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Piles

Last updated: 09 September 2011

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What is Piles

A common complaint, especially during pregnancy when extra strain is put on blood vessels in the bowel because of increased blood flow and compression due to increasing weight.

Also, pregnancy hormones which relax some of the body's vessels and ligaments, mean that circulation can becomes sluggish, and the valves that open to return blood to the heart can become lax, meaning blood pools in the veins.

If that's not enough bad news, constipation caused by the same hormones can result in straining on the loo, which brings more pressure to bear on the blood vessels.

All this can result in varicose veins – and piles are basically varicose veins which are found in or just outside the anus.

Piles can occur in anyone of any age, but are most common, in people aged 45-54 as well as in mums-to-be.

What are the symptoms of Piles?

Symptoms can include bleeding from the rectum, discomfort and/or itching in or around the anus and, in some cases, acute pain.

Piles can be internal or external. External piles protrude from the anus and can have the appearance of small bluish or red-looking grapes.

Piles that originate inside the anus are rated in size and severity from grade one to four. Grades one and two tend to stay inside the anus or, if pushed out when you strain on the loo, shrink back on their own. Grade three can sometimes be felt as small lumps hanging out of the anus and are known as prolapsed haemorrhoids. They can be pushed back inside with your finger. Grade four stay outside the anus and can't be pushed back in. They need medical treatment.

External piles that originate along the outside edge of the anus are rarer, very painful and need immediate treatment.

Piles are usually diagnosed by a digital rectal examination, where a doctor will insert a finger into your anus. In some cases, examination with a protoscope – a slim instrument with a light – for better visibility

What are the treatments and remedies of Piles?

There's usually not a lot that can be done to help piles in pregnancy as most will improve or disappear shortly after the birth.

You'll be advised to increase the amount of fibre in your diet, drink plenty of fluids and take gentle exercise throughout your pregnancy. This should help to soften your stools, making going to the loo less uncomfortable.

There are also creams, ointments and suppositories that can help to reduce symptoms. Painkillers and laxatives can also help, but don't start them without consulting your midwife or doctor if you're pregnant.

In severe cases of piles, medical and surgical treatments may be considered, but not usually in pregnancy. These include injecting a chemical solution around the piles to reduce the blood supply, which will eventually shrink them; 'banding' the piles to cut off the blood supply, which makes them drop off; infrared treatment; or, in extreme cases, surgical removal.

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