"Still Bleeding Every Day, Clear Colonoscopy": A UK Vein Health Doctor Finally Names the Hidden Cause Nobody Treated (and Why "Just Piles" Was Never a Plan)
The NHS letter says "haemorrhoids, unspecified". The pan still goes red most mornings. Before anyone decides what to do about that, it helps to picture the one question the camera answers, the one it can't, the 50-year-old French answer most UK surgeries have never been offered, and the 99-morning test that shows, on anyone's own numbers, when the water stays clear.
Read this while it's still up. Pages that question the usual "creams and wait for surgery" advice tend to get reported and pulled, and we can't say how long this one will stay public in its current form. If any of it sounds like your mornings, read it to the end now.
She has spent years listening to patients who tell their doctor everything, except this.
Nadia De Licht
The hospital car park, last March.
I don't know which of these mornings will sound most like yours. I only know that one of them will.
A woman of 54 sits in her car with the engine off and cries. Not from fear. From relief.
Ten minutes earlier a consultant had said four words to her: "Nothing sinister. Just piles."
She rings her husband. She rings her sister. She rings her mum. Four months of FIT tests, a two-week-wait referral, the prep, the camera. Over.
Two mornings later she goes to the loo, looks down, and the water is red again.
And nobody, at any point, had told her what to do about that.
I'm Dr Nadia De Licht, and I work in digestive and vein health. I have heard the car park story, in one form or another, more times than I can count. The names change. The sentence underneath never does.
"They said it was just piles. So why is it still bleeding?"
This page is my answer. The people who say that sentence were all told the same three things, and all three are half true. The first is harmless. The second wastes money. The third is the dangerous one, and it's the reason the pan keeps going red long after the all-clear.
Before we go any further, though, a check. Because this page is not for everyone.
Who this page is for (and who it isn't)
As a person who has already done the hard part, the GP, the FIT test, perhaps the camera, I'd ask you to read the next lines slowly. The result came back as piles, "haemorrhoids unspecified", or "nothing sinister". And the bleeding carried on anyway. Then this page is for you.
It is not a substitute for that check. If the bleeding is new, if it has changed (darker, heavier, mixed in, with mucus), if there's weight loss or a change in bowel habit, or if nobody has ever actually looked: see a GP first. Always. Bleeding has boring causes far more often than frightening ones, but that is a judgement for a doctor with their eyes on the problem, not for a page on the internet.
And if "just piles" was said over the phone, with no examination and no plan, it is reasonable to go back and ask for one.
Properly checked, genuinely reassured, and still seeing red? Then stay, and let's find out together why.
"Still bleeding every day, clear colonoscopy"
For years I thought this was my clinic's problem. Then I started seeing it everywhere, and what I uncovered on Mumsnet, Cancer Chat, Patient.info and the big Reddit threads is worth reading word for word, typos included:
"I've had blood with every single BM for the last three years. Not only a little blood either, it's quite a bit. Had a clean colonoscopy."
"Still bleeding everyday, clear colonoscopy.. I guess sometimes it really is just hemorrhoids I don't see or feel.. so strange."
"It's quite nasty bleeding, the whole toilet bowl is red."
"im sure I'm now low in iron, but I daren't take iron as I worry it'll make me more constipated and make it worse!"
Real public posts. They describe the problem. None of them mention any product.
And then one line, from a bowel cancer forum of all places, that I think every surgery in the country should pin to the wall:
"Don't let anyone tell you its 'just hemorrhoids' unless they actually examine you AND devise a plan for treatment (not topical medication)."
That person isn't asking for reassurance. They've had the reassurance. They're asking for a plan that isn't a cream.
Hold that thought. Underneath every one of those posts there is one thing none of them can see. We'll get there together in a minute, and as you read the next list, you may wonder how many of the lines could have been written in your own house.
How many of these are yours?
- The morning verdict. Paper first, then the pan, before anything else in the day happens.
- The all-clear that cleared nothing. A letter or a consultant saying piles, and no plan after it.
- Red enough to colour the water. Not a streak. On bad days, drips you can hear before you look.
- Dark trousers. Always. Even in July. A liner or a pad "just in case".
- Tired, and not sure why. Bloods a bit low, iron tablets that bung you up, so back to square one.
