Bleeding piles: causes, symptoms and treatments

What causes piles (haemorrhoids) to bleed?

While it's not always clear what causes bleeding piles, being constipated or straining too much while you’re on the toilet can make them more likely.

When you have hard stools inside of your body or strain too hard, this can increase the pressure on your abdomen and disrupt the normal blood flow to the veins in your bottom (known as the haemorrhoidal plexus).

As a result, this complex network of veins can become swollen and develop into a haemorrhoid – or pile. This can happen either internally (in the upper two-thirds of the anal canal) or externally (around or near your bottom).

Straining even harder on the toilet can further increase the pressure on your bottom’s blood vessels, potentially causing the pile to bleed.

Bleeding piles symptoms

While it may sound fairly obvious, the key symptom to look for with bleeding piles is blood. This will normally appear bright red on the toilet paper after you wipe, in the toilet bowl or covering your stools.

The pain you feel can also vary depending on where your piles develop.

Internal piles, for example, typically cause ‘painless bleeding’, because the nerves in the upper part of the anal canal (where they form) can’t carry pain signals.
Meanwhile, external piles develop in the lower part of the anal canal, where they are more sensitive due to being covered by nerve endings. For this reason, external piles can feel very itchy and painful.

You may also experience other symptoms alongside bleeding, including:

• An itchy bottom
• Needing to visit the toilet again soon after going
• A mucus discharge after passing a stool
• Soreness, redness and swelling around the bottom
• Lumps around your bottom

If you’re concerned about your symptoms and are looking for tailored support, speak to your doctor.
Haemorrhoid bleeding: how much is normal?
When it comes to bleeding piles, the amount of blood can vary. Blood may appear on the toilet paper, in the bowl or on the stool itself, and is usually bright red.

However, if you find that you’re bleeding non-stop or there’s a lot of blood in the bowl after your toilet visits, seek medical attention immediately.

Depending on the type and severity of rectal bleeding you’re experiencing, your doctor will need to work out the exact cause. So, make sure to speak to them for their advice if you’re concerned.

Risks and complications of bleeding piles

Bleeding piles rarely cause any serious problems and often clear up by themselves after a few days. But they can occasionally result in complications.

Bleeding piles can sometimes develop into a blood clot (known as a thrombosed haemorrhoid) which can be very painful. However, these can usually be treated with the right medication or using a non-surgical or surgical procedure. This is why it’s important to always get any type of rectal bleeding checked out by your doctor.

Treatment options for bleeding piles

Living with haemorrhoids can leave people feeling uncomfortable, itchy and embarrassed, but there are a wide range of bleeding piles treatments available to ease your symptoms.

Here’s what you can use to help find relief:

• Paracetamol – taking the recommended dose of these common painkillers can help to take the edge off the pain associated with bleeding piles.
• Laxatives – if your bleeding piles are caused by constipation, your doctor may suggest taking a laxative to help empty your bowels.
• Germoloids® Cream – available over the counter from your local pharmacy, this cream contains a local anaesthetic to help relieve several symptoms associated with bleeding piles, such as pain, swelling, irritation and itchiness.

Depending on the severity of your symptoms and the type of piles you have, Germoloids® Cream is available as an ointment (an oilier alternative) and a suppository (a medicine that you insert into your bottom). Your pharmacist will be able to give you advice on which form of treatment may be right for you.

It’s also important to note that other forms of painkillers, such as ibuprofen, can make your rectal bleeding worse. So, you should avoid taking them unless directed by your doctor.

If you don’t see any improvement in your piles after using at-home treatments, you may need to take a different approach. Talk to your doctor about which treatment options may be best suited to your specific symptoms.

Prevention techniques for bleeding piles

When trying to prevent bleeding piles, one key area to look at is your current diet and lifestyle.

For example, if your diet lacks fibre-rich foods, make sure to include them.2 This can help encourage more regular bowel movements and prevent constipation by making your stools softer and easier to pass.

Here are some good foods to target:

• Wholegrain bread and cereal
• Beans and pulses
• Nuts
• Chickpeas
• Seeds
• Dried fruits

Try to also cut down on the number of caffeinated and alcoholic drinks you consume. Instead, prioritise drinking plenty of fluids – especially water.

From more of a lifestyle perspective, exercising regularly can help to prevent bleeding piles as well. If you are suffering from haemorrhoids, here are some other useful lifestyle-focused tips you may want to consider:

• Avoid straining or pushing too hard when on the toilet
• Use damp toilet paper to clean your bottom after passing a stool
• Have a nice warm bath to ease symptoms like itching and pain
• Try to keep your bottom clean and dry
• Apply an ice pack wrapped in a towel to the area to ease discomfort

To learn more about the available treatment options for bleeding piles, check out our dedicated page on the topic. Alternatively, keep scrolling to discover more of our helpful tips and advice.