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Conditions
Haemorrhoids(Piles)
Swollen blood vessels in or around the anus and rectum. Cause itching, discomfort, and sometimes bleeding. Very common - affect about 50% of adults by age 50.
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avg cert turnaround
13 min
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Symptoms
CommonsymptomsofHaemorrhoids(Piles)
An AHPRA-registered doctor assesses these symptoms online - no in-person visit required.
Bright red blood after a bowel movement
Itching or irritation around the anus
Pain or discomfort, especially when sitting
Swelling or a lump near the anus
Mucus discharge
Feeling of incomplete bowel emptying
Our Scope
Howwecanhelp
InstantMed handles many common conditions entirely online. Here's what fits our service.
What we can help with
- Assessment and treatment advice
- Prescription treatments (topical steroids, laxatives)
- Discussion of prevention strategies
- Medical certificates if symptoms are severe
What needs in-person care
- Physical examination (some haemorrhoids need this)
- Procedures (banding, injection, surgery)
- Assessment of persistent rectal bleeding over 50 (needs colonoscopy)
Depending on your situation, an AHPRA-registered doctor may be able to issue a medical certificate or arrange a repeat prescription after reviewing your request online.
Clinical Guidance
Whentoseeadoctor
These indicators suggest you should seek professional medical advice promptly.
Signs you need a doctor
- 1First episode of rectal bleeding (to confirm diagnosis)
- 2Symptoms not improving with self-care after 1-2 weeks
- 3Recurrent haemorrhoids
- 4Significant pain (possible thrombosed haemorrhoid)
- 5You need treatment advice or a medical certificate
Seek emergency care if
- Heavy rectal bleeding that won't stop
- Severe pain with a large, hard lump at the anus
- Rectal bleeding with dizziness or fainting
- Dark red or black stools (upper GI bleeding - different cause)
Call 000 or go to your nearest emergency department
Clinical Insight
Adoctor'sperspectiveonHaemorrhoids(Piles)
InstantMed Clinical Team
AHPRA-registered medical team · Reviewed 2026-03
Haemorrhoids are one of the most common conditions I see, yet patients are often embarrassed to discuss them. They are caused by increased pressure in the rectal veins - from straining during bowel movements, chronic constipation, pregnancy, prolonged sitting, or heavy lifting. The most important thing I assess is whether symptoms are consistent with haemorrhoids or whether further investigation is needed. Bright red blood on the toilet paper or in the bowl, associated with a known lump, is classic for haemorrhoids. However, any rectal bleeding in someone over 50, or bleeding associated with a change in bowel habits, weight loss, or dark stools, needs investigation to exclude bowel cancer. For straightforward haemorrhoids, the treatment is addressing the underlying cause (constipation) and symptom management with topical preparations.
Treatment
TreatingHaemorrhoids(Piles)
Haemorrhoid treatment combines addressing the underlying cause (constipation, straining) with topical symptom management. Osmotic laxatives (macrogol) reduce straining and are the most important preventive measure. Topical preparations with local anaesthetic and/or low-potency topical corticosteroid (cinchocaine-hydrocortisone) relieve itching and discomfort. Flavonoid preparations (micronised purified flavonoid fraction) have evidence for reducing bleeding and swelling in acute haemorrhoids. Procedures (rubber band ligation, sclerotherapy, surgery) are reserved for persistent or severe cases.