- The 2am question. "They said it was fine. But what if they missed something?"
Four or more? What follows is about you.
"I've tried everything" (and the pan resets anyway)
When I ask "what have you already tried?", the list is the same in Nottingham as it is in Kent. Nobody on it has been sitting on their hands.
Anusol, then Germoloids, then the suppositories. They calm the surface for an afternoon. The bleeding doesn't come from the surface.
Fybogel, two litres of water, prunes, the footstool. All sensible. Keep doing it. It makes what passes softer. It changes nothing about what it passes over.
Iron tablets, because the bloods came back low. They bung you up, you push harder, you bleed more. So you stop the iron, and you're still bleeding.
Banding. £900 privately, or a year on a list. One woman wrote that it stopped the bleeding for exactly three months, then it came back worse.
Here's the pattern, and as you look back over that list you'll realise it yourself. Every single thing on it was missing the same one thing. Not because anyone was careless. Because none of them was ever told to look for it either.
The patient who made me write this page
I'll call her Carol, because that isn't her name.
Carol, 61, a school office in the Midlands. Two FIT tests, both positive. Two-week pathway. Camera in March. Verdict: internal haemorrhoids, nothing else.
I'll be honest about what I believed then: clear camera, piles confirmed, cream and fibre, job done. I had said it myself, more than once.
Three weeks later Carol was back in my clinic, and she said something I still ponder most weeks.
"I don't think I'm scared of cancer any more. I think I'm scared of the pan. Every morning I look, and every morning it tells me they might have been wrong."
That's the bit nobody writes on the discharge letter. The colonoscopy answered the frightening question. It never answered the practical one. And as long as the water is red, the frightening one quietly reopens, every morning.
So we explored, together, what a colonoscopy actually looks at. That was the discovery that changed how I read those letters, and it's where the third half-truth falls apart.
The three things everyone is told (and the one that keeps the pan red)
The first: "bright red means it's nothing." Half true. Colour can't tell anyone what it is; a check can.
The second: "cream is the treatment." Half true. Cream treats the skin. The bleeding does not come from the skin.
The third: "if the camera was clear, there's nothing left to treat." This is the dangerous one. Carol believed it. I believed it. Almost everyone on those forums believes it.
A colonoscopy does one job, brilliantly: it looks for what's there. If yours was clear, that is genuinely good news. But think about how it's done. Lying on your side. Bowel emptied. At rest.
Piles are cushions of blood vessels inside the back passage. Everyone has them. The camera sees the cushion. What it cannot see is what happens to the blood inside that cushion when you're upright, sat for hours, or pushing on the loo at seven in the morning. It was never built to check that.
And that is exactly where the bleeding comes from.
If that last sentence landed like a brick, good. That's a year suddenly making sense. Stay with it, and follow along for one minute of anatomy. I'll keep it simple.
The Pooling Point: the one thing nobody serviced
Your heart pushes blood downwards in a single beat. Getting it back up is a climb with no engine. Blood in the lowest parts of the body climbs home on three things: the wall of the vein squeezing, little one-way valves stopping it falling back, and the muscles that pump when you move.
None of the three works while you sit still. Or stand still. Or push.
So after enough years of a British day (the desk, the drive, the twenty minutes on the loo with the phone, two pregnancies), the climb fails at one spot: the lowest, most loaded point of your body. Blood pools there. The wall stretches. And where blood sits still, the wall gets worn from the inside, so it only ever gets thinner.
In the back passage, the pooling point is the thinnest wall of one of those cushions. Something passes over it, and it leaks. Bright red, into the pan. Often without pain, because it isn't a wound. It's a leak from a wall nobody has ever made stronger.
The thing everyone keeps treating is the pool. Not the fault.
Say it once, the way I say it to patients: it's not the skin, it's the wall. And it's not the wall alone, it's the climb back up.
Notice how much calmer the 2am question already feels, now that the thing has a name. That calm is worth keeping, because it's the reason the rest of this page is easy to read.
Why everything on that list was treating the wrong thing
Once you see the pooling point, the whole graveyard explains itself. Every remedy was aimed one layer too high.
- The creams treat the skin on the outside. The leak is in the wall underneath.
