Piles in special cases (pregnancy, children, elderly)

Piles need extra care in pregnancy, children and older adults.

Pregnancy

• Piles are common, especially in the third trimester, because of pressure on veins and constipation.
• Eat fibre, drink fluids, walk daily and avoid straining.
• Warm sitz baths and cold compresses give comfort.
• Ask a doctor before using any cream, suppository, laxative or herbal product.
• Piles often improve after delivery.
• Tell your doctor about heavy bleeding, severe pain, or bleeding with abdominal pain.

Children

• Piles are uncommon in children. Rectal bleeding is more often from a fissure caused by constipation.
• Increase fibre and fluids, and avoid hard stools.
• See a paediatric doctor for any bleeding, pain or a lump.
• Do not give adult medicines, laxatives or herbal remedies without advice.

Older adults

• Piles are more common with age, but new rectal bleeding must be checked to rule out other causes such as polyps or bowel cancer.
• Constipation may be caused by medicines such as iron, painkillers and some blood pressure medicines. Review them with a doctor.
• Those on blood thinners should report any bleeding.
• Surgery decisions depend on general health.