Haemorrhoids, or piles, are dilated anal vessels which arise in pregnancy as a result of the pressure of the uterus on the veins in the pelvis. First-degree haemorrhoids are swellings at the anal margin which produce discomfort and possibly a mucus discharge. Second-degree haemorrhoids are larger, and prolapse out of the anus during defecation, causing discomfort and bleeding. It may be necessary to replace them using a finger after defecation. Third degree haemorrhoids are present outside the anal margin, and cannot be returned. The symptoms are much worsened by constipation. The pain of prolapsed haemorrhoids can be eased by using an ice pack, and the inflammation reduced by using topical creams.