- The fibre and the water soften what passes over the thin spot. They don't make the spot any thicker.
- The banding removes one swollen cushion. It leaves the stretched walls next to it, with the same slow return journey underneath. Which is why so many people write "it came back".
- The iron refills what you've lost. It doesn't close the leak.
- And the camera checked for what's there. It was never looking at the return journey.
As you recognise that none of this was your fault, something else usually follows. You did everything you were told. You were handed four different ways of mopping the floor, and nobody looked at the pipe.
If that makes you a bit angry, that's reasonable. Then the anger turns into the only question that matters: so what works on the pipe? Honestly, there are two roads. The first is to change the day that built the pooling point: never sit for long, never strain, undo the pregnancies, give up the commute. For most people that isn't a plan, it's a fantasy. The second is to service the return line itself, so the wall squeezes again and the leak seals, without changing a single thing about your day.
For fifty years, one country has been taking the second road.
The 4-Point Vein Service
If the return line fails in four ways, naturally the answer has to touch all four. A service, not a repair:
- Tone the wall. So the vein squeezes blood upward again instead of letting it sit.
- Seal the leak. So the thin, weeping spot stops letting red through. For bleeding piles, this is the point that matters most.
- Unstick the cells. Where blood pools, white cells cling to the wall and wear it from inside. Stop that, and the wall stops thinning.
- Speed the drain. So the fluid that has already escaped gets carried away instead of sitting in the cushion.
Four faults, one return line, one service. That is why the pan clears, and why it doesn't have to keep going red again. Is there anything that actually does all four? Let's look at the research together, limits included.
The vein answer France has used for fifty years
In France, when a patient walks in with bleeding piles, doctors have been prescribing the same thing since the early 1970s: two citrus flavonoids called diosmin and hesperidin, in a precise 90-to-10 ratio, micronised. It's one of the most dispensed treatments in French pharmacies.
Cross the Channel, and almost nobody has heard of it. In the words of one UK Reddit user: "Most physicians in the UK don't seem to have heard of it, pharmacists don't supply it."
It's a capsule, by mouth. Not a cream, not a laxative. It does nothing to the skin and nothing to your stool. It works on the vein wall, and the climb back up.
And here's what made me sit back. The four points of the service are exactly what has been described for this family of flavonoids: tone in the wall, less leaking, fewer cells clinging, better drainage. Most products that mention "the vein" cover one or two. The micronised 90:10 form is the one the four-point literature was written about.
The evidence, with its limits. The strongest results are, usefully, on bleeding. A meta-analysis of 14 trials, over 1,500 patients (Alonso-Coello and colleagues, 2006), found people taking these flavonoids were roughly a third as likely to still be bleeding. The Cochrane review agreed, while being honest that the bleeding figures come from a small number of studies and not everyone responds. I'd rather you heard that from me than from a refund form. That's why I write "studied", never "miracle".
So why have you never been offered it? Not because anyone hid it. The French brand was simply never brought to the UK market, and the British answer to piles has always been fibre, water, cream, and surgery if it gets bad. There is a lot of room between cream and surgery. In France, that room has a name.
While that makes sense, the natural next step is simply to see what the UK version looks like.
Check availability of the UK version →
Before you buy any diosmin: four things to check
Because here's the next trap, and I'd rather we walked round it together. Type "diosmin" into a search bar and you'll find dozens of cheap tubs. Most quietly fail the French standard, and the people who buy them conclude "diosmin doesn't work" when what they took barely delivered it.
Before buying any diosmin, including the one I'm about to recommend, check four things:
- Micronised. The studied form was absorbed at nearly double the rate of ordinary powder. The £9 tub shares a name, not a particle size.
- The 90:10 ratio, printed. 900 mg diosmin + 100 mg hesperidin per daily dose. Not a "bioflavonoid complex" with the dose hidden.
- Milligrams in plain sight. If the dose can't easily be found in ten seconds, that's your answer.
- Independent lab testing. Every batch checked by an outside lab, not just the maker's word.
If a page doesn't give you all four, close the page. Any page.
Diosmin & Hesperidin 900/100 by Vital Rems
The one I point patients to is the Diosmin & Hesperidin 900/100 from Vital Rems, because it's the only one I've found on the UK market that passes that checklist in full:
- Micronised diosmin, 900 mg per daily dose.
