Haemorrhoids (piles) often clear up by themselves after a few days. But there are many treatments that can reduce itching and discomfort.
Making simple dietary changes and not straining on the toilet are often recommended first. Creams, ointments and suppositories, which you insert into your bottom, are available from pharmacies without a prescription. They can be used to relieve any swelling and discomfort.
Dietary changes and self care
If constipation is thought to be the cause of your haemorrhoids, you need to keep your stools soft and regular so you don't strain when going to the toilet.
You can do this by increasing the amount of fibre in your diet. Good sources of fibre include wholegrain bread, cereal, fruit and vegetables.
You should also drink plenty of water and avoid caffeine.
Although most haemorrhoids can be treated using non-surgical methods, around 1 in every 10 people will eventually need surgery.
Surgery is particularly useful for haemorrhoids that protrude out from the anal canal – unlike non-surgical treatments, an anaesthetic is used to ensure you don't feel any pain. There are many different types of surgery that can be used to treat haemorrhoids, but they all usually involve either removing the haemorrhoids or reducing their blood supply, causing them to shrink. Ask your surgeon for further information about the options available.
Over-the-counter topical treatments
Various creams, ointments and suppositories are available from pharmacies without a prescription. They can be used to relieve any swelling and discomfort. These medicines should only be used for 5 to 7 days at a time. They may irritate the sensitive skin around your anus if you use them longer than this. Any medication should be combined with the diet and self care advice discussed above. There's no evidence to suggest that one method is more effective than another.
Ask your pharmacist for advice about which product is most suitable for you, and always read the patient information leaflet that comes with your medicine before using it. Don't use more than one product at once.
If you have severe inflammation in and around your back passage, your GP may prescribe corticosteroid cream which contains steroids. You shouldn't use corticosteroid cream for more than a week at a time as it can make the skin around your anus thinner and the irritation worse.
Common painkilling medication, such as paracetamol, can help relieve the pain of haemorrhoids. But if you have excessive bleeding, avoid using non-steroid anti-inflammatory drugs (NSAIDs), such as ibuprofen, as they can make rectal bleeding worse. You should also avoid using codeine painkillers as they can cause constipation. Your GP may prescribe products that contain local anaesthetic to treat painful haemorrhoids. Like over-the-counter topical treatments, these should only be used for a few days because they can make the skin around your back passage more sensitive.
If you're constipated, your GP may prescribe a laxative. Laxatives are a type of medicine that can help you empty your bowels.
If dietary changes and medication don't improve your symptoms, your GP may refer you to a specialist.
They can confirm whether you have haemorrhoids and recommend appropriate treatment.
Banding involves placing a very tight elastic band around the base of your haemorrhoids to cut off their blood supply.
This involves the insertion of a very short telescope (proctoscope) into your anal canal and a suction device is then used to apply the bands. The procedure normally takes less than 5 minutes. The haemorrhoids should then fall off within about a week of having the treatment.
Banding is usually a day procedure that doesn't need an anaesthetic, and most people can get back to their normal activities the next day.
You may feel a bit light-headed initially but this normally only lasts 30 mins to an hour. Pain or discomfort can last for a few days afterwards. Normal painkillers are usually adequate, but your GP can prescribe something stronger if needed.
You may not realise that your haemorrhoids have fallen off, as they should pass out of your body when you go to the toilet. If you notice some mucus discharge within a week of the procedure, it usually means that the haemorrhoids have fallen off.
Directly after the procedure, you may notice blood on the toilet paper after going to the toilet. This is normal, but there shouldn't be a lot of bleeding. If you pass a lot of bright red blood or blood clots, go to your nearest accident and emergency (A&E) department immediately.