Piles (haemorrhoids)

Piles (haemorrhoids) are swollen blood vessels around and inside the opening of your bottom (anus). The swellings can be:

  • internal piles, which are inside the anus
  • external piles, which are outside the anus and cause lumps

Piles might get better on their own after a few days. There are also things you can do to treat and prevent piles.  

If your piles are large, you might need surgery to remove them. This is called a haemorrhoidectomy

Symptoms of piles

You might have all or some of these symptoms: 

  • bleeding (usually bright red and separate from your poo)
  • itching
  • soreness around your bottom (anus) 

You might also get pain when having a poo. Piles that have dropped down from your anus and appear as lumps around your bottom (external piles) can be particularly painful. 

Causes of piles 

The causes of piles are not known. There are some things that make piles more likely, including: 

  • finding it hard to have a poo (constipation)
  • pushing down when trying to have a poo (straining), which can also can make the symptoms of piles worse 
  • pregnancy because of the baby’s weight pushing down on the tummy (abdomen)
  • heavy lifting


You might have already bought medicines or creams from a pharmacy or shop, or tried treatments recommended by your pharmacist or GP.

Avoiding constipation and straining can sometimes help your symptoms and treat small, internal piles. You can read more information about making lifestyle changes.

There are different hospital treatments for piles. The most suitable treatment for you depends on your circumstances and the size of the piles.

Your consultant or specialist nurse might talk to you about these options.


We can put special rubber bands around the piles. The piles then fall off, usually 3 to 7 days after banding.

Read more information about banding to treat piles.  


If your piles are large, you might need surgery to remove them. This is called a haemorrhoidectomy.

Read more information about surgery to treat piles.


This is a liquid injected into your piles to make them shrink. However, we often need to repeat this treatment with time. 

Resource number: 0570/VER7
Last reviewed: March 2022
Next review: February 2024

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