​Piles (Haemorrhoids)​​​


Haemorrhoids (also called piles) refer to swollen and inflamed veins in your rectum or anus. They appear as swellings that contain enlarged blood vessels which are located inside or around the rectum and anus. You may have either have an internal haemorrhoid, which lies far enough inside the rectum that you may not feel or see, or external haemorrhoids, which lie within the anus and prolapses on the outside (usually while passing a stool). 

Piles is caused by an increased pressure in your lower rectum. This may be due to a number of factors, such as straining during bowel movements, sitting or long periods of time and chronic constipation or diarrhoea.

Small haemorrhoids can be asymptomatic, other symptoms may be:

  • Bleeding – while passing a stool which is usually painless. The blood will appear to be bright red and may streak stool .

  • Anal itchiness

  • Perianal swelling

  • Mucus anal discharge ​

The symptoms of piles usually clear up on their own. However, you should visit a doctor if there is blood in your stool so that he can rule out other causes of blood in stools. 

Some people are hesitant or embarrassed about visiting their doctor about anal problems. However there is no reason to be ashamed about seeking help with piles, as doctors are trained and used to treatment them. The doctors working with the GI and Surgery Service Line​ at The Aga Khan University Hospital will do their best to make the process as comfortable for you as possible.

Your time with your doctor maybe limited, so make sure to prepare for your visit beforehand. Here​ are some tips to help get you started.

Piles is usually easily diagnosable on clinical examination. Your doctor will begin by asking you details about your symptoms. 

If these are indicative of haemorrhoids, he or she may ask to examine your back passage for signs of swollen blood vessels and  a proctoscopy, which involves a thin hollow tube that is inserted into your anus to examine the area. You may need to undergo a colonoscopy, which is a more extensive examination of your entire bowel (colon) in order to check for indications of another underlying problem. ​

Most instances of piles clear up on their own after a few days, or can be treated by medications. However, some more serious or repeat cases of haemorrhoids may require surgical intervention.

Your doctor may suggest a surgery to treat haemorrhoids if the other forms of treatments have not been successful, or if your personal case requires it. There are a number of treatment options, which include:

  • Band ligation: Clinic procedure to apply rubber bands on the piles .

  • A haemorrhoidectomy – this operation is performed to remove the haemorrhoid. 

  • Transanal haemorrhoidal dearterialisation – this operation aims to reduce the blood flow to your haemorrhoids.

  • Stapling – this procedure is an alternative to a conventional haemorrhoidectomy and may be performed to treat prolapsed haemorrhoids. 

Your surgeon will best be able to decide which form of treatment is most appropriate for you and which will give you the highest chances of full recovery with minimum side-effects and chances of complications. ​

Please click here​ for some guidelines on “what to do before your surgery”

Please click here​ for some guidelines on “what to do on the day of your surgery”

The surgical procedures to treat piles are considered low risk. However, occasionally there may be some complications after the surgery. These may include:

  • Bleeding or blood clots – this may happen a week or so following the procedure

  • Infection – there is a chance that you may develop an infection which could lead up to build-up pus. This is usually easily treatable with a short course of antibiotics. 

  • Faecal incontinence – this refers to the involuntary passing of stool, it is usually temporary.

  • Urinary retention – this is described as difficulty with emptying your bladder

  • Stenosis – this refers to the narrowing of your anal canal. 

These complications can usually be effectively treated with medication or by surgical treatment

Please click here​ for some guidelines on “what to do on after your surgery”

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage.


The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.​