Piles, also known as hemorrhoids, are swollen veins in the lower anus and rectum. They can cause lumps in and around the anus and vary in size. Piles develop when the veins in the anal canal become swollen, which may happen for a number of reasons, including straining when going to the toilet, anal canal weakening with age, persistent cough, and lifting heavy objects. Piles can be self-managed up to grades III or IV, but if a complication develops, such as a fistula, it can become serious. There are several medicinal options available to make symptoms more manageable, such as pain relievers, stool softeners, and corticosteroids. Surgical options are available for more advanced piles, which are normally outpatient procedures with minimal recovery time. Pharmacies can suggest creams, treatments to help constipation and soften poo, and cold packs to ease discomfort. A GP can diagnose haemorrhoids (piles) by examining the back passage to check for swollen blood vessels.