- Hesperidin 100 mg. The 90:10 ratio printed on the label, exactly as studied.
- Two ingredients, full doses. No "proprietary blend", nothing hidden.
- Independent lab testing on every batch.
Plainly: it is NOT a cream, a numbing gel or a laxative. It is NOT the French brand, and nobody should tell you it is. It IS the same two flavonoids, the same ratio, the same daily dose, micronised, with an English label.
And if you're expecting the pan to be clear by Thursday, skip it. A wall that took years to stretch doesn't firm up over a weekend. This is for people willing to give it ninety-nine mornings. Two small capsules with breakfast. Nothing to look at, touch or insert. Plain box, discreet billing.
As you become aware that the checklist is now done for you, the only thing left to decide is how to judge it. I'll show you the fairest way I know.
Check availability →The 99-Morning Test
Don't judge it on my words. Judge it on the pan.
You already look every morning. Keep looking, but from today the look has a different job. It's not a verdict any more. It's a measurement. One tick per clear morning. Ninety-nine mornings, with a bottle that's allowed to be empty at the end.
What to expect, honestly
Days 1 to 7Probably nothing
I'm telling you now because this is where people give up. If anything, you'll notice you're watching the pan harder than ever. That's the test starting.
Weeks 2 to 3The red thins
Bleeding is where these flavonoids show effects first. Pink rather than red. A clear morning here and there, and the odd feeling of not quite trusting it yet. Keep the fibre and water going.
Day 21The first verdict
Most customers feel relief within 21 days. Count the clear mornings in week three against week one. That's your number, not mine.
Weeks 6 to 12The flare that didn't come
The bad week after the curry, the long drive. The thing that used to open the leak doesn't.
Picture one morning in that third week. I'm not sure just how clearly you can already imagine it: the bathroom at seven, the kettle downstairs, the glance down out of habit, nothing, and then looking again because you don't believe it.
Carol told me, around week five, that one morning she'd flushed without looking at all. "I'd forgotten what it was like not to think about my bum."
That's who this is for. Not the piles. The person who stops checking.
Any new or changed bleeding during those 99 mornings still goes to your GP first. This supports the vein wall. It doesn't replace a doctor's eyes.
What people write after the all-clear
"Clear camera in February, still red every morning till May. I was wearing the pantyliners my daughter left behind when she moved out, which tells you everything. Week three I looked in the pan on a Tuesday and there was nothing, so I stood there and looked again. Three months in now. The drawer's still full, and my daughter has her mum back at the pool."
"Bought it for my husband after I saw the bowl myself. Two colonoscopies, always 'piles', never a plan, and he's the type who won't take a paracetamol. Capsules went next to his cereal and that was the end of the argument. Seven weeks on the 5-month pack. He's back on the bike on Sundays, and I've stopped listening at the bathroom door."
Comments (26)
Bloke here, 58, desk job, "bladder control pads" from the big Tesco because that's what was on the shelf. 5 weeks in, pads are in the cupboard not my coat. The bit about the camera looking for what's there, not how the blood gets back up, is what made it click.
Low iron for years because of this, and the iron tablets made it worse, exactly as the page says. Kept my GP's iron plan and added these. Bloods at 10 weeks were the best since my second. Not a cure, I know, but the leak the iron was topping up has slowed right down.
My husband called me into the bathroom one morning to "look in the toilet and tell him". That was a year ago. He ordered the big pack after reading this. I didn't say I told you so. Much.
Do the maths
Now that the third-week morning feels that close, the practical question is simply how to get there. So let's count, together, what the pan has already cost.
In money: the pads, the creams, the £900 banding that bought three months, the £3,000 to £5,000 surgery everyone warns you about. Then the cost with no number on it: the pool you didn't go to, the dark trousers in July, and a year, or ten, of looking before you flush.
Diosmin & Hesperidin 900/100 is sold as a single bottle, or as a 3-month or 5-month programme. The programme is where the price falls hardest: the full 5-month service is the lowest price per bottle we offer, and works out at well under a pound a day. Less than the pads.
