What Is It?
Haemorrhoids, also called piles, are swollen blood vessels around the anus or lower rectum. They may cause itching, discomfort, swelling, a lump near the anus, or bright red blood after passing stool.
Haemorrhoids are common and are usually not dangerous, especially when symptoms are mild and linked to constipation, straining, or sitting on the toilet for too long. However, rectal bleeding should not automatically be assumed to be piles, especially if it is new, heavy, recurrent, or linked with other symptoms.
Bright red blood may appear on toilet paper, on the surface of stool, or in the toilet bowl. New rectal bleeding, especially in adults aged 50 years and above, should be checked even if piles are suspected.
Haemorrhoids may be internal, meaning they develop inside the rectum, or external, meaning they occur around the anal opening. Internal haemorrhoids may cause painless bright red bleeding, while external haemorrhoids may cause soreness, swelling, itching, or a tender lump.
Symptoms may develop gradually over days or weeks, or appear suddenly after straining. Other conditions can look similar, including anal fissure, rectal prolapse, skin tags, abscess, inflammatory bowel disease, bowel infection, or colorectal cancer.
What Causes It?
Haemorrhoids usually happen when pressure increases around the anal and rectal veins.
Why Haemorrhoids Are So Common
Haemorrhoids are common because pressure around the lower rectum and anus can affect the blood vessels in that area. Constipation, hard stools, pregnancy, prolonged sitting, heavy lifting, ageing, and low-fibre diets can all contribute.
People often search for haemorrhoids because symptoms can feel embarrassing or worrying. Bleeding, itching, pain, or a lump near the anus may make people wonder whether it is piles, a tear, infection, or something more serious.
Common Causes and Risk Factors
Constipation and straining
Hard stools and straining increase pressure on rectal blood vessels, making haemorrhoids more likely.
Sitting on the toilet for too long
Long toilet sitting, especially while using a phone, can increase pressure around the anus.
Pregnancy and childbirth
Pregnancy can increase pressure in the pelvic area. Haemorrhoids are also common after childbirth, but heavy bleeding, severe pain, or a painful lump should be assessed.
Low fibre intake or poor hydration
Low fibre and low fluid intake can make stools harder and more difficult to pass.
Ageing and repeated pressure
Haemorrhoids become more common with age, especially from around 45 years and above, as supporting tissues may weaken.
Haemorrhoids are different from an anal fissure. A fissure is a small tear that often causes sharp pain during or after passing stool, while haemorrhoids more commonly cause swelling, itching, discomfort, or bright red bleeding.
What Should You Do?
If symptoms are mild, first observe the pattern. Notice whether bleeding is bright red, whether pain is present, whether stools are hard, and whether symptoms started after straining.
Avoid straining and avoid sitting on the toilet for long periods. Do not ignore rectal bleeding, especially if it is new, heavy, recurrent, dark, or linked with bowel habit changes.
What to Observe First
Pay attention to:
- Whether bleeding is bright red, dark, heavy, or mixed with stool
- Whether pain is mild, sharp, severe, or worsening
- Whether there is itching, swelling, or a lump
- Whether the lump goes back in or stays outside
- Whether there is constipation, diarrhoea, or straining
- Whether symptoms are new, recurrent, or lasting longer than expected
- Whether there is weight loss, fever, tiredness, or change in bowel habit
How to Tell If It Is Mild, Moderate, or Concerning
Mild haemorrhoids may cause occasional itching, mild discomfort, slight swelling, or small amounts of bright red blood after straining.
Moderate haemorrhoids may cause more frequent discomfort, swelling, bleeding, or a lump that comes out during bowel movements.
Concerning symptoms include heavy bleeding, black stools, severe pain, fever, pus, unexplained weight loss, or a new change in bowel habit.
A sudden painful hard lump near the anus may be a thrombosed external haemorrhoid and should be assessed.
How Is It Usually Managed?
Haemorrhoids are usually managed by reducing strain, keeping stools soft, improving toilet habits, and checking for warning signs. General steps may include increasing fibre gradually, drinking enough fluids, avoiding long toilet sitting, and not forcing bowel movements.
A pharmacist can help assess whether symptoms sound like uncomplicated piles or whether medical review is safer. This is especially useful if symptoms are mild but uncomfortable, recurrent, or linked with constipation.
Ask a Pharmacist If Unsure
Ask a pharmacist if symptoms are mild, familiar, and there are no red flags.
Seek medical advice earlier for children under 12 years old, adults aged 50 years and above with new rectal bleeding, pregnant women with severe symptoms, people taking blood thinners, or anyone with inflammatory bowel disease, bowel cancer history, or unexplained weight loss.
When to See a Doctor
See a doctor if symptoms are linked with:
- First-time rectal bleeding
- Heavy bleeding or bleeding that keeps returning
- Black, tarry, or dark red stool
- Severe or worsening anal pain
- A painful hard lump near the anus
- Fever, pus, or feeling unwell
- Unexplained weight loss or persistent tiredness
- Change in bowel habit lasting more than 2 to 4 weeks
- Symptoms not improving after 7 days of basic self-care
- Rectal bleeding in a child under 12 years old
- New rectal bleeding in adults aged 50 years and above
Quick Summary
- Haemorrhoids are swollen blood vessels around the anus or lower rectum.
- They are also called piles.
- Common signs include itching, swelling, discomfort, a lump, or bright red bleeding.
- Bright red blood may appear on toilet paper, stool surface, or in the toilet bowl.
- Rectal bleeding should be assessed if new, heavy, recurrent, dark, painful, or linked with bowel changes.
FAQ
What are haemorrhoids?
Haemorrhoids are swollen blood vessels around the anus or lower rectum. They are commonly known as piles.
Are haemorrhoids serious?
Most mild haemorrhoids are not serious, but bleeding, severe pain, fever, dark stools, or bowel habit changes should be assessed.
Can haemorrhoids cause a lump?
Yes. External haemorrhoids may cause a lump near the anus, while internal haemorrhoids may sometimes protrude during bowel movements.
Why do haemorrhoids bleed?
Straining or hard stool can irritate swollen blood vessels, causing bright red bleeding.
How long do haemorrhoids last?
Mild haemorrhoid symptoms may improve within a few days. Symptoms lasting more than 7 days, worsening, or returning often should be checked.
Can haemorrhoids go away on their own?
Mild haemorrhoids may settle when straining reduces and stools become easier to pass. Persistent or bleeding symptoms should not be ignored.
Is rectal bleeding always haemorrhoids?
No. Bright red bleeding can happen with haemorrhoids, but bleeding may also come from fissures, infection, inflammation, polyps, or bowel cancer.
When should I see a doctor for haemorrhoids?
See a doctor for first-time bleeding, heavy or recurrent bleeding, severe pain, black stools, fever, pus, unexplained weight loss, bowel habit changes, or symptoms not improving after 7 days.