Living with piles, also known as haemorrhoids, can be both uncomfortable and inconvenient. The itching, pain or bleeding that often occurs during bowel movements can easily disrupt daily routines. Yet, many people choose to delay medical treatment, hoping that the condition will simply improve with time.
But can piles really go away without medical help, or do they tend to worsen as time goes on? The outcome largely depends on the type, severity and underlying cause of the haemorrhoids. Keep reading to understand when piles may settle naturally and when professional care is needed.
Understanding Piles
Piles occur when veins in or around the anus and rectum become swollen. They are generally classified into two types. Internal piles develop inside the rectum and are often painless in their early stages, although you may notice bleeding after passing stool. External piles, on the other hand, form under the skin surrounding the anus and tend to cause more noticeable discomfort such as swelling, irritation or pain.
Common causes include straining during bowel movements, chronic constipation or diarrhoea, prolonged sitting on the toilet, pregnancy and a low-fibre diet. All of these increase pressure in the rectal veins, which can lead to or worsen haemorrhoids over time.
Can Piles Resolve Naturally?
If you are dealing with mild symptoms, there is a chance that the condition can improve on its own, especially when addressed early. Adjusting certain habits can make a significant difference, easing discomfort and preventing further irritation.
Here are some lifestyle habits that may help:
Increase Fibre Intake
: Including more fruits, vegetables and whole grains in your meals helps soften stools, making them easier to pass and reducing the need to strain.Stay Hydrated
: Drinking plenty of water supports regular bowel movements and prevents constipation, both of which help reduce pressure on the rectal veins.Avoid Prolonged Sitting
: Spending long periods sitting, particularly on the toilet, places extra pressure on the anal area and can worsen symptoms.Exercise Regularly
: Keeping active promotes healthy digestion and improves circulation, both of which can aid recovery and overall bowel health.
These measures work best for early-stage (Stage 1) piles, helping to relieve discomfort and keep the condition from advancing. However, if symptoms persist or worsen despite these efforts, it is best to consult a doctor for further assessment and appropriate treatment.
When Piles May Not Go Away on Their Own
While early-stage piles can sometimes resolve naturally, moderate to severe cases usually require medical attention. If left untreated, haemorrhoids can progress through four stages of severity, each presenting more noticeable and persistent symptoms.
Stage 1
You may notice some bleeding during bowel movements, but the haemorrhoids remain inside the rectum. At this stage, dietary adjustments and topical treatments are often enough to improve symptoms.
Stage 2
The haemorrhoids prolapse, or slip out, during bowel movements but retract on their own. Non-surgical options such as rubber band ligation or sclerotherapy may be recommended to ease symptoms and prevent recurrence.
Stage 3
The piles prolapse and must be manually pushed back into the rectum. Discomfort, pain and swelling are more pronounced, and medical procedures are often needed. Doctors may suggest minimally invasive treatments like haemorrhoidal artery ligation (HAL), haemorrhoid energy therapy (HET) or, in some cases, laser piles surgery.
Stage 4
At this point, the haemorrhoids remain permanently prolapsed and cannot be pushed back in. Pain, bleeding and possible complications such as blood clots or infections may occur. Surgery, including laser piles treatment or haemorrhoidectomy, is often necessary to remove the affected tissue and prevent further problems.
As the condition progresses, symptoms can become increasingly disruptive, affecting your ability to sit comfortably or go about your day. If bleeding or pain continues despite home remedies, early medical evaluation through effective piles treatment is key to preventing complications.
Experiencing ongoing discomfort or bleeding? Consider scheduling a consultation with Dr Ho Kok Sun at HKS Piles Clinic for an accurate diagnosis and a personalised treatment plan today.
About Dr Ho Kok Sun
Dr Ho Kok Sun
Consultant Colorectal and General Surgeon
MBBS (Singapore), M Med (General Surgery) (Singapore)
FRCS (General Surgery) (Edinburgh), FAM (Singapore)
Dr Ho Kok Sun has dedicated more than a decade to the management of piles and haemorrhoids, offering both surgical and non-surgical treatment options. He is the past President of the ASEAN Society of Colorectal Surgeons and the Society of Colorectal Surgeons (Singapore), and a founding member of the Eurasian Colorectal Technologies Association.
Beyond clinical practice, Dr Ho has been actively involved in training medical students and residents and has contributed extensively to medical literature through journal publications and book chapters. He believes that every patient’s treatment should be individualised, focusing on safety, comfort and long-term results.
