Treatment for Haemorrhoids (Piles)

Haemorrhoids (also known as piles) can be itchy, uncomfortable and even painful in some cases. Fortunately, however, there are several treatment options available to relieve your symptoms.

What are the treatment options for haemorrhoids (piles)?

If you’ve ever suffered from haemorrhoids, you will have likely experienced the common symptoms that come with the condition first-hand, including bright red blood after a bowel movement, itching, pain and general discomfort around the bottom.

In many cases, haemorrhoids will often get better on their own after a few days. But, for some people, the itchiness, pain and discomfort can be hard to deal with and may require additional treatment from a pharmacist or doctor.

The main treatment options for piles typically include:

▶Home remedies and lifestyle changes

▶Over-the-counter creams, ointments, or suppositories

▶Non-surgical procedures

▶Surgical procedures to remove haemorrhoids.

The NHS states that you should see a doctor if you have symptoms that show no sign of improvement after seven days, you keep getting piles or you notice a change around your anus that isn’t normal for you. This is because you might need to have a stronger medicine prescribed for your symptoms and to check that another issue isn’t causing them to appear.

Aside from the physical discomfort, many people also feel uncomfortable or embarrassed when talking about piles. But it’s important to realise that you’re not alone, with the condition estimated to affect around 10% of adults globally.

Which haemorrhoids (piles) treatment is best for me?

Determining the right treatment option for you will depend on the size, severity and type of haemorrhoids you have – internal or external.

External haemorrhoids typically cause itching, pain or one or more hard, tender lumps to appear around or near your bottom (anus).

On the other hand, internal haemorrhoids develop in the upper two-thirds of the anal canal. They tend to be associated with symptoms like bleeding from the rectum and prolapsing (piles that fall through the anal opening), which can cause pain and discomfort.

Internal and external haemorrhoids can also become what’s known as a thrombosed haemorrhoid, which is when a blood clot develops. While this is more commonly associated with external haemorrhoids, thrombosed haemorrhoids are a common complication of piles and can cause extreme pain.

Unless you know already, your doctor will be able to determine which type of haemorrhoids you have through a digital rectal examination (DRE) or proctoscopy.

A DRE is an internal examination where your doctor will use gloves and a lubricant to feel for any abnormalities in your bottom. A proctoscopy is another type of internal examination that involves using a proctoscope (a hollow tube with a light at the end of it) to examine your rectum and anus.

Using the results of these tests, your doctor will be able to advise you on their recommended course of treatment.

Some people with haemorrhoids are reluctant to see their doctor, but there’s no need to be
embarrassed – all GPs are used to diagnosing and treating piles.

Home remedies and lifestyle changes

Several home remedies can help ease some of the symptoms of haemorrhoids when they first appear. For example, the NHS states that you can treat the symptoms of piles by:

Taking paracetamol
Having a warm bath
Wrapping an ice pack in a towel before applying it to the painful area
Wiping your bottom softly with damp toilet paper
Keeping your bottom clean and dry

However, since lifestyle habits like diet and weight are some of the key risk factors for haemorrhoids, there are several other things you can do to stop them from coming back.

Drink more water

Keeping hydrated helps to soften stools, making them easier to pass and reducing the overall strain put onto your rectal area. This can not only prevent the future development of haemorrhoids but also help alleviate any discomfort you currently have, by allowing the fibre you eat in your diet to work more effectively.

Eat more fibre

Fibre-rich foods promote regular bowel movements, prevent constipation and reduce bleeding.

Incorporating higher-fibre foods like fruits, vegetables, pulses and whole grains into your diet may help keep your digestive system running smoothly.

Exercise regularly

Performing regular exercise promotes colon health and prevents constipation. However, it’s important to choose the right exercise, as certain types may make the problem even worse.

Exercises like walking, swimming and yoga, for example, are all generally considered helpful and effective.

