Hemorrhoids Treatment Online (Piles) — Prescription Cream & Advice
Itching, a swelling you can feel, bright red blood on the paper — piles are common, embarrassing and mostly treatable at home once a doctor has confirmed they are piles. An EU-registered doctor reviews a 3-minute questionnaire, usually within 15 minutes, screens the warning signs, and prescribes a short course of cream or suppositories plus the fibre plan that stops them coming back. €34.
- €34, one fixed fee
- Doctor review usually within 15 minutes
- Daily 7am–11pm CET
- 14 EU countries, no appointment
Cream is the relief, fibre is the treatment
A short course of a steroid or anaesthetic cream settles the itch and pain within days; a fibre supplement and enough fluid, kept up, is what stops the bleeding and the next flare. The doctor prescribes both.
Bleeding is checked, not assumed
Blood from the back passage is usually piles — but not always. Blood mixed in the stool, a change in bowel habit, weight loss or a first bleed over 50 is examined and tested first, and the doctor says so.
What needs a clinic
A hard, very painful lump that appeared suddenly (a thrombosed pile), piles that stay out, or bleeding with warning signs need to be seen — sometimes within 72 hours. The €34 is refunded in full.
Hemorrhoids treatment online — key facts
| Who it is for | Adults with piles diagnosed before, or typical symptoms — itch, discomfort, a soft swelling — and none of the warning signs; a first-ever bleed is examined before it is treated |
|---|---|
| First treatment in every guideline | Soluble fibre (psyllium or ispaghula) daily, 1.5–2 litres of fluid, no straining and no long sits on the toilet — this reduces bleeding and recurrence more than any cream |
| Prescription creams and suppositories | Hydrocortisone or a corticosteroid with lidocaine or cinchocaine, for up to seven days; longer courses thin the skin |
| Tablets | Flavonoids (diosmin / MPFF) for a few weeks reduce bleeding and itching in a flare; paracetamol for pain — avoid codeine, which constipates |
| Not treated online | Blood mixed with the stool or dark blood, a change in bowel habit, weight loss, anaemia, a first bleed over 50, a family history of bowel cancer, a sudden very painful lump, or piles that will not go back in |
| When cream is not enough | Piles that keep bleeding are treated with rubber-band ligation, a quick clinic procedure; large piles that stay out need surgery — the doctor refers |
| Price and time | €34, one fee; an EU-registered doctor reviews the questionnaire usually within 15 minutes, daily 7am–11pm CET; full refund if it cannot be treated online |
What is the treatment for hemorrhoids?
Hemorrhoids (piles) are treated first with daily soluble fibre, enough fluid and no straining, which reduces bleeding and stops most flares coming back; a flare gets a short course — up to seven days — of a steroid-anaesthetic cream or suppositories, and flavonoid tablets for bleeding and itch. Piles that keep bleeding are banded at a clinic in minutes; large piles that stay out need surgery. Blood mixed into the stool or a change in bowel habit is examined first.
How to get haemorrhoid treatment online — what happens after you press start
1. The questionnaire — about 3 minutes
It asks about blood in your stool, pain when passing stool, haemorrhoids that come out, swelling, fever, night sweats or weight loss, loose stools with blood or mucus, other conditions, family history of bowel disease, allergies and the medicines you take.
2. The doctor's review
The doctor reads it personally. Typical symptoms with no warning signs, or a flare of piles diagnosed before, are treated: a short course of prescription cream or suppositories, a flavonoid where bleeding and itch dominate, and the fibre and fluid plan written out. Blood mixed in the stool, a change in bowel habit, weight loss, a first bleed over 50, or a sudden agonising lump is not treated from a questionnaire — the doctor moves you to a video consultation, at no extra charge, and says how quickly you need to be examined.
3. The pharmacy
The prescription appears in your Mobi Doctor profile in English, naming the active ingredients, so a pharmacy you choose in any of the 14 EU countries can dispense the local product. You pay the pharmacy for the medicine; Mobi Doctor does not sell or dispense medicines.
Blood mixed in the stool, dark or heavy bleeding, a change in bowel habit, weight loss, or a sudden hard, very painful lump? Book a video consultation instead — the lump may need treatment within 72 hours.
Right for the Express Assessment if
- Piles have been diagnosed before, or your symptoms are typical — itch, discomfort, a soft swelling — with no first-ever bleed
- Your bowel habit has not changed and you have lost no weight
- You are under 50, or over 50 with piles already diagnosed by examination
- You are 18 or over and in one of the 14 EU countries Mobi Doctor covers
Book a video consultation instead if
- Blood mixed into the stool, dark blood, or bleeding heavy enough to colour the water
- A change in bowel habit lasting more than a few weeks, weight loss, or tiredness suggesting anaemia
- Bleeding for the first time — at any age it is examined before piles are treated — or any bleeding over 50, or a family history of bowel cancer
- A sudden, hard, very painful lump at the anus — a thrombosed pile is best treated within 72 hours
- Piles that stay out and cannot be pushed back, or a discharge of pus
- Pain like passing glass, worst during and after stool — that is more often a fissure, treated differently
List every medicine you take and answer each question fully — the doctor's decision depends on it. Your answers are confidential.
