Treatment
Self-help
If you have daily bowel movements that are solid but soft, and you don't need to strain, faeces will pass easily and will not put pressure on the blood vessels in your anal area.
To keep your bowel movements soft, you should:
* eat plenty of fibre-rich foods such as fruit, vegetables and wholegrain cereals (eg brown rice, wholemeal bread and wholemeal pasta)
* drink plenty of water
You shouldn't spend too much time on the toilet (reading, for example). Regular warm baths may relieve irritation and help to keep the area clean.
If you are still passing hard or infrequent faeces, you could try a fibre supplement such as ispaghula husk (eg Fybogel) or mild laxatives such as lactulose, which soften faeces. Don't use strong laxatives, such as the stimulant laxative senna, unless your doctor advises you to.
Medicines
There are a number of over-the-counter treatments that can help relieve the symptoms of piles, but won't cure them.
* Soothing creams, ointments and suppositories may ease pain and itchiness. There are many different products available without prescription. Some contain a local anaesthetic such as lidocaine.
* Products containing corticosteroids, such as Anugesic-HC and Proctosedyl, may reduce inflammation and pain.
Always read the patient information leaflet that comes with your medicine and ask your doctor or pharmacist for advice.
If these self-help measures don't work, or you have a higher grade of piles, you may need hospital treatment with one of the following procedures.
Out-patient treatments
These are treatments that you can have in hospital, but you won't need to stay overnight.
Banding
This is used mostly for second and third degree piles, but you can also have it if self-help treatments haven't worked for your first degree piles.
Your doctor will place a small elastic band just above the pile. This will cut off the blood supply to the pile, causing it to die and fall off after a few days. The raw area left behind will heal up naturally.