Why the programme? The first weeks seal the leak. The months after are when the wall firms up and the flares stop arriving. One bottle tends to end in "it helped and then it came back". The full service tends to end in "I'd forgotten about it".
No contract. Your choice. Pay once and that's it, or pick Refill & Save for the lowest price and pause or cancel in two clicks.
I'm not asking for a yes. Just a maybe.
Many guarantees only apply to sealed bottles: try it, and you can't return it. This is the exact opposite. The 99-Day Empty-Bottle Guarantee: ninety-nine days, and if the pan hasn't changed, write to customer service and you get your money back. Even on an empty bottle. No hoops, no return postage, free UK tracked shipping.
So, while you're still deciding, notice that the decision isn't "does this work". It's smaller: "am I willing to find out, with someone else carrying the risk". Ninety-nine mornings is more than four full rounds of the 21-day test. Tick the clear mornings. Decide on your own numbers.
The only real risk is doing nothing, and reading this page again in a year.
Choose your supply: 99 mornings to try it →✓ FREE tracked shipping · ✓ 99 days, even on an empty bottle · ✓ No contract: pay once, or refill and cancel anytime
Before you decide
Now, as you sit there reading this, possibly on the loo, possibly at 10.30 at night with the house quiet, we've walked a long way from that car park. So let me say the next part plainly, as a person who has already done the responsible thing.
I'm not sure just how clearly you can already picture a morning a few weeks from now, the one where you glance down out of habit and there's nothing to see.
And I don't know which feeling will reach you first that morning. The relief of a clear pan. The quiet of a mind that's stopped asking "what if they missed something". Or the slightly silly pride of having fixed a thing nobody else even looked at.
It doesn't really matter why you choose to start, for whatever reasons feel right to you. What I do know is this: ninety-nine mornings from now, looking back at this page, you'll recognise it as the morning the checking stopped being a verdict and started being a countdown.
Notice, too, how different the 2am question feels now from the way it felt at the top of this page. That difference is something you did, by reading to here. It's also the clearest reason to let the next step be an easy one.
So you can simply allow yourself to make the decision you already made somewhere around the third half-truth. Choose your supply on the next page, the 5-month service if you want the full job done.
The choice is yours. Nobody on this page can convince you of something you already know.
Choose your supply →✓ FREE tracked shipping · ✓ 99 days, even on an empty bottle · ✓ No contract: pay once, or refill and cancel anytime
Two ways this can go
So now that you know the truth about what it really takes to stop the leak, there are two ways this ends.
The first: close the page, keep checking, and hope that one morning it stops on its own. For the people in those forums it has been three years, five, ten. It doesn't, because nothing in that routine touches the wall.
The second: let someone else carry the risk for 99 mornings, and find out what it's like to flush without looking.
None of this was your fault. But now that you know what the pan is actually telling you, you're the one responsible for what it says tomorrow morning.
This isn't about a bottle. It's about who walks into that bathroom tomorrow: the person who checks, or the person who flushes.
Check first. Then deal with the wall.
Important questions before you start
Still here? Good. These are the questions patients ask once they've decided; as you read them you may find your own already answered.
I've seen blood. Can't I just take this?
No. New, changed, darker or heavier bleeding goes to your GP first, every time, even if you're "sure" it's piles. If you were told "just piles" without an examination, go back and ask for one. Once you've been checked, this page will still be here.
I'm on blood thinners (warfarin, apixaban, aspirin). Can I take it?
Ask your pharmacist or GP first and show them the label. In 2026 the Canadian regulator flagged a possible link between diosmin and bleeding risk on anticoagulants. It's a question for them, not for this page.
My iron is low. Will this replace the iron?
No. Keep following your GP's plan for iron. This works on the leak, not on the levels. The iron fills the tank; this slows what's draining it.
Is this the same as the French one (Daflon)?
Same two flavonoids, same 90:10 ratio, same daily dose, micronised, with an English label. It is not the French brand and I don't claim it is.
What if it's not for me?
You have 99 days to try it. Even on an empty bottle: write to customer service and you get your money back. No hoops.
Two colonoscopies in four years. Both times "nothing sinister, just piles". Both times I left the hospital relieved and was back to red in the pan by the weekend. Nobody has EVER explained it like this. The camera checks what's there, not how the blood gets back up. That one sentence has made more sense than 6 years of appointments.
