Haemorrhoids

Haemorrhoids


Symptoms, Causes and Treatment
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Haemorrhoids (also known as piles) are swollen and inflamed veins in the rectum or anus.

What are Haemorrhoids?

Haemorrhoids, commonly known as piles, are swollen blood vessels in or around the anus and rectum. The haemorrhoidal veins are located in the lowest part of the rectum and the anus. Sometimes they swell so that the vein walls become stretched, thin, and irritated by passing bowel movements. 

What different types are there?

Haemorrhoids are classified into two general categories - internal and external.

1. Internal haemorrhoids lie far enough inside the rectum that you can't see or feel them. They don't usually hurt because there are few pain-sensing nerves in the rectum. Bleeding may be the only sign that they are there. Internal haemorrhoids are deeper and initially form above a point 2-3 cm inside the back passage (anal canal) in the upper part of the anal canal.

2. External haemorrhoids lie within the anus and are often uncomfortable. If an external haemorrhoid prolapses to the outside (usually in the course of passing a stool), you can see and feel it. 
External haemorrhoids start off nearer the surface, below a point 2-3 cm inside the back passage.

Signs and Symptoms

Symptoms often depend on whether a haemorrhoid is located on the inside or outside of the body. Signs and symptoms of haemorrhoids may include: 

  • pain or discomfort, especially when sitting
  • pain during bowel movements
  • itching or irritation around the anal region
  • bright red blood on your stools, toilet paper or in the toilet bowl
  • swelling around the anus
  • one or more lumps near the anus, which might be tender or painful.
Bleeding during bowel movements is the most common sign of haemorrhoids. Rectal bleeding can, however, indicate a more serious condition, such as bowel cancer or anal cancer. You should consult if your haemorrhoids:
  • bleed frequently or excessively
  • do not respond to self-treatment
  • if haemorrhoid symptoms have been accompanied by an obvious change in bowel habits
  • if you are passing black or maroon-coloured stools
  • blood clots have formed
  • blood is mixed in with the stool.

Causes

Haemorrhoids are caused by increased pressure in the lower rectum. The blood vessels around the anus and in the rectum will stretch under pressure and may swell or bulge, forming piles. This may be due to:

Chronic constipation

Chronic diarrhea

Lifting heavy weights

Pregnancy

Straining when passing a stool

Obesity

Colon cancer

Spinal cord injury

Treatments


More serious or repeat cases may require medication or a surgical procedure. Haemorrhoids can recur after treatment; hence, they are controlled rather than cured. 

Lifestyle changes


We will initially recommend some lifestyle changes to manage Haemorrhoids.

Diet

A change in diet can help keep the stools regular and soft. This involves eating more fiber, such as fruit and vegetables, or primarily eating bran-based breakfast cereals.

Body weight

Losing weight may help reduce the incidence and severity of piles. Exercising is one of the main therapies for piles.

Medications


Several medicinal options are available to make symptoms more manageable for an individual with Haemorrhoids.
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OTC medications

These are available, including painkillers, ointments, creams, and pads, and can help soothe redness and swelling around the anus. Do not use them for more than 7 days in a row

Laxatives

The doctor may prescribe laxatives if a person with piles suffers from constipation. These can help the person pass stools more easily and reduce pressure on the lower colon.

Surgical options


Advanced Haemorrhoids require surgical treatment. 

Hemorrhoidectomy

The excess tissue that is causing the bleeding is surgically removed. This can be done in various ways.

Banding

An elastic band around the base of the pile, cutting off its blood supply. After a few days, the hemorrhoid falls off. This is effective for treating all hemorrhoids of less than grade IV status.

Hemorrhoid stapling

Blood flow is blocked to the hemorrhoid tissue. This procedure is usually less painful than hemorrhoidectomy.

Sclerotherapy

Medicine is injected to make the hemorrhoid shrink. The hemorrhoid eventually shrivels up. This is effective for grade II and III hemorrhoids and is an alternative to banding.

Prevention

Keeping your stools soft is the best way to prevent haemorrhoids from occurring. The following steps can help to prevent haemorrhoids from occurring and reduce symptoms of existing haemorrhoids

Eat high-fibre foods

Drink plenty of fluids

Avoid straining when on the toilet

Go to the toilet as soon as you feel the urge

Do plenty of exercise

Avoid sitting for long periods

Consult doctor before going for any treatment


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