
Many people manage mild haemorrhoids at home with a few changes to diet and toilet habits, and a lot of symptoms settle within a week or two. But bleeding, pain and lumps around the bottom are not always piles, and it is not possible to tell for certain from symptoms alone. This guide explains which signs mean you should be examined, which are usually less urgent, and what the appointment involves.
See a GP or a specialist promptly if you have bleeding from the bottom for the first time, bleeding that is heavy, keeps coming back or happens without wiping, blood mixed in with the stool or dark, tarry stools, or a change in your usual bowel habit lasting more than a few weeks, such as new constipation, looser stools or a feeling of not emptying fully. Unexplained weight loss, tiredness, or a lump you cannot explain are also reasons not to wait. These can be caused by piles, but they can also be caused by other conditions that need a proper examination. Our article on haemorrhoids or bowel cancer explains the differences.
Seek urgent medical help if you are bleeding heavily, feel dizzy or faint, have severe pain that is getting worse, have a very painful hard lump that appeared suddenly, have a fever with anal pain or swelling, or cannot pass urine or stool. A sudden, tense, purple lump can be a thrombosed haemorrhoid, which is painful but not dangerous; our guide to thrombosed haemorrhoids covers it. Severe pain with fever can point to an abscess, which needs prompt treatment. Call 999 or go to A&E for heavy bleeding that will not stop or if you feel faint.
A small amount of bright red blood on the paper or in the bowl after a hard stool, mild itching, a slight sense of fullness, or a soft lump that goes back in by itself are common with haemorrhoids, particularly if you already know you have piles. Soft stools, enough fibre and fluid, not straining and not sitting on the toilet for long usually help; see our guides on constipation and haemorrhoids and straining on the toilet. Warm baths can ease discomfort, and our hygiene article explains how to clean gently. If symptoms have not clearly improved within about two weeks, or if they keep returning, book an appointment rather than waiting.
The older you are, the more important it is to have new bleeding checked, because the chance of other bowel conditions rises with age. In the UK, new rectal bleeding or a persistent change in bowel habit in someone over 50 is usually looked into rather than put down to piles. If you take blood thinners or aspirin, bleeding can be heavier and should also be reviewed. Our guide to haemorrhoids over 60 covers this in more detail. Younger people with bleeding, a family history of bowel cancer, or other symptoms should also be examined.
Internal haemorrhoids are often painless, with bleeding as the main sign. Sharp pain on passing a stool, especially with a tear-like sensation, is more often an anal fissure, and constant severe pain can be a thrombosed haemorrhoid or an abscess. If pain is significant, it is worth working out the cause rather than treating blindly; our article on haemorrhoids or anal fissure explains how they differ.
A doctor will ask about your symptoms, bowel habits, diet and medicines, then usually examine the area and may use a short, well-lit tube called a proctoscope to look inside the lower bowel. This is quick and is not usually painful, although it can be uncomfortable or embarrassing. Our guides to proctoscopy and to what happens at a haemorrhoid appointment explain the process step by step. Depending on your age and symptoms, you may also be offered blood tests or referred for further investigation of the bowel.
A GP is a sensible first step, especially for new bleeding or if you are over 50. NHS treatment for haemorrhoids is available, although waiting times for a specialist can be long. Some people choose to be seen privately to be examined and treated sooner; our article on NHS or private haemorrhoid treatment compares the options, and our guide to haemorrhoid treatment costs in the UK sets out typical prices.
At our clinics in Glasgow and London we examine patients and treat internal haemorrhoids with eXroid electrotherapy, which applies a low-dose direct current to the base of the haemorrhoid so that it shrinks over the following weeks, without cutting or a general anaesthetic. Of 116 patients treated at our clinics since January 2025, 84% needed only one session, although individual results vary and some people need a follow-up. A consultation with examination is £365, consultation and treatment on the same visit is £1,095, and a follow-up treatment, if needed, is £795. If what we find is not something we treat, or needs a referral for further tests, we will say so and tell you who to see.
If you are unsure whether your symptoms need attention, an examination is the quickest way to know what is causing them. Our severity test takes a couple of minutes and can help you think through your symptoms, although it is not a diagnosis. You can read about our procedure or book an appointment at our Glasgow or London clinic.
Haemorrhoid centre London
93 Wardour Street
London, W1F 0UD
Haemorrhoid centre Glasgow
1 Blythswood Square
Glasgow, G2 4AD
Haemorrhoid centre Edinburgh
53 Dundas Street
Edinburgh, EH3 6RS
Tel: 020 3910 1601
Email: info@haemorrhoidcentre.com