214
Same here. Mine said "haemorrhoids, unspecified" and that was literally it. No plan, no follow up.
38Carol Benson that word unspecified drove me mad. Like, specify it then?! 😂
22Lynn, thank you for writing this. You did exactly the right thing getting checked, twice. The letter answers the frightening question. It just doesn't answer the practical one.
61
Honest question. Is this not just another supplement that does nothing? I've tried every cream in Boots and I'm a bit cynical now.
47
I was exactly the same Mark. The difference is it's not a cream, it's a capsule that works on the vein itself. Creams never touched my bleeding either. Took about 3 weeks for me but the pan has been clear most mornings since September.
89Sandra Kelly 3 weeks is fair enough. And the 99 days thing means I'm not really risking much is it.
12Mark Pennington that's what swung it for me too. Worst case you get your money back.
9
Waited 14 months for banding on the NHS. Had it done in March. Bled again by June. I honestly thought that was my life now.
132
Banding took one off for me and the others carried on. Exactly what the doctor says in the article about the walls next to it.
41Pauline Grant yes!! that's exactly what happened. Ordered the 5 month one last night, figured if it took years to stretch it's not going to fix in a week.
37
Bloke here. 61, cyclist. Been buying my wife's pantyliners for two years and hiding them in the garage 🙈 Glad I'm not the only man reading this.
176
You're definitely not mate. Lorry driver, 8 hours a day sitting. The bit about the pooling point when you sit all day was me to a T.
54Steve Marlow it's the sitting isn't it. 6 weeks on these now and I did 40 miles on Sunday in my normal bibs. Small win but it's a big one.
48
I'm on apixaban. Is this safe with blood thinners?
19
I'm on warfarin, I asked my pharmacist first like the FAQ says and showed him the label. He was fine with it and told me to keep him posted. Worth the 2 minute chat.
27Angela, please do ask your pharmacist or GP first and show them the label. It's a quick conversation and it's the right one to have.
33
Low iron for 3 years, iron tablets bung me up, then I strain and bleed more. The tank and the leak thing in the article is EXACTLY my situation. Nobody ever connected those two for me.
98
Same loop for me Debbie. Kept my iron like my GP said and added these. My bloods in August were the best they've been in years.
31
My mum is French and when I told her about this she laughed. She's been taking diosmin for her legs since the 90s, every pharmacy has it there. Why is it not a thing here??
143
I said the same when I read that part. In France it's normal, here it's cream and wait for surgery.
26Nicola Hart literally. Ordered the 3 pack for me and one for my sister.
18
Week 5 update for anyone sitting on the fence. Days 1 to 10 nothing, like it said. Week 3 it went pink instead of red. This week 5 clear mornings out of 7. I flushed without looking on Tuesday and only realised afterwards. Honestly cried a bit.
267
This made me well up Sue. The not looking thing. That's all I want.
44Jan Hollis give it the full time Jan. I nearly gave up at day 10.
39
Saving this comment. Starting mine on Monday.
12
Does it come in plain packaging? I live with my son and his girlfriend and I'd die if they saw.
31
Plain box Linda, nothing on the outside at all. Mine came with the post and my husband thought it was a phone case 😂
24This content does not replace medical advice. Any bleeding from the back passage should be assessed by a doctor before you take anything. If you are on prescription medication, including anticoagulants, speak to your prescriber or pharmacist before adding any supplement. Diosmin & Hesperidin 900/100 is a food supplement: it is not intended to diagnose, treat or cure any condition and does not replace a varied diet and healthy lifestyle. Do not exceed the recommended daily dose. Keep out of reach of children. Quoted sentences in the opening section are real public online posts reproduced verbatim: they describe the problem and are not testimonials about any product. "Carol" is a composite of patient accounts, with details changed. Individual results vary.
Sources: NHS, Piles (haemorrhoids): causes and treatment · Alonso-Coello et al., Br J Surg 2006, meta-analysis, 14 trials, 1,514 patients · Perera et al., Cochrane Database 2012, phlebotonics for haemorrhoids · Garner et al. 2002, pharmacokinetics of micronised diosmin · Health Canada safety review, 2026 · Product label, Vital Rems.
