Mistake 1: Pushing on the toilet
The most common of all piles mistakes, and the one that feels like the only option. Hard stool, so you push. Every push sends blood into the cushions at the bottom. Years of it and they stay swollen.
UK health service: "do not push too hard when pooing." Charaka's list of causes of piles: "continued and excessive strain".
The fix: make the stool soft so it does not need pushing: fibre, water, isabgol. Knees above hips on a footstool. If nothing comes in a few minutes, get up and come back later. The full method is in constipation and piles.
Mistake 2: Holding the urge
A meeting, a journey, a dirty office toilet, or simply the fear that it will hurt. You hold it. Water is drawn out of the stool. When you finally go, it is harder, and now you must push. The mistake feeds Mistake 1.
UK health service: "do not ignore the urge to poo." Charaka: "suppression of natural urges" among the causes of piles.
The fix: go when the body says go. For the office toilet problem, eat a proper breakfast at home so the bowel gives its signal before you leave. If it hurts to go, a warm water sit before and after takes the edge off.
Mistake 3: The phone on the toilet
A 3-minute job becomes 20 minutes of sitting with the bottom open and under pressure, usually with a few pushes "to finish". Of all the piles mistakes, this is the newest and the easiest to fix.
UK health service: "do not spend more time than you need to on the toilet."
The fix: phone stays outside the bathroom. Toilet is for the toilet. Done, or not done in a few minutes: get up either way.
Mistake 4: Isabgol done wrong
Isabgol is the best home fix for hard stool, and the most often misused. People take it dry, or in a sip of water, or stirred into hot chai or milk, or at the same time as their tablets. Done wrong, it can make stool harder, not softer.
US medicine guide (MedlinePlus): take it with a full glass of liquid, about 240 ml, every time; mix just before use and drink at once; keep it 3 hours away from aspirin and some other medicines; trouble swallowing is among the side effects of too little liquid.
The fix: one dose at night, in a full glass of water, drunk at once, then a little more water. Tablets with meals, isabgol at bedtime. Not in chai, not in milk, never dry.
Mistake 5: The wrong painkiller
It hurts, so you buy the "strong" tablet at the counter. Many strong painkillers contain codeine, which constipates. Now the stool is harder and the piles worse. Or you take ibuprofen while bleeding.
UK health service, word for word: "do not take painkillers that contain codeine, as they can cause constipation" and "do not take ibuprofen if your piles are bleeding." Its advice: "take paracetamol if piles hurt."
The fix: paracetamol, and read the strip. Warm water sitting and an ice pack in a towel do more for the pain than most tablets anyway.
Mistake 6: A cream for months, no examination
The chemist's cream eases pain and itching for a few days. That is what it is for. The mistake is buying it again and again for months, because it means two things: the real cause, hard stool, is untouched, and nobody has ever confirmed that the lump is piles.
UK health service: see a doctor if there is "no improvement after 7 days of treatment at home", or if you keep getting piles. And: "Treatment does not always prevent piles coming back."
The fix: cream for a week, habits for life. If piles return after the cream, the answer is not more cream; it is the stool, the toilet habit, and one visit to a doctor to confirm what it is.
Mistake 7: Ignoring bleeding, or assuming it is piles
Two opposite mistakes, same risk. One person sees blood for months and tells no one. Another sees blood and says "piles", and never gets it checked. Most bleeding from the bottom is piles. Not all of it.
UK health service, on symptoms that need a check: "blood in your poo, which may look red or black", "bleeding from your bottom", a change in stool habit that is not usual for you, "losing weight without trying", tummy pain, feeling very tired or short of breath. Urgent if stool is "black or dark red" or there is "bloody diarrhoea". Emergency if bleeding does not stop, is heavy, or has large clots.
The fix: new bleeding gets one examination. It is quick, and it usually ends with "it is piles" and a plan. After that, bleeding that changes colour, or comes with weight loss, tiredness or a change in habit, goes back to the doctor. Our blog on piles symptoms has the full list.
Why piles keep coming back
Charaka's chapter on piles says the cause is weak digestion, and from it constipation, "the root cause of arsha". His first step of treatment is to remove the causes: holding the urge, straining, hard seats, no exercise, day sleep, heavy and stale food. The Ashtanga Hridaya says piles uprooted with chaas do not grow back, and it says that in a chapter about food and habits, not creams.
Read the seven mistakes again. Every one of them leaves the cause in place. The cream shrinks the lump; the hard stool, the pushing, the phone and the held urge build it back. The UK page's line, "treatment does not always prevent piles coming back", is not a warning about creams. It is a warning about habits.
The 2-week reset
Week | Do this |
|---|---|
Week 1 | Phone out of the bathroom. Go when the urge comes. Footstool. No pushing. Isabgol in a full glass at night. 1-litre bottle emptied twice. Breakfast every day. Warm water sit after going if it hurts. Paracetamol only. |
Week 2 | Atta roti not maida. A full katori of dal at both meals. A big sabzi. Fruit with skin. Chaas with lunch. A 10-minute walk after lunch and dinner. Stand every 30 minutes at the desk. |
After 2 weeks | Better: keep every habit; this is the treatment. No better, or bleeding, or any warning sign: see a doctor. |
The food side is in the piles diet chart; the desk-day side is in sitting and piles; the home care is in home remedies for piles.
Piles mistakes all have one shape: treating the lump, feeding the cause. Fix the stool and the toilet habit, and the piles stop returning.
Ayuvya's Pyl Ease is made from Ayurvedic herbs to support people with piles, and comes with a piles diet chart built to avoid every mistake on this page. See Pyl Ease. If you have bleeding with any warning sign, see a doctor first.
Sources
- NHS (UK). Piles (haemorrhoids): treatment: paracetamol; no codeine; no ibuprofen when bleeding; "treatment does not always prevent piles coming back". nhs.uk
- NHS 111 Wales. Haemorrhoids (piles): do not push, do not ignore the urge, do not spend more time than needed on the toilet; when to see a GP. 111.wales.nhs.uk
- NHS (UK). Bowel cancer: symptoms and when to get help. nhs.uk
- MedlinePlus (US National Library of Medicine). Psyllium: liquid amount, mixing, medicine gap, side effects. medlineplus.gov
- Charaka Samhita, Chikitsa Sthana, chapter 14 (Arsha Chikitsa): constipation as the root cause; causes including suppression of urges and strain. carakasamhitaonline.com
- Ashtanga Hridaya, Chikitsa Sthana, chapter 8, verse 42 (takra). English rendering at Easy Ayurveda. easyayurveda.com
