Piles (Haemorrhoids)

Updated 16 March 2016

How a doctor would diagnose and treat piles

Suffering from piles is a common problem, but the condition is very treatable. This is what the doctor would do.

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Consulting your GP about piles is embarrassing, but suffering from haemorrhoids is actually a very common condition that can be managed quite effectively.   

Don't suffer in silence

Piles or haemorrhoids are very common in people who suffer from long-term constipation or diarrhoea, and are associated with conditions such as irritable bowel syndrome (IBS). Haemorrhoids occur when veins in the anus swell and expand as a result of excessive straining, and can be very painful when sitting or passing a stool.

Despite the discomfort and severe pain at times, people suffering from this condition often suffer in silence, hoping that, by some miracle, the piles will just disappear. But, once established, they hardly ever heal on their own. 

Don't be embarrassed about piles – your doctor won't even blink an eye.

Before going to your GP, you might want to:

1. Try and recall when your symptoms and discomfort first started

2. Note if there is any blood or mucus present in your stool

3. Take note of your stool habits

4. Find out if certain foods make you more constipated or bloated

Preparing for the exam, make sure the anal area is clean, and if you feel the need to pass stool, to do so. Do not apply any creams or ointments in or around your anus.

Your doctor will also ask:

1. If you spend a long time on the toilet, and if there is a reason why

2. If you have noticed any fleshy parts protruding from your anus

3. If you suffer from anal itch

4. If you strain when you pass a stool

5. If your piles are self-reducing, if you have to press them back, or if they are beyond the point of you being able to reduce them?

Your doctor will do a physical examination to establish the extent of your piles. He will ask you to lie on your side, legs pulled up towards your tummy. At first he will just examine the outside of your anus to check for any external piles, signs of thrombosed piles and signs of infection.

If your piles are not visible externally, your doctor will also do a rectal exam. During this exam, he will placed a gloved, lubricated finger in your anus to feel for any piles and masses. He will also check for any bleeding.

An internal exam might be slightly uncomfortable, but should never be painful. Inform your doctor if you experience any pain.

Once your doctor have established the extent of your piles, he will do one of the following:

1. Prescribe a local anaesthetic cream, stool softeners and pain pills. He will most likely ask you to follow-up.

2. If any signs of thrombosis are present, he will most likely refer you to a general surgeon who will do an operation to reduce or remove the piles.

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