Almost everyone knows someone with piles, yet very few people talk about it openly. Bawaseer is one of those problems that people suffer through for months because of embarrassment. The good news is that most cases settle with simple changes and the right medicines. This guide explains what piles are, which creams and tablets doctors commonly use, and the warning signs that mean you should not wait.
Piles, also called haemorrhoids, are swollen cushions of blood vessels in and around the back passage. Internal piles sit inside and usually cause painless bleeding. External piles form under the skin around the anus and tend to cause itching, a lump and pain. Both types are very common in adults, and they often flare up during constipation, pregnancy or long periods of sitting.
Bright red blood on the tissue or in the toilet bowl after passing stool is the classic sign. Other symptoms include itching, a feeling that the bowel has not emptied fully, a soft lump near the anus, mucus discharge and discomfort when sitting. Pain that is sharp and severe during a motion may point to an anal fissure instead, which needs a slightly different treatment.
The main cause is straining. When stool is hard and dry, you push harder, and that pressure swells the veins. Low fibre meals, too little water, ignoring the urge to go, heavy lifting, obesity, pregnancy and sitting on the toilet with a mobile phone for a long time all add to the problem. If you often struggle with hard stools, read our guide on gas and bloating and browse the constipation range for stool softening options.
There is no single magic tablet. Treatment usually combines a few things, and which one suits you depends on your symptoms.
Stool softeners and fibre. These are the foundation. Soft stool means less straining, and less straining means the piles can shrink. Plain psyllium husk (ispaghol) taken with plenty of water is a time-tested option, and a product like Marhaba Ispaghol Husk is easy to find and use. Doctors may also suggest a gentle laxative syrup for a short time. See more in our digestive and ispaghol section.
Local anaesthetic creams and gels. These numb the area and ease burning or itching for a few hours. They are meant for short use only, because the skin there is delicate.
Steroid-containing ointments and suppositories. Some combination products include a mild steroid to reduce swelling. Doctors usually limit these to a short course, since long use can thin the skin. If you want to know more about the risks of steroid creams, ask your pharmacist before you start.
Flavonoid tablets. Medicines such as diosmin and hesperidin combinations are prescribed to improve vein tone and reduce bleeding and swelling during flare-ups. These are prescription medicines, so you can upload your prescription here and our team will help you with availability.
Pain relief. Simple painkillers help when the area is sore, but check with your doctor first if you take blood thinners or have stomach problems. Our painkillers guide explains the differences.
You can browse the piles and varicose veins category to see what is currently available, but please do not self-prescribe steroid or prescription items.
Drink enough water through the day and add fruit, vegetables, daal, oats and whole wheat roti to your meals. Go to the toilet as soon as you feel the urge and avoid sitting there for more than a few minutes. A warm sitz bath, which means sitting in a shallow tub of warm water, for about ten to fifteen minutes can calm the area. Pat dry gently instead of rubbing, and avoid scented wipes. Light walking daily also keeps the bowels moving, and losing extra weight lowers pressure on the veins.
Do not label every bleed as piles. Please see a doctor if bleeding is heavy or does not stop, if the blood is dark or mixed with stool, if you notice a change in bowel habit lasting more than two weeks, if you lose weight without trying, or if you feel dizzy and weak. A hard, very painful lump may be a clotted pile and needs prompt care. Bleeding for the first time after the age of forty should always be checked, because other conditions can look similar.
Ask whether your problem is internal or external piles, or a fissure. Ask how long you should use any cream, whether a procedure such as banding is worth considering, and what to do if the bleeding returns. If you are pregnant or breastfeeding, always say so before taking any medicine.
Can piles go away without treatment? Mild piles often settle in a week or two once constipation is fixed, but they tend to return if the habits stay the same.
Is it safe to use a cream for a long time? No. Most piles creams are meant for short courses. If you need one for weeks, see a doctor.
Do piles turn into cancer? No, but bowel cancer can cause similar bleeding, which is why persistent symptoms must be examined.
Are spicy foods the cause? Spice does not cause piles, but it can irritate them during a flare-up. Hard stools are the real trigger.
Can I exercise with piles? Yes, walking and light exercise are good. Avoid heavy weight lifting while you have symptoms.
Disclaimer: This article is for general awareness and is not a substitute for medical advice. Please consult a doctor or pharmacist before starting any medicine, especially if you are pregnant, elderly or take other medicines.
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