Everything You Need to Know About Haemorrhoids

Haemorrhoids also known as piles, haemorrhoids are swollen blood vessels in the anus and rectum. Although the condition is quite painful, it usually gets better on its own. While home remedies can offer relief, adopting a healthy lifestyle, eating a fibre-rich diet and exercising can help in the prevention of piles.

What are Haemorrhoids?

Haemorrhoids are swollen veins in the anus and rectum that can result in itching, pain, discomfort and bleeding. They develop when increased pressure in the lower rectum causes the blood vessels in that area to stretch and bulge. This pressure can be caused by various factors, including constipation, straining during bowel movements and heavy lifting.

Haemorrhoids Symptoms

In many cases, haemorrhoids or piles might not present any symptoms and are sometimes discovered during a routine medical or rectal examination. Following are few common symptoms:

• Irritation and itching around the anus
• Soreness, discomfort and pain around the anal area
• Swelling and lumps in the anus
• Rectal bleeding
• Bulging or dilation of a vein which may or may not be painful
• Prolapsed or protruding haemorrhoid, causing irritation or pain

Haemorrhoids Causes

Although the exact cause of piles is not known, some of the possible reasons include:

• Constipation: Excessive straining on the veins in the anal area during bowel movements increases the risk.
• Ageing: Piles are more common in adults over the age of 45.
• Pregnancy: Hormonal changes and weakened rectal tissues can lead to haemorrhoids during pregnancy.
• Chronic Diarrhoea: This can increase the risk of development of haemorrhoids due to the pressure and strain on the veins in the anal area.
• Diet: Not consuming enough fibre can increase the risk.
• Weight: Being overweight or obese puts added pressure on the rectal veins.
• Prolonged Sitting: Sitting for extended periods, especially on the toilet, can contribute to haemorrhoids.
• Lifting Heavy Weights: Regularly lifting heavy weights strains the blood vessels in the anal region.
• Genetics: Some individuals may have a genetic predisposition to developing haemorrhoids.

Haemorrhoids Types

Haemorrhoids can be external or internal, depending on the location of the swollen veins around the anus or within the rectum.

External Haemorrhoids

Some of the characteristics of external haemorrhoids include:

• These usually develop around the anal area appearing as lumps, but they may not always be visible.
• Due to the presence of nerves in the anal area, external haemorrhoids can be quite painful.
• Bleeding can occur due to straining while passing stool.
• Symptoms include pain during bowel movements, discomfort while sitting on hard surfaces for extended periods, straining, and specific activities.

Internal Haemorrhoids

Characteristics of internal haemorrhoids include:

• They develop inside the rectum and are not visible externally.
• Usually, they do not cause any pain but cause rectal bleeding, which is the main symptom of the condition.
• Haemorrhoids protruding through the anus because of the weakening of the anal muscles are called prolapsed haemorrhoids.
• Internal haemorrhoids are categorised into:
  • Grade 1: Stay inside the rectum without protruding (prolapsing).
  • Grade 2: Prolapse during bowel movements but go back in on their own.
  • Grade 3: Prolapsed and needs to be pushed back in manually.
  • Grade 4: Prolapsed and can’t be pushed in manually.

Haemorrhoids Diagnosis

Typically, external haemorrhoids are visible and can be diagnosed easily. However, diagnosing internal haemorrhoids requires:

• Digital Exam: The doctor inserts a lubricated, gloved finger to check for any growths or abnormalities in the rectum.
• Visual Exam: The doctor may use specialised instruments such as a proctoscope, anoscope or sigmoidoscope to examine the rectum and lower colon to check for internal haemorrhoids.

Haemorrhoids Prevention

Some ways to prevent haemorrhoids are:

• Maintain a healthy weight as obesity increases the risk of haemorrhoids.
• Increase dietary fibre or consider fibre supplements.
• Stay well-hydrated by drinking plenty of water and fluids.
• Respond promptly to the urge to pass stool, avoiding delay.
• Stay physically active to promote proper bowel movements.
• Avoid prolonged sitting or straining on the toilet.
• Use enemas or laxatives only as prescribed by the doctor.
• Do not suppress the urge or delay bowel movement

Haemorrhoids Treatment and Home Remedies

It’s advisable to consult with a general surgeon for screening and accurate treatment advice before relying on home remedies. While a few pain relieving or piles management practices are mentioned below, note that application of coconut oil, aloe vera gel, or tea tree oil is anecdotal and not backed by robust scientific evidence.

• Increase intake of high-fibre foods like whole grains, vegetables and fruits to soften the stool and prevent straining.
• Take sitz baths by soaking the anal area in warm water for 10-15 minutes, 2-3 times a day.
• Apply ice packs to the affected area.
• Use coconut oil, aloe vera gel or tea tree oil topically.
• Use suppositories, OTC creams with a numbing agent or witch hazel pads.
• Take oral painkillers like ibuprofen, aspirin or acetaminophen for pain relief.

These remedies can help alleviate pain, inflammation and swelling. However, if symptoms persist or worsen, or if there is bleeding or severe pain, it is advisable to seek medical attention for proper piles treatment.

Haemorrhoids Medications

It is best to consult with the doctor for piles treatment. The doctor may prescribe

• OTC options containing hydrocortisone, witch hazel or lidocaine
• Topical cream or ointment
• Suppositories
• Pads

These products can help to alleviate itching, discomfort and pain caused by the haemorrhoids. However, the creams and ointments containing steroids must be used only as prescribed by the doctor and not more than a week as they can cause skin thinning.