Reduce your alcohol and caffeine intake

The diuretic effects of caffeine (which means it makes you wee more) can dehydrate the body and worsen constipation, while alcohol can irritate the intestinal tract and speed up digestion.

Limiting your intake of both these substances should help you to stay hydrated and keep you regular.

Over-the-counter creams, ointments or suppositories

If you find that home remedies aren’t helping your symptoms, you may need to use a form of over-the-counter medication.

These types of haemorrhoid treatment come in a variety of formats, including creams, ointments and suppositories (which are inserted into your bottom), and are available from pharmacies without needing a prescription.

Certain over-the-counter remedies, such as Germoloids®, are designed to provide symptomatic relief of pain, swelling, irritation and itching associated with haemorrhoids. These formulas contain an anaesthetic, which acts quickly to provide fast, numbing relief.

Germoloids® is also available in different formats for use on internal or external piles. See below to discover the full range of products.

If you find that your symptoms persist or worsen after taking over-the-counter medication, it’s always best to speak to your doctor for further advice.

Non-surgical procedures

If dietary changes and medication don’t improve your symptoms, your doctor may decide to refer you to a specialist for further diagnosis and non-surgical treatments. This could involve:

Injections or ‘sclerotherapy’

An alternative way of treating haemorrhoids is through a series of injections, known as sclerotherapy.

During this procedure, liquid containing medication designed to shrink the swollen blood vessels is injected into the area around them. This helps to reduce blood flow to the affected area(s) and will often take between four and six weeks before the haemorrhoids are fully treated.

Rubber band ligation

Rubber band ligation is another non-surgical solution used to remove haemorrhoids.

During the procedure, the doctor will wrap the haemorrhoid in two small rubber bands to constrict the affected area and stem the circulation of blood.

The result should be that the haemorrhoid, starved of blood and oxygen, will gradually shrink and fall off, usually within the space of a week.

Surgical procedures to remove haemorrhoids

Most cases of haemorrhoids can be treated through lifestyle changes, over-the-counter medications or non-surgical interventions. However, around 10% of people will eventually require surgery to remove them effectively.

Some of the most commonly used surgical interventions include:

Haemorrhoidectomy (haemorrhoid removal)

If medication or non-surgical procedures fail to treat your haemorrhoids, or you experience particularly large ones, a surgical procedure called a haemorrhoidectomy may be required to remove them.

This involves gently opening the anus to allow the haemorrhoids to be cut out. However, as the procedure is usually carried out under general anaesthetic, you’ll be asleep throughout and won’t feel any pain.

The area may be painful for a period afterwards though, but you’ll be given painkillers to manage this. After having it done, there’s also around a one in 20 chance of the haemorrhoids returning, which is lower than with non-surgical treatments.

Stapling

Stapling, otherwise known as stapled haemorrhoidopexy, is a procedure designed to produce results similar to those of banding by reducing the circulation to the haemorrhoids. It’s also often used to treat prolapsed haemorrhoids.

During the procedure, which is also carried out under general anaesthetic, part of the haemorrhoid tissue is removed before ‘stapling’ the remaining tissue in place inside the bottom.

This form of surgery has a shorter recovery time than traditional haemorrhoidectomy and also tends to be less painful.

Haemorrhoidal artery ligation

Haemorrhoidal artery ligation, otherwise known as HALO, is a form of surgery that's used to reduce blood flow to your haemorrhoids.

Recommended by the National Institute for Health and Care Excellence (NICE) as an effective alternative to the other surgical procedures mentioned above, this operation involves using a proctoscope and specialist ultrasound probe to target the blood vessels supplying blood to your piles.

Once targeted, stitches are used to cut the blood supply, causing them to shrink over time.

As with all treatments and procedures, there are various advantages and disadvantages associated with each. So, if you think you might have haemorrhoids but don’t know which treatment option is right for you, consult your local pharmacist or doctor for their advice.

Remember, you can always ask to speak to your pharmacist in private to help you feel more comfortable talking about the condition.