Piles (or haemorrhoids) are simply varicose veins which occur around the anus. Although the cause isn’t really known it is likely that they can be inherited and certain that chronic constipation, pregnancy and the excessive use of laxatives and purgatives can make them worse.

Itching, bleeding and a clear discharge are among the commonest early symptoms. Piles which can’t be pushed back into the anal canal inevitably feel lumpy and uncomfortable and may be painful.

Before beginning to treat any of the symptoms which I have listed it is important to seek medical advice. More serious conditions can produce the same symptoms and even with the help of a bathroom mirror it isn’t easy to make a precise diagnosis that is reliable. At the most try treatment for five days before asking for help.

There are a number of preparations available for easing and relieving the problems associated with piles. These are all intended to provide symptomatic relief rather than a cure.

Pills which are sold usually contain a laxative. George’s Pil/s for the Piles No. 3 and Pile Tablets both contain ingredients designed to ease constipation. Creams and ointments contain a variety of oils, antiseptics and other substances. They may soothe a little. The following products are widely available: Am/sol, Boots HP Ointment, Germoloids, Haemorex, Heath and Heather’s Pile Ointment, ManZan Pile Ointment, Pilease, Pilogene, Preparation H and Pylatum Pile Ointment. Some of these can be bought as both creams (or ointments) and suppositories. As is always the case with medicated creams patients who use some of these compounds may suffer allergic problems, particularly when the products are used for long periods of time. No treatment for piles should be used for more than five days without a doctor being consulted.

Inevitably, there are now sprays available for the treatment of piles -Haemorrhoidal Spray contains an antiseptic and an anaesthetic – and medicated wipes have also been introduced. I can see little point in spending money on these products.

To avoid suffering from piles it is important to avoid constipation. A diet which includes plenty of liquids and fruit and not too much carbohydrate will help. Once piles do develop discomfort can be relieved by putting bricks or books under the foot of the bed which helps the return of blood from the swollen veins to the heart, or by taking hot baths. Ice packs may also prove helpful.