel cushions; they only cause trouble when they become swollen or stretched.[2][3] There are two main types:[2]

Internal haemorrhoids form inside the rectum. You usually can't see or feel them, and they are often painless, but they can bleed. Sometimes they are pushed out through the anus when you strain, which is called a prolapsed haemorrhoid.
External haemorrhoids form under the skin around the anus. They can itch or ache, and if a blood clot forms inside one, it can suddenly become a painful, hard lump.

Haemorrhoids are very common. In the US, about half of adults older than 50 have them.[2]

Common piles symptoms

Not everyone with haemorrhoids has symptoms. When they do appear, the common ones are:[1][3][6]

bright red blood after you poo, on the toilet paper or in the toilet bowl
an itchy or irritated anus
a lump in or around the anus
pain or discomfort, especially when sitting or passing a stool
mucus in your underwear or on the toilet paper
a feeling that you still need to poo after you've been.

Piles that bleed are often painless. Sharp pain while passing a stool, with a little bright red blood, can instead point to an anal fissure, a small tear in the skin of the anus.[1][7]

What causes haemorrhoids?

Piles develop when pressure on the veins around the anus and rectum increases. Common causes and risk factors include:[1][3][6]

constipation and straining on the toilet
sitting on the toilet for a long time
ongoing diarrhoea
pregnancy
being overweight
regularly lifting heavy objects
getting older, as the tissues supporting the veins weaken
a family history of piles, and long periods of standing or sitting.

Because constipation and straining are such common triggers, keeping stools soft is the main way to ease and prevent haemorrhoids.[1][8]

Looking after piles at home

Many people find these steps help their symptoms settle:[1][5][8]

Eat more fibre, such as fruit, vegetables, wholegrains, beans and lentils, and add it gradually to limit wind and bloating.
Drink plenty of fluids, especially water, to keep stools soft.
Don't strain, and don't stay on the toilet longer than you need to. Go when you feel the urge rather than holding it in.
Keep the area clean: take a warm bath to ease itching and pain, and pat the area dry instead of rubbing.
Stay active, which helps keep your bowels moving.
Ask a pharmacist about creams, ointments or suppositories to ease pain, itching and swelling, and about laxatives for constipation. Check with a pharmacist or doctor before using these if you're pregnant or have other conditions.
Avoid painkillers that contain codeine, which can cause constipation, and don't take ibuprofen if your piles are bleeding.

Haemorrhoids treatment by a doctor

If piles keep bleeding, keep coming back or don't get better with self-care, a doctor may suggest further treatment. Options depend on the type and size of the haemorrhoids and on your symptoms.[1][5]

Treatments without an operation

For internal haemorrhoids, a doctor may offer a procedure that shrinks or removes them without an operation. Examples include:[1][5]

rubber band ligation (banding), where a tight band is placed around the base of the haemorrhoid to cut off its blood supply so it falls off
sclerotherapy, an injection that makes the haemorrhoid shrink
infrared coagulation or electrotherapy, which use heat or a mild electric current to shrink it.

Surgery

Surgery may be considered if other treatments haven't helped or the haemorrhoids are large or prolapsed. It is usually carried out by a surgeon. Operations include removing the haemorrhoids (haemorrhoidectomy), stapled haemorrhoidopexy and haemorrhoidal artery ligation, which reduces their blood supply.[1][5]

Your doctor can explain which option, if any, suits you, along with the possible benefits and risks. Questions about procedures or practical arrangements can be raised at a consultation; you can contact the clinic or request an appointment.

How piles are diagnosed

A doctor will usually ask about your symptoms and bowel habits, check your medical and family history, and look at the area around the anus. They may also carry out a digital rectal examination, gently feeling inside the rectum with a gloved finger, and may look inside with a short, lighted tube (anoscopy or proctoscopy).[4]

Because bleeding from the back passage can also be caused by conditions such as inflammatory bowel disease or colorectal cancer, your doctor may suggest a colonoscopy or sigmoidoscopy to look further along the bowel, particularly if you have other symptoms, a family history of bowel cancer or are older.[3][4] Our guides to colonoscopy and gastroscopy, colorectal cancer screening in Singapore and colon polyps and polypectomy explain these tests and conditions.

