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Piles / Haemorrhoids


Haemorrhoids are also known as piles, are engorged/swollen veins (varicose veins) inside and around the anus. When the veins engorge with blood they can be felt and seen as either a hard or soft lump in the rectum and around the anus. They range in size from a small pea up to a large grape – sometimes the walls of the veins are so stretched they bulge out & get irritated especially when passing a bowel movement.  Haemorrhoids can be itchy or painful and are the most common causes of rectal bleeding.

Internal Haemorrhoids – Ones Higher Up Inside the Rectum

Generally the internal haemorrhoids are not that uncomfortable as they are higher up in the rectum and there are not as many pain sensing nerves there. However they can be the cause of blood on toilet paper after you wipe.  They can sometimes prolapse out as well.

External Haemorrhoids – Ones You can See & Feel on the Outside 

The external haemorrhoids are the ones that are most frustrating and painful.  They are quite common in the third trimester of pregnancy. This is due to the increase in progesterone hormone as well as increased pressure on the anus from the growing uterus as well as any issues with constipation. The straining during constipation or giving birth can increase the likelihood of developing them.


Haemorrhoids are generally benign and will resolve on their own. However there are a number of things that can be done for symptomatic relief.

Avoid Constipation and Straining 

Ensuring sufficient fibre and fluid intake and adhering to the advice on our constipation post will help to not irritate the haemorrhoids.

Keep the area clean

Using a squirt bottle or sitz bath or wet toilet wipes both after using the toilet and for symptomatic relief.


Ice can be used for symptomatic relief but should not be applied directly (due to risk of ice burns) and should not be left too long.


When using the toilet ensure to use a stool or potty squatty to help optimise relaxation of the pelvic floor.  Where possible relieve pressure by lying down to offload the pelvic floor and anal region. Or sitting on a ring cushion or a wedge cushion.



Over the counter medications and stool softeners

There are many creams and ointments which can be applied for symptomatic relief. However it is best to discuss these with your health care provider especially if you have had an episiotomy or tear.


Gentle movement and non-strenuous exercises are advised.  Pelvic floor activations can be of help in the case of weak muscles but this should be ideally assessed by your health care provider.

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