Haemorrhoids Explained

Haemorrhoids Explained

What are Haemorrhoids?

Haemorrhoids, commonly known as piles, are swollen and inflamed blood vessels located in the rectum and anus. They can cause discomfort and bleeding during bowel movements. There are two main types: internal and external, which vary in their symptoms and treatment.

Classification of Haemorrhoids

Haemorrhoids are classified as a condition affecting the vascular system, particularly in the anal and rectal areas. They are not an illness but a common condition that can cause significant discomfort.

Haemorrhoids Health Signs and Symptoms

• Bleeding: Bright red blood on toilet paper, in the toilet bowl, or on the surface of stools.
• Pain or Discomfort: Especially during bowel movements or when sitting.
• Swelling: A lump near the anus, which may be sensitive or painful.
• Itching or Irritation: Around the anal area, often due to moisture and irritation.
• Mucus Discharge: A feeling of moistness around the anal area, sometimes accompanied by a mucus discharge.

Types of Haemorrhoids

1. Internal Haemorrhoids: Located inside the rectum, usually painless, and may bleed during bowel movements.
2. External Haemorrhoids: Located under the skin around the anus, can be painful, itchy, and may swell or form clots (thrombosed haemorrhoids).

How to Test for Haemorrhoids

Diagnosis of haemorrhoids typically involves:

• Physical Examination: A healthcare provider will perform a visual examination of the anal area.
• Digital Rectal Exam (DRE): A gloved finger is inserted into the rectum to check for internal haemorrhoids or other abnormalities.
• Anoscopy: A small tube with a light (anoscope) is inserted into the anus to visualize internal haemorrhoids.
• Sigmoidoscopy or Colonoscopy: May be recommended if there are concerning symptoms to rule out other conditions such as colorectal cancer.

What Type of Health Professionals Treat Haemorrhoids?

• Primary Care Physicians: Often the first point of contact for diagnosis and management.
• Gastroenterologists: Specialists in digestive system disorders who can provide in-depth evaluation and treatment.
• Colorectal Surgeons: For surgical interventions if conservative treatments fail.

How to Prepare to See a Health Specialist

• Symptom Diary: Keep track of symptoms, their frequency, and any triggers.
• Medical History: Prepare information about past bowel issues, surgeries, and family history of gastrointestinal disorders.
• List of Medications: Bring a list of any medications and supplements you are currently taking.
• Prepare Questions: Write down any questions or concerns you have regarding your symptoms or treatment options (see next section).

What Questions to Ask a Doctor?

• What is the likely cause of my haemorrhoids?
• What tests will you perform to confirm the diagnosis?
• What treatment options are available for my condition?
• Are there lifestyle changes I can make to alleviate symptoms?
• Is surgery necessary in my case?
• How can I prevent haemorrhoids from recurring?
• Are there any risks associated with treatment?
• What over-the-counter remedies do you recommend?
• How should I manage pain and discomfort at home?
• When should I seek immediate medical attention?

What Type of Treatments Exist?

• Lifestyle Changes: Increasing dietary fiber, staying hydrated, and avoiding straining during bowel movements.
• Topical Treatments: Over-the-counter creams or ointments containing hydrocortisone or witch hazel to reduce itching and inflammation.
• Medications: Oral pain relievers like acetaminophen or ibuprofen for pain management.
• Minimally Invasive Procedures:
  • Rubber Band Ligation: Tying off the haemorrhoid with a rubber band to cut off blood supply.
  • Sclerotherapy: Injecting a solution to shrink the haemorrhoid.
  • Infrared Coagulation: Using infrared light to clot blood vessels.
• Surgery: For severe cases, options include haemorrhoidectomy (surgical removal) or stapled haemorrhoidopexy.

How to Monitor Haemorrhoids

• Symptom Tracking: Monitor the frequency and severity of symptoms like bleeding and pain.
• Bowel Movement Patterns: Keep track of changes in bowel habits, such as constipation or diarrhea.
• Use of Home Devices: A stool diary can help identify triggers related to diet and bowel habits.

How to Manage Haemorrhoids

• Dietary Adjustments: Increase fiber intake through fruits, vegetables, and whole grains to soften stools.
• Hydration: Drink plenty of water to stay hydrated and prevent constipation.
• Warm Baths: Soaking in a warm bath (sitz bath) can relieve pain and reduce swelling.
• Exercise: Regular physical activity helps promote regular bowel movements.
• Avoid Prolonged Sitting: Take breaks to stand and walk if sitting for long periods.

Nutrition Dos and Don’ts

• Dos:
  • Include high-fiber foods such as beans, whole grains, fruits, and vegetables in your diet.
  • Stay hydrated by drinking at least eight glasses of water daily.
• Don’ts:
  • Avoid low-fiber foods that can contribute to constipation, such as processed foods.
  • Limit caffeine and alcohol, as they can dehydrate and aggravate symptoms.

Lifestyle Dos and Don’ts

• Dos:
  • Maintain a regular exercise routine to encourage healthy digestion and bowel movements.
  • Practice good hygiene after bowel movements to minimize irritation.
• Don’ts:
  • Avoid straining during bowel movements, which can worsen haemorrhoids.
  • Don’t ignore symptoms of persistent bleeding or pain; seek medical advice promptly.

Emergency Situations

While haemorrhoids typically do not lead to emergencies, certain situations require immediate attention:

• Severe Bleeding: If there is heavy bleeding that does not stop after a few minutes.
• Severe Pain: Sudden, severe pain that could indicate a thrombosed haemorrhoid or other complications.
• Fever: Fever accompanying the bleeding or pain may indicate an infection.

What to do:

• Apply pressure with a clean cloth to stop any bleeding.
• Seek immediate medical attention if symptoms do not improve or worsen.

Questions Related to Haemorrhoids 

1. What causes haemorrhoids?

   • Factors include straining during bowel movements, obesity, pregnancy, and prolonged sitting.

2. Are haemorrhoids serious?

   • They are usually not serious, but they can cause significant discomfort and complications if untreated.

3. How are haemorrhoids diagnosed?

   • Diagnosis is based on a physical exam and possibly further tests like an anoscopy.

4. Can haemorrhoids go away on their own?

   • Yes, mild haemorrhoids may resolve with lifestyle changes and home treatment.

5. What are the risks of haemorrhoid surgery?

   • Risks include bleeding, infection, and pain after surgery.

6. Are there over-the-counter treatments for haemorrhoids?

   • Yes, creams and ointments are available to relieve symptoms.

7. How can I prevent haemorrhoids from returning?

   • Maintain a high-fiber diet, stay hydrated, and avoid straining.

8. Do haemorrhoids ever require surgery?

   • Surgery may be necessary for severe cases that do not respond to other treatments.

9. Can I still exercise with haemorrhoids?

   • Yes, low-impact exercises are generally safe; avoid heavy lifting and high-impact activities.

10. What should I do if my haemorrhoids bleed?

    • If bleeding is significant or persistent, seek medical attention immediately.