Piles and rectal bleeding: when to get checked

Bleeding is one of the most common piles symptoms, but it should not be assumed to be piles without a check, especially if it's new for you. See a doctor if:[1][6]

your symptoms are getting worse, aren't improving with self-care, or keep coming back
you have bleeding from the back passage that isn't clearly linked to passing a stool
you notice a change in your bowel habits or in the shape of your stools
you have unexplained weight loss or loss of appetite
you feel a hard lump around your anus
you have a high temperature, feel unwell, or notice pus from the area.

Some of these symptoms overlap with those of bowel cancer, which is why they need a doctor's review.[6] Our article on blood in stool explains other possible causes of bleeding and what a doctor looks for.

Get urgent medical help (call 995 or go to the nearest Emergency Department) if you have bleeding that won't stop, are passing a lot of blood or large clots, have severe pain, or feel faint or dizzy.[1][3]

Possible complications

Most haemorrhoids are not serious, but complications can occur. These include a blood clot in an external haemorrhoid, skin tags, infection, a strangulated haemorrhoid (where the blood supply to a prolapsed haemorrhoid is cut off, causing severe pain) and, rarely, anaemia from long-term blood loss.[3]

Frequently asked questions

Are piles the same as haemorrhoids?

Yes. Piles is the everyday name for haemorrhoids, which are swollen blood vessels in and around the anus and lower rectum.[1][2]

What do piles symptoms usually feel like?

Common symptoms are bright red blood after passing a stool, itching, a lump around the anus, discomfort when sitting and mucus on the toilet paper. Internal piles are often painless.[1][3]

Do haemorrhoids go away on their own?

They often get better with self-care, such as more fibre and fluids, not straining and keeping the area clean. See a doctor if your symptoms don't improve, keep coming back or change.[1]

Is rectal bleeding always caused by piles?

No. Bleeding can also come from an anal fissure, inflammatory bowel disease, polyps or bowel cancer, so new or unexplained bleeding should be checked by a doctor.[3][6][7]

What haemorrhoids treatment options are there?

Self-care and pharmacy creams or laxatives help many people. If symptoms persist, a doctor may suggest procedures such as banding or injections, and surgery is considered for some people.[1][5]

Can I prevent piles?

Keeping stools soft with fibre and fluids, not straining or sitting on the toilet for long, staying active and avoiding regular heavy lifting can lower your risk.[3][8]

Sources

NHS. Piles (haemorrhoids). https://www.nhs.uk/conditions/piles-haemorrhoids/
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Definition & Facts of Hemorrhoids. https://www.niddk.nih.gov/health-information/digestive-diseases/hemorrhoids/definition-facts
NIDDK. Symptoms & Causes of Hemorrhoids. https://www.niddk.nih.gov/health-information/digestive-diseases/hemorrhoids/symptoms-causes
NIDDK. Diagnosis of Hemorrhoids. https://www.niddk.nih.gov/health-information/digestive-diseases/hemorrhoids/diagnosis
NIDDK. Treatment of Hemorrhoids. https://www.niddk.nih.gov/health-information/digestive-diseases/hemorrhoids/treatment
HealthHub (Ministry of Health, Singapore). Piles. https://www.healthhub.sg/health-conditions/piles
NHS. Anal fissure. https://www.nhs.uk/conditions/anal-fissure/
NIDDK. Eating, Diet, & Nutrition for Hemorrhoids. https://www.niddk.nih.gov/health-information/digestive-diseases/hemorrhoids/eating-diet-nutrition

Haemorrhoids (Piles): Symptoms, Causes and Treatment Options