Haemorrhoids are small, blood-filled swellings caused by dilated varicose veins. Initially, they are located just inside the anus (internal haemorrhoids) but can sometimes protrude (external haemorrhoids). Haemorrhoids are not dangerous.
Constipation and prolonged straining when using the toilet are thought to contribute to the formation of haemorrhoids by increasing the pressure in the veins.
What are the Symptoms of Haemorrhoids?
Haemorrhoids may be present for many years but remain undetected until symptoms appear. They can cause anal bleeding and itching and also pain and discomfort. Normally, the bleeding is limited to small stains of fresh blood on the toilet paper, but more severe bleeding can sometimes be present when stools are passed. A lump may also be felt in the anus and large haemorrhoids give a sensation that the bowel hasn't emptied completely.
If you observe blood in your stools, and have the symptoms mentioned above, you should visit your doctor for a check-up. If haemorrhoids are present, the doctor will then perform an examination to find out if there are any other possible causes of the bleeding that may be more serious. The doctor will feel the anal canal by digital rectal examination and may go on to inspect the mucous membrane of the rectum and lower part of the large intestine using an examination tube called a proctoscope or sigmoidoscope.
How are Haemorrhoids Treated?
Some haemorrhoids can get better without medical treatment. This can happen if they are caused by constipation. The doctor may recommend a change of diet with the addition of more fibre and roughage particularly green vegetables, fresh fruit, wholegrain cereals and bran. Drinking 8 to 10 glasses of fluid daily is advisable.
It is advisable to avoid straining when passing a bowel motion. Nobody should strain to push out a stool. The feet can be placed on a low foot stool to aid the bowel movement. Using toilet tissue wipes or moist toilet paper to clean with, then patting the area dry rather than rubbing it will reduce the risk of aggravating the problem. Sitting in a shallow bath of hot water for 15 minutes several times a day, will reduce the pain. Your GP may recommend laxatives to avoid constipation, in addition to dietary changes. Paracetamol and anti-inflammatory medication such as Ibuprofen can also assist with pain relief. It is important to avoid codeine and other opiate-related pain killers, as they tend to cause or worsen constipation.
In the case of a pile protruding from the back passage, which has become swollen and painful, a day's bed rest with an ice pack applied to the anal area should be helpful. A pack of frozen peas wrapped in a tea towel is ideal for this purpose. Never allow the ice to come directly into contact with the skin and only use this treatment for 20 minutes in an hour for a limit of three hours a day.
Relatively minor haemorrhoids can be treated using creams available directly from your local pharmacy or on prescription. Five to 7 days' treatment is usually enough, and then the irritation will settle spontaneously. More severe cases need to be treated by a specialist.
There are many facts and myths surrounding piles, here are just a few:
• You can get them by sitting on cold floors: False, the temperature of where you sit does not cause piles.
• You can get them by sitting on radiators: False.
• Only unhealthy people get them: False, although a good diet will reduce your chance of getting piles, however, lots of healthy people also suffer.
• Only older people get them: False, young men and women can also suffer from piles.
• There is nothing you can do to to heal them: False, your GP can determine the best course of treatment for you, depending on the severity of your piles. If conservative treatments fail to help, a referral to a specialist may be required.
• Black pepper and spicy foods can cause them: False.
• Everyone has piles: True…piles are normal bodily structures, it is only when they swell that they cause problems.
• Pregnancy can cause them: True… pressure from an expanding womb and a general relaxing of the pelvic muscles can cause them to swell painfully, and prolapse so they protrude from the bottom.
• Napoleon had piles during the Battle of Waterloo: True, Napoleon may have done better at Waterloo had an attack of the piles not prevented him from riding his horse into battle.
• Bleeding from the bottom can be a symptom: True..this is usually seen as small amounts of bright red blood on the toilet paper or surface of the motions. Occasionally, they cause severe bleeding. It is always advised to see your doctor if you experience any symptoms at all.
• Piles affect at least half of the population: True.. piles are a common problem that affect at least 50% of people in the UK and Ireland, at some point in their life.
One possible treatment is rubber band ligation. Rubber band ligation can be performed in the doctor's surgery or outpatient clinic and does not require hospital admission. The procedure involves placing a small rubber band at the base of the haemorrhoid with a special applicator. The rubber band cuts off the blood supply to the haemorrhoid, which eventually falls off after a few days. Injection of a substance that makes the blood in the haemorrhoid clot is another option (sclerotherapy).
The most serious cases are third-degree haemorrhoids. These protrude through the back passage and can require surgical removal or 'haemorrhoidectomy'. Such operations are successful in 90 per cent of cases. However, many third-degree haemorrhoids shrink and become symptom-free without surgical treatment.
After surgery, after haemorrhoids have been removed, small skin tags can develop beside the back passage. In some cases they will be slightly painful or itchy and if they cause considerable difficulty with personal hygiene they can be surgically removed by a minor operation.
Following any treatment for haemorrhoids, it is very important to avoid constipation and straining or the condition may recur. One may experience bright red blood on the toilet tissue after going to the toilet, but excessive bleeding shouldn't occur after any of the treatments described. If you do experience significant bleeding, especially the formation and passage of solid blood clots, immediately attend your local accident and emergency department.
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