Dr Morton's

medical empowerment

012 123 123 12

Email a GP Register for free Log in
  • Home
  • Real Doctors
  • Helpline prices
  • Prescriptions
  • FAQ
  • News
In the news...

Nobby’s piles

piles
Posted by Dr Mortons 1 Comment

Written by Mr Shaun Preston, Consultant Surgeon and adviser to Dr Morton’s – the medical helpline

See Dr Morton’s page soothe piles

Ooh my piles!

Whilst clearing out a garage and attic full of boxes that had remained unopened since our move to Surrey eight years ago, I came across a copy of Viz magazine from my student days. Growing-up in Newcastle, where the magazine originated, I felt compelled to look inside…

The comic strips of ‘Nobby’s Piles’ and ‘Buster Gonad’ (I am sure suitable ‘ammo’ for another article) appealed to my surgical incline. ‘Nobby’, a man clearly troubled by his enormous haemorrhoids utilised innumerable different terms for them: piles, grapes, Chalfonts (St Giles), farmers (Giles), Emmas, Sigmunds and Clements (Freud) and several others, not suitable for such a forum, were laid out in black and white. Whilst this whimsical, school-boy humour made me giggle it also brought home an insight into the reluctance of ‘the British’ to talk of such things.

Apologising is a very British thing to do. We do it when we don’t even know what we are apologising for! The frequency with which people apologise when referred to me with either a bowel problem or when I ask them about their bowel habit as part of an assessment of the ‘general health’ is incredible. The lack of a willingness of the population to talk about their bowels is one of concern.

Rectal bleeding or pain is a common problem. Frequently it is caused by haemorrhoids, but equally there are other more serious conditions that may cause either a change in bowel habit or bleeding per rectum. It is therefore important that anyone bleeding from their bottom take medical advice.

The term ‘piles’ is frequently applied to describe two main conditions.

Internal piles

“True haemorrhoids” typically present with an awareness of painless bright red rectal bleeding after or along with the passage of a stool. The blood may cover the stool, drip into the pan or merely be evident upon the toilet tissue. Haemorrhoids are classically graded into four groups:

Grade I:              no prolapse

Grade II:             prolapse upon ‘bearing down’ but reduce spontaneously

Grade III:           prolapse upon ‘bearing down’, but requiring manual reduction

Grade IV:            prolapse with inability to be manually reduced

Once the piles prolapse through the anal verge they may also cause a mucous discharge, a perianal mass, itchiness, and rarely incontinence. Pain is rarely a feature unless they become thrombosed (clotted) or necrotic.

External piles

This is a very painful condition where the blood clots in the prolapsed haemorrhoids. Alternatively it may occur de novo without any clear evidence of internal piles where it is more of a burst blood vessel in the skin just beyond the anal verge. Whist intense this pain typically resolves in 2–3 days. The swelling may take a few weeks to resolve, however some people are left with small perianal skin tag(s) after healing.

Internal and external haemorrhoids may present differently; however, many people may have a combination of the two. The presence of a pile in the anal canal or at the verge may cause irritation of the surrounding skin, and thus itchiness around the anus.

A “>topical anaesthetic such as Scheriproct helps ease any pain or itching and also helps reduce swelling and irritation. This must also be supplemented with good perianal hygiene and constipation should be avoided.

Prolonged use of topical treatments may in themselves cause perianal irritation and should symptoms not settle quickly then a prompt medical opinion should be sought.

Share on FacebookTweet about this on TwitterShare on LinkedInShare on TumblrEmail this to someoneShare on Google+
Tags: haemorrhoids, piles

One Response

  • john says:
    March 8, 2015 at 9:22 PM

    Thanks. I never quite understood this before. Now I know what help to get

    Reply

Leave a Reply

Click here to cancel reply.
Name:
Email (will not be published):
Website (not required):
Comments:
Search for:

Recent posts

  • Cervical cancer symptoms
  • Chest infection symptoms: acute bronchitis
  • Chest infection symptoms: pneumonia
  • Help with Fertility
  • It’s never too late to start getting fit!
  • It’s time to take control of our health; hard data is what the doctor needs!
  • Choosing the right foods to manage healthy blood sugar levels
  • Why does COVID-19 (SARS-CoV-2) cause such damage in some people but not in others?
  • The value of having a dog or cat at this difficult time must be huge!
  • Coping with isolation: difficult times with COVID-19

Topics

  • Allergy, asthma or hay fever
  • Anxiety, stress or emotional health
  • Bereavement
  • Cancer
  • Charity
  • Cold Sores
  • Cold, coughs and flu
  • Diabetes
  • Domestic abuse
  • Dr Morton’s casebook
  • Ear, nose and throat
  • Email marketing
  • Ethics
  • Fatigue
  • Fever or high temperature
  • Gender pay gap
  • Grief
  • Heart disease
  • In the news
  • Infectious Diseases
  • Junior Doctor Cartoon Campaign
  • Junior Doctor Strike
  • Long-term medical conditions
  • Medical specialty
  • Medication enquiry
  • Men’s health
  • News
  • NHS
  • Nutrition
  • Other medical conditions
  • Pain, headaches and migraine
  • Pregnancy
  • Rash or skin condition
  • Sexual health
  • Sports injuries, bones, muscles and joints
  • Stem Cells
  • Stomach ache, diarrhoea or lower gut
  • Travel health
  • Uncategorized
  • Women's health

Real Doctors at Dr Morton's in the news...

Appearance of Dr Morton’s doctors, at the request of TV or other media channels to make expert comment on medical matters, does not amount to advertising or endorsement

  • About Us
    Our story
    Our values
    Our doctors
    NHS ♥
  • Getting started
    How it works
    Terms and conditions
    Our pharmacy
    Our laboratory
  • Trust & Security
    Privacy policy
    CQC Regulated
    Cookies
    Recommend us
  • Connect

    Contact us
    Delivery information
    Site map