Cinchocaine + hydrocortisone (topical)
Proctosedyl, Scheriproct
Class:Topical local anaesthetic + low-potency corticosteroid
Typical dose:Apply cream or suppository twice daily and after each bowel movement for up to 7 days
PBS:Proctosedyl available OTC (S3, pharmacist supply); Scheriproct requires prescription
- Cinchocaine provides local anaesthesia; hydrocortisone reduces inflammation and itching
- Limit to 7 days per course -- prolonged topical corticosteroid use can cause perianal skin thinning
- Suppositories for internal haemorrhoids; cream for external involvement
- Does not treat the underlying cause -- use alongside stool-softening measures
Macrogol (polyethylene glycol)
Movicol, Osmolax
Class:Osmotic laxative
Typical dose:1-2 sachets daily dissolved in water; adjust to achieve soft, easy-to-pass stools
PBS:PBS listed; $25.00 general / $7.70 concession (PBS, 2026)
- Reduces straining -- the primary aggravating factor for haemorrhoids
- Soft stools reduce trauma to haemorrhoidal tissue during bowel movements
- Safe for ongoing use; highly recommended in combination with dietary fibre
Diosmin + hesperidin (micronised purified flavonoid fraction)
Daflon
Class:Venous tonic / flavonoid phlebotonic
Typical dose:500mg twice daily for acute haemorrhoid episode; or 1000mg twice daily for 4 days then 500mg twice daily for 3 days during flare
PBS:Available OTC without prescription; not PBS listed
- Cochrane review evidence supports flavonoid preparations for reducing haemorrhoidal bleeding and acute symptoms
- Reduces capillary fragility and venous tone in haemorrhoidal tissue
- Well tolerated; no significant drug interactions
Source: Therapeutic Guidelines -- Gastrointestinal, 2023; Colorectal Surgical Society of Australia and New Zealand (CSSANZ) haemorrhoid management guidelines. This information is educational only and does not replace clinical assessment.
Specialist referral: Refer to a colorectal surgeon or gastroenterologist for: haemorrhoids not responding to 4-6 weeks of conservative management, thrombosed external haemorrhoids causing severe pain, recurrent significant bleeding, or internal haemorrhoids Grade 3-4. Any rectal bleeding in patients over 50, or with alarm features, should be investigated with colonoscopy before assuming haemorrhoidal cause.
Haemorrhoids (Piles) in Australia
Haemorrhoids affect approximately 50% of Australian adults by age 50
They are more common during pregnancy - up to 35% of pregnant women are affected
Haemorrhoids are a leading cause of rectal bleeding in adults under 50
Australia's National Bowel Cancer Screening Program recommends testing from age 50 - rectal bleeding at any age should be assessed
Recovery
Whattoexpect
Typical recovery timeline and return-to-work guidance for most patients.
Typical recovery
Mild haemorrhoids: 1-2 weeks with self-care. Thrombosed haemorrhoids: 2-4 weeks for the clot to resolve. After banding procedures: 1-2 weeks. Post-surgery: 2-6 weeks.
Return to work
Mild haemorrhoids: most people can work normally. Thrombosed or painful haemorrhoids: 1-3 days off may be needed, especially if sitting is required. Post-procedure: 1-7 days depending on the type.
When to reassess
See a doctor if bleeding is persistent or increasing, if you develop a hard, painful lump at the anus (possible thrombosed haemorrhoid), if symptoms are not improving after 2 weeks of self-care, or if you are over 50 with new rectal bleeding.
Self-Care
ManagingHaemorrhoids(Piles)athome
Evidence-based tips to support your recovery alongside medical treatment.
Increase fibre intake gradually to 25-30g/day - this is the single most effective long-term treatment
Drink at least 2 litres of water daily - fibre without water can worsen constipation
Don't strain or sit on the toilet for extended periods - if it hasn't happened in 5 minutes, get up and try later
A sitz bath (sitting in warm water for 10-15 minutes) soothes irritation and promotes healing
Use moist toilet wipes instead of dry paper - or rinse with water. Pat dry, don't rub
Over-the-counter haemorrhoid creams (with local anaesthetic or hydrocortisone) provide temporary symptom relief
FAQ
CommonquestionsaboutHaemorrhoids(Piles)
Answers to the most common questions from patients.
No. While haemorrhoids are the most common cause of bright red rectal bleeding in younger adults, other causes include anal fissures, inflammatory bowel disease, and rarely, colorectal cancer. Any new rectal bleeding should be assessed, especially if you are over 50.
Mild haemorrhoids often improve within a week with self-care (fibre, fluids, topical treatments). Larger or more persistent haemorrhoids may need medical treatment. They tend to recur if the underlying cause (straining, constipation) isn't addressed.
Most haemorrhoids are managed conservatively. Surgery or procedures (banding, sclerotherapy) are typically reserved for large internal haemorrhoids that don't respond to other treatments, or for thrombosed external haemorrhoids causing severe pain.
Yes, largely. The key is preventing constipation and straining: high-fibre diet, adequate fluids, regular exercise, and not sitting on the toilet for extended periods (put your phone down).
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Australian-registered doctors review your request when available.
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