Bright red blood on the paper after the toilet, or lumps around your bottom, may be piles (haemorrhoids). The NHS describes them as lumps of swollen blood vessels inside and around the anus and says they often get better on their own within a few days. This sets out the NHS page: home care such as fluids and fibre, not straining and warm baths, and the point at which non-stop or heavy bleeding means A&E.
1. They often get better on their own within a few days. Fluids and fibre to soften stools; don’t strain.
2. Avoid ibuprofen if they’re bleeding, and codeine, which can cause constipation. Paracetamol for pain.
3. Non-stop or heavy bleeding, large clots or severe pain: A&E or 999 (119 in Korea).
Symptoms — NHS
The NHS lists bright red blood after a poo, an itchy anus, feeling you still need to go after the toilet, mucus in underwear or on paper, lumps around the anus and pain around the anus. They range from pea-sized pink or purple lumps to grape-sized ones.
Things to do and avoid — NHS
| Type | What the NHS says | Worth noting (ours) |
|---|---|---|
| Do | Gently push a pile back in if you can | — |
| Do | Paracetamol for pain | Acetaminophen in Korea |
| Do | An ice pack in a towel | — |
| Do | Plenty of fluids and fibre to keep stools soft | See constipation |
| Do | A warm bath to ease itching and pain | — |
| Do | Keep clean and dry; pat, don’t rub | — |
| Do | Cut back on alcohol and caffeine (tea, coffee, cola) | — |
| Don’t | Ignore the urge to go, or push too hard | — |
| Don’t | Codeine painkillers — can cause constipation | — |
| Don’t | Ibuprofen if they’re bleeding | — |
| Don’t | Spend longer than needed on the toilet | — |
The NHS advice on softer stools is in constipation. A pharmacist can suggest creams for pain, itching and swelling, laxatives and cold packs.
When to get help — NHS
| If | Where | Worth noting (ours) |
|---|---|---|
| Symptoms worse or not improving with home care | GP | — |
| Piles keep coming back | GP | — |
| An unusual change around the anus | GP | To rule out other causes |
| Very high temperature, hot and shivery or generally unwell | Urgent appointment or 111 | — |
| Painless bleeding from the bottom | Urgent appointment or 111 | — |
| Pus leaking from piles | Urgent appointment or 111 | — |
| Bleeding non-stop, heavy bleeding or large clots | A&E or 999 | 119 in Korea |
| Severe pain | A&E or 999 | Don’t drive yourself |
Hospital treatment — NHS
| Treatment | What the NHS says | Worth noting (ours) |
|---|---|---|
| Rubber band ligation | A band makes them drop off | Awake; usually home the same day |
| Sclerotherapy | An injection shrinks them | — |
| Electrotherapy, infrared coagulation | A mild current or infrared light shrinks them or cuts blood supply | — |
| Surgery | Haemorrhoidectomy, stapled haemorrhoidopexy, haemorrhoidal artery ligation | Usually asleep; home that day or the next |
The NHS says treatment doesn’t always stop them coming back. The cause isn’t clear; constipation, straining, heavy lifting, pregnancy, getting older and being overweight make them more likely.
Checklist
- ☐ Fluids and fibre; don’t ignore the urge or strain
- ☐ Paracetamol for pain — no ibuprofen if bleeding
- ☐ Warm bath; pat dry
- ☐ Not improving or recurring: GP. Pus, painless bleeding or high temperature: urgent
- ☐ Non-stop bleeding, large clots or severe pain: 999
Questions that remain
If it bleeds but doesn’t hurt, is that fine?
The NHS lists painless bleeding from the bottom as a reason for an urgent appointment — so not something to ignore (our reading).
Can they happen in pregnancy?
The NHS lists pregnancy as a risk factor and covers piles in pregnancy on a separate page, which we didn’t read.
Sources
- NHS — Piles (haemorrhoids) — source (page shows: reviewed 1 April 2026, next review 1 April 2029; checked 19 October 2026). 6 symptoms, 7 dos and 5 don’ts, pharmacy, 3 GP, 3 urgent and 3 emergency signs, non-surgical and surgical treatment, causes.
- Not read. The NHS page on piles in pregnancy; Korean guidance.
- What we added. The “worth noting” column and the Korean care gloss.
Where to check further
- A colorectal or general surgery clinic — if they don’t improve or keep returning.
Written on 19 October 2026. The content is from the NHS; the glosses are ours.
