A haemorrhoid, also known colloquially as a pile, is a vein or veins that become dilated, engorged, inflamed, painful and occasionally thrombosed or clotted. Symptoms range from mild itching to severe pain or bleeding. There is a thin line where the skin of the buttocks meets the membrane of the anus, known as the anorectal line. Haemorrhoids that originate below this line are called external haemorrhoids and those above the line are called internal haemorrhoids. Internal haemorrhoids may well extend down past the anorectal line. are also causes. Sitting on a cold surface can cause constriction of the muscle and straining after this may push a vein through the wall, or prolonged sitting or sitting on a warm surface may draw blood into the veins, which may then pass through weakened muscle walls. Treatment and avoiding recurrence requires consideration of all these factors.

A pile may bleed gently and appear only as a smear on the toilet paper, or may bleed more aggressively and may show as bright blood in the toilet. Provided that the bleeding stops, neither is a serious condition although a persistently heavy-bleeding pile may require surgical treatment.


A breach or weakness in the anal muscular wall is the cause of a haemorrhoid. Weakness may occur through a lack of dietary fibre, deficiencies that reduce the strength and amount of the connective tissues in the muscular walls, and through trauma from a penetration of the anus. Medical conditions that can cause haemorrhoids are a build up of pressure from straining, constipation and an obstructed bladder outlet. Pregnancy, obesity and an increase in pressure in the veins from obstruction in the abdomen or an enlarged liver blocking the main vein of the body, the vena cava,

Any bleeding from the back passage must be reviewed by a doctor, with the possibility of a referral for proctoscopy or colonoscopy because bleeding may represent colitis or even cancer.

Ensure an increase in dietary fibre by eating more fresh fruit and vegetables, lightly cooked. At the time of the pile, one or two teaspoonfuls of psyllium husks twice a day, shaken vigorously with 8oz of water and drunk immediately, will help prevent constipation.

Ensure that one pint of water per foot of height is drunk, spaced throughout the day. Avoid drinking water around meal times.

Avoid caffeine and alcohol until the problem has resolved. These substances dehydrate and therefore increase the risk of constipation and also weaken muscular walls.

Core out an index finger-size portion of raw potato and insert as a suppository before bed five nights in a row.

Peppermint oil can be applied with a clean finger.

Witch-hazel or Hamamelis fluid extract should be soaked into a flannel and the flannel wrapped around an ice cube and applied to the anus.

A cream containing Arnica or Calendula should be applied before and after each stool and before bed .

Homeopathic remedies may be of benefit. Aesculus 6 four times a day for itching, Hamamelis 6 for bleeding with a bruise sensation and Capsicum 6 if the sensation is of burning. Other remedies may be chosen depending on the variety and severity of symptoms.

Sitting in a bath of water at around 40°C may offer relief.

Haemorrhoids are a varicose vein, see Varicose veins for further medicinal treatments.

Surgical treatment may be required but before this takes place, see if you can find a practitioner who uses monopolar direct current therapy, which can be applied with local anaesthetic. Operative procedures may include banding, where an elastic band is place around the base of the engorged vein, or injecting with a sclerosing fluid that causes the vein to collapse and stick together, thereby not allowing blood into the protruding area. If either technique is not convenient or suitable then a haemorrhoidectomy and surgical sealing of the vein may need to be carried out .