Prefer to listen? The Mobi Doctor podcast episode on haemorrhoids.
About haemorrhoids (piles): what they are, the grades, and how the symptoms differ
Haemorrhoids are cushions of blood vessels at the anal canal that everyone has; they become 'piles' when they swell, bleed or slide down. Internal piles start above the anal canal's sensitive zone and are graded I to IV: grade I bleed but do not come out; II come out on straining and go back on their own; III have to be pushed back; IV stay out. External piles form under the skin at the anal margin, where they can itch, swell and — if a clot forms inside one — become a hard, blue, intensely painful lump within hours. Bright-red blood on the paper or the surface of the stool, itching, a feeling of incomplete emptying and a soft swelling are the typical symptoms; pain is not, unless a pile is thrombosed or something else is going on. Many adults have symptoms at some point — estimates vary widely — and pregnancy, constipation, straining, long sits on the toilet and heavy lifting are the usual reasons.
Treatment for hemorrhoids and piles: what the doctor prescribes — and what actually works
The European Society of Coloproctology's guideline is clear about the order. First, and for everyone: a soluble fibre supplement (psyllium or ispaghula) every day, one and a half to two litres of fluid, no straining, no reading on the toilet, and treating constipation — this halves bleeding and keeps flares away, and it is the only treatment with strong evidence. Second, for symptom relief during a flare: a topical treatment for up to seven days — hydrocortisone or another corticosteroid, usually combined with a local anaesthetic such as lidocaine or cinchocaine, as cream for external piles and suppositories for internal ones. Steroid creams thin the skin if used for weeks, which is why the doctor prescribes a short course and the fibre plan together.
Third, oral flavonoids — diosmin, hesperidin or the micronised purified flavonoid fraction — reduce bleeding, itching and discomfort during a flare and are well tolerated; the guideline says they may be used. Paracetamol handles pain; codeine and other opioids constipate and make everything worse. A thrombosed external pile is treated with cold, sitz baths, pain relief and stool softeners if it is settling, or cut out under local anaesthetic if it is seen within about 72 hours and very painful — which is why that one is not a questionnaire case.
Prescription hemorrhoid cream versus what the pharmacy sells
Pharmacies across the EU sell haemorrhoid creams and suppositories over the counter — mostly local anaesthetics, astringents and low-dose hydrocortisone — and they are reasonable for a mild flare. The prescription products differ in strength and combination: higher-dose corticosteroids with anaesthetic, and the flavonoid tablets, which are prescription-only in several of the 14 countries. The more important difference is the doctor: knowing that the bleeding is piles and not something else, that the pain is not a fissure, and that a seven-day course is the limit is what turns a cream into a treatment. If the symptoms are the same after a proper course plus fibre, the next step is band ligation, not another tube of cream.
Treatment of piles in women, and during and after pregnancy
Piles are especially common in the last months of pregnancy and after delivery, driven by pressure from the uterus, constipation and the pushing of labour. The first-line treatment is the same and is safe throughout: fibre, fluid, stool softeners and short courses of topical treatment — a plain local anaesthetic or a low-dose hydrocortisone preparation, agreed with your maternity doctor. The questionnaire covers both when you say you are pregnant or breastfeeding. Flavonoid tablets are generally avoided in pregnancy. Most pregnancy piles settle within weeks of delivery; those that do not are assessed then, and procedures wait until afterwards.
Piles treatment without surgery: what to expect, and when to see a doctor
With cream and fibre, itching and discomfort ease within two to three days and a flare settles in one to two weeks. Bleeding should lessen and stop; if it continues beyond two weeks of proper treatment, becomes heavier, or the blood is mixed into the stool or dark, stop treating and be examined. A colonoscopy is the test for bleeding with warning signs, and grade I–III piles that keep bleeding are banded at a clinic in minutes. Piles that keep coming out, or a lump that stays hard and painful, are surgical questions. And a fissure — pain like passing glass, worst during and for an hour after a stool — is treated with different creams, so the doctor asks about the pain carefully.
Using the prescription at a pharmacy anywhere in the EU
The prescription is issued in English by an EU-registered doctor, names the active ingredient rather than a brand, and carries a verification code the pharmacist can check at mobidoctor.eu/verify. A prescription issued in one EU country must be recognised in another (Directive 2011/24/EU); the active-ingredient name is what makes that work at the counter. Dispensing is the pharmacist's decision under the rules of the country you are in, and depends on the medicine being available there. If you need a supply covering several months, say so in the questionnaire — the doctor decides the quantity. The other conditions the Express Assessment covers — 13 in all, plus repeat prescriptions — are listed on the online doctor prescription page.
Read our guide to how haemorrhoids form and how to prevent them
Sources: European Society of Coloproctology — guideline for haemorrhoidal disease (van Tol et al., Colorectal Disease 2020) · European Society of Coloproctology — guidelines
Start Express Assessment — €34 About 3 minutes to complete.
Dr. Chrysoula I. Liakou MD, PhD
Hemorrhoids and piles treatment online — your questions answered
Medical Build Order
About 3 minutes of questions — then the doctor takes over. No waiting room.