What are haemorrhoids?
Haemorrhoids are swollen veins found in the wall of the rectum and around the anus (‘the back passage’).
What causes haemorrhoids and who is at risk?
Haemorrhoids are common in pregnant women because of hormonal changes and pressure from the growing foetus. They are also common in people with chronic constipation who repeatedly strain to pass bowel movements. In severe liver disease, there may be an increase in blood pressure in the veins around the intestines that may result in haemorrhoids. Rarely, a tumour in the large intestine will cause straining during bowel movements or will put pressure on the veins, both of which can result in haemorrhoids. Almost half the population will have had haemorrhoids by the age of 50 years.
What are the common symptoms and complications of haemorrhoids?
If haemorrhoids protrude from the anus they are called ‘external’ haemorrhoids; if they remain within the anus or rectum they are called ‘internal’ haemorrhoids.
If you have haemorrhoids you may notice:
Bleeding, especially after moving your bowels
Blood in stools
Blood on toilet paper or in the toilet bowl
Pain during bowel movements
A discharge of mucus from the anus
The feeling of incompletely emptying the bowels even after a bowel motion
Although itching of the anus is not a symptom of haemorrhoids, if they are painful it may make it difficult to keep the area clean, which can lead to itching.
These symptoms occur with both internal and external haemorrhoids. If your haemorrhoids are external, you will have a painful swelling or lump around your anus. They may be gently pushed back inside the anus with your finger or they may go back in on their own.
Very rarely, blood lost from haemorrhoids can cause anaemia, but this is almost never severe and can be avoided by early treatment.
What is the treatment for haemorrhoids?
Self-care action plan
You can reduce your chance of getting haemorrhoids by eating plenty of fibre. Foods rich in fibre include fruit, vegetables and whole grains. Fibre helps to soften stools making their passage easier. Drinking plenty of fluid may also help. Sitting in a warm bath or applying ice packs and local anaesthetic creams to the area can help to relieve some discomfort.
Surgery
If your haemorrhoids are more severe your doctor may suggest one of several minor operations:
Rubber band ligation. This is a common procedure and involves rubber bands being placed around the base of the haemorrhoid to cut off its blood supply, causing it to drop off painlessly. It is a successful operation and can be performed quickly and easily. However, as haemorrhoids are treated one at a time, a number of treatments may be required.
Haemorrhoidectomy. This is a minor surgical procedure to clamp and remove the haemorrhoid.
Cryosurgery. This involves freezing the haemorrhoid by spraying it with a very cold liquid to make it shrink.
Sclerotherapy. A special fluid is injected into the haemorrhoid to make it shrink.
Laser. A laser is used to burn the haemorrhoid away.