External Haemorrhoid Thrombectomy

External haemorrhoid thrombectomy is a surgical piles treatment that involves:

• Removing the thrombosed haemorrhoid if a thrombus (blood clot) has formed inside the external haemorrhoid and is causing tenderness and pain.
• Done under local anaesthesia, the procedure can help to relieve pain immediately.
• It is best to perform the procedure within 72 hours after the clot develops for optimal results.

Minimally Invasive Procedures

Minimally invasive piles treatments are usually recommended for painful or bleeding haemorrhoids, which are usually done as outpatient procedures without anaesthesia.

• Rubber Band Ligation: Small rubber bands are tied around internal haemorrhoids to stop circulation, causing them to shrink and fall off in a few days.
• Sclerotherapy: This is a painless procedure that involves the injection of a chemical solution into the haemorrhoid tissue, causing it to shrink.
• Coagulation Techniques: These include laser, infrared or bipolar techniques that utilise light or heat to harden bleeding haemorrhoids and shrink them.

Surgical Procedures

Piles treatment rarely involves surgery; however, if the haemorrhoids are too large or other treatments fail, the doctor may recommend surgery.

• Hemorrhoidectomy: This involves the surgical removal of the haemorrhoids under anaesthesia. The procedure is extremely effective for recurring or severe haemorrhoids.
• Stapled Hemorrhoidopexy or Haemorrhoid Stapling: This piles treatment is used to treat internal haemorrhoids and works by blocking blood flow to the tissue. Although the procedure is less painful and the recovery is quicker, there is a higher risk of rectal prolapse and recurrence of piles.

How do Healthcare Providers Treat Haemorrhoids?

It is best to resort to at-home remedies for piles treatments, which can help to alleviate the symptoms such as discomfort, itching and pain. However, if the symptoms persist or worsen after a week of home remedies and interfere with sleep or daily routine, then it is best to seek medical help.

The medical practitioner may treat the condition by any of the following:

Minimally Invasive Procedures

• Rubber band litigation
• Infrared coagulation
• Electrocoagulation
• Sclerotherapy

Surgical Piles Treatment

• Haemorrhoids stapling
• Hemorrhoidectomy

Haemorrhoids Complications

Haemorrhoids can cause discomfort and pain but are not generally serious. In rare cases, people may develop:

• Blood clots in external haemorrhoids
• Anaemia
• Infection
• Strangulated haemorrhoids (blocked blood supply to prolapsed internal haemorrhoid)
• Skin tags (tissue flap hanging from skin)

When to Call the Doctor

If a person suspects haemorrhoids, they should consult their doctor if they are having:

• Abdominal pain
• Nausea and vomiting
• Chronic constipation or diarrhoea
• Severe rectal bleeding and pain
• Fever and chills

Conclusion

• Haemorrhoids, or piles, are a common condition that affects around 50% of adults who are 50 years or older.
• Home remedies can provide relief from discomfort, pain, itching, and other symptoms of haemorrhoids.
• It is best to consult a doctor if there is severe pain, heavy bleeding or fever, as these may be caused by some other medical condition.
• By making a few lifestyle changes, haemorrhoids can be prevented.

Frequently Asked Questions

1. What is The Best Treatment For Piles?

Low-grade piles can be treated with home remedies like increasing fibre intake, staying hydrated, exercising and using topical creams, corticosteroids and laxatives. However, for more severe cases, non-surgical medical treatments or even surgery may be necessary.

2. How To Reduce Piles Fast?

Minimally invasive procedures such as rubber band ligation, sclerotherapy and coagulation techniques are the best to shrink piles fast. These are usually painless and are performed in the doctor’s clinic or as outpatient procedures.

3. Do Piles Go Away Naturally?

In many cases, piles resolve on their own within 1-2 weeks without requiring treatment. However, if the haemorrhoids are visibly protruding, causing severe pain or bleeding, surgical removal may be necessary for long-term relief.

4. What Is The Main Cause Of Piles?

Piles are primarily caused by excessive pressure on the lower rectum, which can result from factors such as chronic constipation, straining during bowel movements, diarrhoea, heavy lifting, pregnancy, anal sex or genetic predisposition.

5. How Do I Treat Piles At Home?

The best at-home piles treatments include warm sitz baths, ice pack application, applying witch hazel, coconut oil, aloe vera, tea tree oil, increased fibre intake, drinking water and wearing loose cotton clothing.

6. How Long Do Piles Take To Heal?

Small piles typically resolve on their own within a few days. However, large external piles may take longer to heal and can be accompanied by significant discomfort and pain. If the piles persist beyond a few days, it is advisable to seek medical advice.

7. How Common Are Haemorrhoids?

Haemorrhoids are a common occurrence in both women and men, affecting approximately 50% of individuals aged 50 years or older.

8. Who Might Get Haemorrhoids?

Anyone can get haemorrhoids, but it is more common in older adults over the age of 50 years. Haemorrhoids commonly occur in pregnant women, overweight persons and people suffering from chronic constipation.

9. What’S The Difference Between Haemorrhoids And Anal Fissures?

Haemorrhoids or piles are swollen veins in the anus or rectum. Fissures, on the other hand, are cracks or tears in the anal lining.

10. What Other Conditions Cause Haemorrhoid-Type Symptoms?

Other conditions that cause haemorrhoid-like symptoms include anal fissure, perirectal abscess, diverticulosis, pruritis ani or anal itching, anal warts, proctitis and colorectal cancer.