Haemorrhoids / Piles
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What are haemorrhoids?
Also known as piles, haemorrhoids are swollen, inflamed veins around the anus or lower rectum that cause pain and discomfort. Haemorrhoids can be present inside the anus or under the skin around the anus and are often the result of long-term straining during bowel movements.
Haemorrhoids are a very common problem for both women and men. In fact, it is estimated that about half of all individuals will have haemorrhoids by the age of 50. Haemorrhoids are also common in pregnant women because pressure caused by the foetus and hormonal changes can cause inflammation in the anal tissue. This tissue can also be damaged during childbirth, leaving pregnant women susceptible to the development of haemorrhoids.
Haemorrhoids can be either external or internal, depending on the condition’s underlying cause and location in or around the anus.
Internal haemorrhoids cannot be seen or felt but, straining or irritation from passing stools can damage these haemorrhoids and cause bleeding. If you have an internal haemorrhoid, you may occasionally pass varying amounts of brightly coloured blood. Usually, internal haemorrhoids do not cause discomfort. Sometimes, however, straining can push an internal haemorrhoid through the anal opening and cause pain and irritation.
External haemorrhoids are painful, and sometimes blood may pool in the area to form a clot. This can cause further pain, swelling and inflammation.
Symptoms and causes of haemorrhoids
Haemorrhoids can develop from any increase in pressure in the veins of the lower rectum. Predominant sources of increased pressure include constipation, straining, diarrhoea, and sitting or standing for prolonged periods of time. Obesity and a poor diet along with your family history may add to your risk of developing haemorrhoids too. Pregnancy, ageing, chronic constipation or diarrhoea can also lead to the condition.
The most common symptom of haemorrhoids is brightly coloured blood in the stool. You may notice this blood on toilet paper or in your toilet bowl. You may also experience pain and discomfort in the region of the haemorrhoids too, and this could make it difficult to sit or pass stools. Though symptoms associated with haemorrhoids usually go away within a few days, haemorrhoids can be recurrent and affect your quality of life
If left untreated, haemorrhoids can produce several uncomfortable problems. Haemorrhoids can ooze fresh red blood too, and external haemorrhoids can be itchy, especially if the area is moist and irritated. Haemorrhoids, however, do not develop into cancer or any other serious colorectal condition.
Diagnosis and treatment
A thorough evaluation and proper diagnosis are important at any time rectal bleeding occurs. Bleeding may also be a symptom of other digestive diseases such as colorectal cancer, bleeding ulcers or inflammatory bowel diseases like Crohn's disease and ulcerative colitis. Dr Elliot will examine the anus and rectum at his rooms to look for swollen blood vessels that indicate haemorrhoids. A rectal exam will also be performed to feel for abnormalities too.
Dr Elliot will use an anorectal ultrasound probe to assess the size and nature of your haemorrhoids. To exclude any other cause for gastrointestinal bleeding, you will usually be given two fleet enemas, and we will pass a video endoscope into the rectum and left colon.
Medical treatment for haemorrhoids is directed at relieving symptoms. If you are constipated, laxatives will be given and straining while passing a stool must be avoided.
Measures to reduce symptoms of haemorrhoids include:
- Soaking in a bath several times a day in warm water for approximately ten minutes
- Application of a haemorrhoidal cream either by means of a suppositories or ointment
- Increasing your fibre and increasing fluids intake
If these methods do not improve your haemorrhoids, medical attention must be sought. A number of methods may be used to remove or reduce the size of internal haemorrhoids, including rubber band ligation and surgery.
During rubber band ligation, a rubber band is placed around the base of the haemorrhoid. The band cuts off circulation and the haemorrhoid withers away within a few days. Pain is likely for a period of 24 to 48 hours after the rubber band ligation procedure, which is performed at Dr Elliot’s rooms.
Haemorrhoid surgery or haemorrhoidectomy is a procedure that aims to relieve the effects of haemorrhoids. Dr Elliot uses a minimally invasive procedure known as PPH (or Procedure for Prolapse and Haemorrhoids) to perform haemorrhoid surgery. The procedure avoids the need for wounds in the sensitive perianal area and considerably reduces post-operative pain and recovery time.
Haemorrhoid surgery requires hospitalisation for approximately 24 hours. During the procedure, a minimally invasive technique will be used to remove the haemorrhoids and repair the affected tissue. Post-operative pain levels are lower, and you will be able to resume normal activities within a few days.
