Haemorrhoids (piles)

What are haemorrhoids (piles)?

Everybody normally has tissue near the back passage that can sense the difference between solid, liquid and stool.  It is also part of the continence mechanism.  In some cases if the pressure upstream builds up then this tissue swells and that swollen tissue is what we call piles (or haemorrhoids).  In about half the cases of piles it is this upstream pressure that causes them, the other half just occur on their own.

Known Causes

Factors that cause piles are: constipation, diarrhoea, straining on the toilet and classically pregnancy.

Piles Haemorrhoids Colo Rectal Surgeon Exeter Devon

Symptoms of Piles

The two most common symptoms of piles are bleeding and itching. The itching is caused by a small amount of mucous that the piles produce, which people often don’t notice. When the piles get bigger people can notice the lump and it can occasionally be very painful. It is important to know that there are other, more serious causes of these symptoms (particularity bleeding) and you should not ignore these and I would happily see you in clinic to discuss this.


The first step in the managing of piles is to make sure there is not a more serious, underlying cause of this bleeding. This will often involve a simple camera test to have a look at the bowel higher up (either a flexible sigmoidoscopy or a colonoscopy).

Once something more serious is ruled out, the next step is to try simple dietary modifications including laxatives. If this doesn’t work and the piles are still causing significant problems then we move on to surgery.

Surgical Treatment of Piles

There are a variey of options for treatment of piles and we would discuss this when we met in clinic.

  • The simplest is to apply small bands to the piles and this works well for small piles and can be done at the same time as the camera test.
  • The next operation is done with you asleep and involves using a special ultra-sound probe (a THD operation) to identify and tie off the blood vessels coming into the pile. This works well for larger piles that don’t have a lump on the outside.
  • For the largest piles the most effective operation is to excise the pile with a cautery device. The down side of this operation is for the first week after the operation it is painful.

All operations done for haemorrhoids can be performed as a day case.

Make an appointment today

Rob is a Consultant Colo-Rectal Surgeon at the Royal Devon and Exeter NHS Foundation Trust and also sees patients privately at Exeter Nuffield - contact sophie.punter@nuffieldhealth.com 01392 262183

Mr Rob Bethune provides quality care