Acidity and GERD: Beyond the Antacid Bottle
Reaching for an antacid several times a week is not a solution — it is a symptom. Persistent reflux damages the oesophagus and occasionally hides something more serious.
Read articlePiles, or haemorrhoids, are swollen veins in the lower rectum and anal canal that bleed and prolapse. They are extremely common and very treatable, but bleeding from the back passage should never simply be assumed to be piles.
Symptoms
Not everyone gets every symptom, and the pattern can differ in older people, in people with diabetes and in children. These are the ones most often reported.
- Bright red bleeding at the end of passing stool, on the paper or in the pan
- A lump or swelling coming out of the anus, which may go back on its own or need pushing
- Itching, mucus discharge and a feeling of incomplete evacuation
- Pain, usually when a pile becomes thrombosed or when there is an associated fissure
- Discomfort on prolonged sitting
When to see a doctor
Do not wait these out
If any of the following applies, arrange to be seen the same day. For anything sudden or severe, call 9281862028 or come straight to the emergency department at SIMS — it is open 24 hours and does not need an appointment.
- Any bleeding from the back passage — it must be assessed, not assumed
- Bleeding with weight loss, change in bowel habit or a family history of bowel cancer
- A painful swelling that has come out and cannot be pushed back
- Heavy or persistent bleeding causing weakness and giddiness
Tests that may be advised
Your consultant will order only the investigations that change the plan. Most of the following are available on the SIMS campus, so results usually come back the same visit.
- Clinical examination including digital rectal examination
- Proctoscopy to see the haemorrhoids directly
- Colonoscopy in older patients or where the pattern of bleeding is atypical
- Complete blood count to check for anaemia from chronic blood loss
- Stool examination where infection or inflammation is suspected
How it is treated
Treatment is decided case by case — by how advanced the problem is, what else you are being treated for, and what you can realistically sustain. Broadly, it involves the following.
- High-fibre diet, generous water intake and avoiding straining and long periods on the toilet
- Stool softeners and topical treatment for early-grade piles
- Sitz baths for symptomatic relief
- Banding or injection for selected grades
- Surgery — haemorrhoidectomy or stapled procedures — for advanced or persistent disease
This page is general information, not a diagnosis
Piles can look like several other conditions, and the reverse is equally true. Nothing here can replace an examination, your test results and the judgement of the doctor treating you — and no medicine mentioned by name to a friend or relative should be started on the strength of this page. If you recognise yourself in it, book a consultation with the General Surgery department. If a symptom is sudden or severe, call 9281862028.
