Haemorrhoids

What are haemorrhoids?

Haemorrhoids, also known as piles, are swollen veins located around the rectum or in the anal canal. Haemorrhoids can occur internally inside the rectum (internal haemorrhoids) or externally under the skin around the anal opening (external haemorrhoids).

Types of haemorrhoids:

  1. Internal haemorrhoids

    These haemorrhoids develop within the rectum, where there are fewer pain sensing nerves. As a result, internal haemorrhoids are less likely to be painful. However, they can cause other symptoms such as bleeding, protrusion during bowel movements or a feeling of fullness or discomfort.

  2. External haemorrhoids

    External haemorrhoids occur under the skin around the outside of the anal opening. They can be itchy or painful.

    A clot within the haemorrhoid (thrombosed haemorrhoid) can cause significant pain.

What causes haemorrhoids?

  • Straining during bowel movements

  • Pregnancy – due to pressure on pelvic veins and hormonal changes.

  • Obesity

  • Sitting for prolonged periods in the toilet

  • Age -Aging weakens the tissues that support veins in the rectal area, making older adults more susceptible to haemorrhoids.

  • Chronic diarrhoea or constipation

  • Heavy lifting – Straining increases pressure on the rectal veins.

  • Genetics – A family history of haemorrhoids may increase an individual’s risk.

What are the symptoms of haemorrhoids?

  • Bleeding – Bright red blood on the toilet paper, in the toilet bowl, or on stool may indicate bleeding from haemorrhoids.

  • Itching and discomfort

  • Pain or discomfort – External haemorrhoids may cause pain, especially during sitting or bowel movements.

  • Prolapse – Internal haemorrhoids may protrude outside the anal opening during straining or bowel movements.

How are haemorrhoids treated?

The treatment of haemorrhoids varies based on the type and severity of the condition.

Minor bleeding from internal haemorrhoids can be managed by increasing fibre intake, staying hydrated and avoid straining during bowel movements.

Over the counter creams and ointments that contain hydrocortisone can provide relief from itching and discomfort.

When conservative measures are ineffective, procedures such as rubber band ligation, haemorrhoid artery ligation or haemorrhoidectomy can be performed.

It is important to note that symptoms of bleeding can also be caused by other conditions such as bowel cancer. A referral to a colorectal surgeon is required to assess for sinister causes of bleeding.