think it reassures us telling us our bleeding is probably piles - but many
people don’t like the thought of having ‘piles’, believing they must have done
something wrong (bad diet, bad habits, straining etc) Bleeding affects
one in five of us in any year and can continue on and off throughout our lives
bleeding, usually short bursts after passing a motion or small amounts seen on
the toilet paper for a few days at a time, usually comes from ‘cushions’ around
the anus - natural spongy bulges of tissue and blood vessels which close the
anal canal to hold in gases. Pass a hard motion or strain and they can bleed
easily, especially when we’re younger
for no reason is less common particularly in older people. It still mostly
goes away with no treatment.
the word ‘piles’ should be kept for patients whose ‘cushions’ are so large they
come through the anal canal and the patient has to push them back (prolapsed
piles). These are more likely to happen as we get older and may need surgical
you are straining and grape-like little lumps appear around the anus,
disappearing when you stop straining, they’re normal too. Occasionally a
painful clot can form in one of them - that’s known as a thrombosed pile.
55, any bleeding from the bottom should probably be investigated with a five-minute
short colonoscopy called a “flexible signmoidoscopy” – flexi-sig for
short. See our Videos for what it
What can be done to
reduce or stop the bleeding?
Change your diet to more fibre so that the motions are softer and easier to
Straining a lot is an important cause of bleeding or piles - some straining to
start the bowels working is normal but try to avoid excessive straining
Try buying products at the chemists but, as bleeding tends to come and go, it
can be hard to know if the product has worked or the bleeding has stopped by
If bleeding is a nuisance and you are referred to hospital, injections or
rubber banding can control it. In some patients this is a permanent cure but as
it is impossible to get rid of the ‘cushions’ which are normal structures
and in some patients the bleeding can
recur and it is possible to repeat the treatments.
fact some patients get bleeding on and off in early adult life, whatever is
done to them. All hospital treatments involve some discomfort but this usually
settles down quickly and most are very safe.
piles - banding with a rubber band to shrivel them or injections with phenol is
becoming less common. Quick but does not always work
large piles which prolapse- usually surgery is the only option but last resort.
Recovery can be painful for a couple of weeks, especially when going to the
toilet. Laser, infra-red and cryotherapy treatments have been tried in the past
but are not usual treatments at the moment. Newer treatments using stapling are
less painful but they occasionally have bad complications.