The Aword

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Haemorrhoids (piles) are enlarged and engorged blood vessels in the anal
canal, which may prolapse out of the anus.

Causes include pregnancy, chronic constipation (due to straining), obesity
and less commonly, liver disease, rarely a mass in the abdomen.

About half of the UK population will suffer from piles at some time in their
life. The prevalence increases with age.

Haemorrhoids are classified as

  • first degree (bleed),
  • second degree (bleed and prolapse)
  • third degree (bleed, prolapse and require manual reduction),
  • fourth degree (bleed, incarcerate and cannot be reduced).


  • Bleeding: bright red streaks on stool or toilet paper
  • Anal itching or pain. Thrombosed haemorrhoids are extremely tender
  • Mucous discharge or a sense of rectal fullness or discomfort


  • Avoid constipation/ straining on the toilet: high fibre diet and plenty of fluids (at least 12 cups/8 glasses a day
  • Lose weight if necessary
  • Soothing creams/ointments/suppositories may ease discomfort and can be used as often as needed. (most of these are available over the counter at pharmacies.)
  • Anaesthetic creams/ointments/suppositories may ease the burning/itching pain but should be used only for short periods at a time (5-7 days). They may irritate or sensitise the skin around the anus.
  • Steroid containing creams/ointments/suppositories may help reduce inflammation and therefore ease pain but should be only used for 1-2 weeks at a time. They can only be used provided that any infection has been excluded.
  • An ice pack (or bag of frozen peas) pressed on for 15-30 minutes may help if the pile is very painful.  

Thrombosed haemorrhoids (with a blood clot)

  • Pain relief, bed rest and cold compresses (e.g. bag of frozen peas) may help relieve symptoms. Incision and drainage of the clot may be necessary and is very effective in providing pain relief.

Dr. Sarah Andreae-Jones MB BS
Patron of ASG