Medicines and products for piles

Medicines can ease symptoms of piles but do not remove the cause. Fibre, fluids and avoiding straining remain the base of treatment.

Common options

• Fibre supplements and stool softeners: psyllium husk (isabgol) or lactulose, to soften stool and reduce straining
• Soothing creams and ointments: to relieve itching and discomfort. Some contain a mild local anaesthetic or a short course of steroid.
• Suppositories: inserted into the rectum for relief
• Painkillers: paracetamol is usually safest for pain. Avoid codeine-type painkillers, as they cause constipation.
• Flavonoids: these vein-supporting medicines are used in some countries for bleeding. Evidence is mixed, so ask your doctor.

Cautions

• Do not use steroid creams for more than about 7 days without medical advice. Long use thins the skin.
• Avoid strong laxatives for long periods.
• Check with a doctor before using any medicine in pregnancy or for a child.
• Tell your doctor about all medicines, including blood thinners.
• Avoid "guaranteed cure" products and unregulated powders or pastes.

Procedures if medicines are not enough

• Rubber band ligation
• Sclerotherapy
• Infrared coagulation
• Surgery such as haemorrhoidectomy for large or advanced piles

Ayurvedic view (interpretive)

Herbal ointments and Triphala are used traditionally. They are adjuncts, and evidence is limited.

When to get help

See a doctor for persistent bleeding, severe pain, or a lump that cannot be pushed back.

Remember

Medicines relieve symptoms. Soft stool and no straining prevent them coming back.