Haemorrhoids

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Haemorrhoids are enlarged veins that appear as lumps, which can be found in and around the rectum and anus. More commonly, they are referred to as 'piles', with an estimation of at least half the UK populus developing them at some point in their life.

It is possible to have a singular haemorrhoid or multiple haemorrhoids. Typically, haemorrhoids will go away by themselves, but in some cases, further investigation and treatment can be required. Haemorrhoids are more prevalent in adults as they age.

There are some factors which can increase a person’s chances of developing haemorrhoids.

Pregnancy and obesity can be linked to a person developing haemorrhoids, as well as old age and hereditary risks. Furthermore, it is widely thought that working in jobs that require heavy lifting can also cause haemorrhoids.

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There are 3 different types:

• External haemorrhoids – are found around the anus and are small haemorrhages which can feel lumpy when touched. They are typically caused by tension when a person repeatedly has to strain whilst moving their bowels. This is because pressure in the blood vessels is increased when moving large and hard stools which won’t pass easily. In addition, pregnant woman can be more prone to external piles due to the pressure on the veins from the uterus.
• Internal haemorrhoids – can be located inside in the anus and tend to be so far inside that they cannot be seen or felt. Due to their location in the body, they are less likely to be painful, as there are less nerves in this area.
• Prolapsed haemorrhoids – are a more severe form of internal haemorrhoids and can be much more painful. In some cases, the anal sphincter can compress the veins which protrude the anus. A prolapsed haemorrhoid can develop into a thrombosed haemorrhoid which can cause even more pain for a person when their bowels move.

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There are a variety of symptoms which are related to haemorrhoids. Not everyone will suffer from noticeable symptoms if they have piles, and the severity of the symptoms will depend on the type of haemorrhoids.

• External haemorrhoids – itching anus, blood in the stool, pain around the anus and purple lumps around the anus and rectum.
• Internal haemorrhoids – discharge of mucus from the anus, itching anus, pain around the anus, pain whilst passing bowel movement and swelling.
• Prolapsed haemorrhoids – similar symptoms to internal haemorrhoids. They can cause further discomfort and a person may feel as though they haven’t fully finished emptying their bowels, even if they have.

In most cases, haemorrhoids will go away by themselves. If constipation is the main cause of haemorrhoids, a person may be prescribed laxatives by a medical expert, as they can prevent further haemorrhoids developing and stop present ones worsening by helping bowel movements pass with less straining.

If a person is suffering from severe pain, due to their piles, there are a number of creams, ointments and suppositories that can be used to ease the pain and discomfort. This includes local anaesthetics, astringents, and topical steroids.

If haemorrhoids are severe or recurrent, it is possible that a person may need more complex treatment. This can entail; sclerotherapy, haemorrhoidectomy or a rubber band ligation.

• Sclerotherapy – is an injection containing phenol into the pile, which causes the vein to collapse. It can take a few days for the pile to disappear completely.
• Haemorrhoidectomy – is a surgical procedure where the pile(s) is removed under a general anaesthetic.
• Rubber band ligation involves cutting off the blood supply to the haemorrhoid by placing a rubber band around it, this then causes the haemorrhoid to drop off in a few days time.

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Living with haemorrhoids presents different issues, dependant on the individual case. In some cases, they have little to no impact on a person’s day-to-day life. However, if the haemorrhoids are recurrent, or severe, this can warrant taking further measures.

Piles are typically the result of constipation. To reduce the risk of a person being constipated, eating a balanced diet rich in fibre can help. Foods such as wholemeal bread, pasta and brown rice, along with plenty of fresh fruit and vegetables can contribute to a healthy diet. Moreover, drinking plenty of fluids and avoiding sitting down, particularly on a hard or cold surface for long periods of time, can also prevent the development of haemorrhoids.

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Various forms of support are available for people who are finding that their haemorrhoids are having a negative impact on their lives. Some treatment, such as creams and suppositories, can be bought over the counter at pharmacies without a prescription. Additionally, there are aids such as ring-shaped pressure cushions which can alleviate discomfort felt from haemorrhoids.

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Medical terms are often baffling and difficult to fully understand. To help, we have listed some frequently used terms below.

Astringents – lotions that can be applied to the skin to limit bleeding from the skin

Haemorrhages – this is where the blood escapes the blood vessel due to a rupture

Laxatives – a medicine which is used to treat or prevent constipation and thus stimulates evacuation of the bowel

Prolapse – used to describe when a body part has fallen, or slipped, out of place from its 'normal' position

Topical steroids – these are the most commonly prescribed topical form of corticosteroids. They have anti-inflammatory properties and can be applied directly to the skin to reduce irritation and inflammation