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Clinical features

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Haemorrhoids often only produce intermittent symptoms. Symptomatic episodes are often precipitated by constipation. These episodes usually last from a few days to a few weeks. Often they are completely asymptomatic between episodes.

Clinical features of haemorrhoids (piles) include:

bright red bleeding after defaecation:

  • may just stain the toilet paper or streak the faeces (it is not mixed in)
  • if copious it may splash around the lavatory pan

  • faecal soiling due to impaired continence

  • mucus discharge

  • pruritus ani, caused by a persistent discharge irritating the perianal skin


  • a feeling of incomplete evacuation after a bowel movement if prolapse occurs

  • occasionally pain:
    • thrombosis may cause acute severe anal pain occasionally necessitating hospital admission

  • grades 2-4 may be felt as a rectal mass

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