HealthInfo Aoraki South Canterbury
Haemorrhoids (piles)
Mate tero puta
Important
It is important to tell your general practice team about any bleeding from your bottom to rule out serious causes.
Haemorrhoids (piles) are cushion-like structures in your anal canal (back passage) where poo (faeces) is passed. We all have them to help control passing poo.
Sometimes the blood vessels in them fill with too much blood and become swollen lumps causing symptoms. This is very common, occurring in up to 50% of the adult population at some time.
If they swell in the upper part of your anal passage, they are called internal haemorrhoids. These are often painless. Sometimes they can extend out past your anus, but they are still internal haemorrhoids. This can be painful if they will not go back in.
When the blood vessels in the lower part of your anal canal near the opening swell up, they are called external haemorrhoids. These often project out of the anus but not always. These can be painful because you have nerve fibres in this area.
Causes of haemorrhoids
Swollen haemorrhoids usually develop due to pressure in the anal region, but sometimes they happen for no apparent reason.
They can be caused by:
- constipation and straining on the toilet
- passing frequent or hard stools (poos)
- pregnancy – due to pressure from the baby and from the effect of hormones on your veins
- ageing
- hereditary factors that can run in families due to an inherited weakness in the tissues in the anal canal
- other causes, including heavy lifting and persistent cough.
Symptoms of haemorrhoids
There are several possible symptoms.
Bleeding from your bottom
It is usually bright red blood. You may notice it when you wipe, or it may be in the toilet.
Itching or irritation of your anal area
Especially if there is a mucus discharge from the haemorrhoids. Internal haemorrhoids can make you feel as if you have not completely emptied your bowels when you go to the toilet.
A lump in your anal area
This may come down after you pass a bowel motion then go back up. If an internal haemorrhoid comes down and gets caught in your anus, it may become strangulated. This can be very painful as the blood supply to the haemorrhoid gets cut off. Sometimes it goes back up by itself or you may need to push it back up. An external haemorrhoid can form a clot of blood in it and this can also be very painful. This is called a thrombosed external haemorrhoid.
If you have any of these symptoms, you need to see your general practice team to be examined.
It is particularly important to report any bleeding from your bottom to have it checked and rule out more serious causes.
Diagnosing haemorrhoids
Your general practice team will ask you about your symptoms then examine you. This involves a visual inspection of the anal area and a digital rectal exam. Your GP will insert a lubricated gloved finger into your anal canal to feel for lumps and look for bleeding.
Sometimes your GP may need to look inside your anal canal if they cannot see anything externally. They will use a small hollow plastic tube (proctoscope), which is inserted into your anus to view the anal passage.
If your GP does not find any haemorrhoids, they may refer you to a specialist for further investigation.
HealthInfo recommends the following pages
- Patient.info – Piles
Factsheet about piles, including information about symptoms and treatment.
On the next page: Treating haemorrhoids (piles)
Written by HealthInfo clinical advisers. Last reviewed July 2022.
SourcesReview key: HIHAE-13803
