are inflamed blood vessels which become swollen and distended usually caused by increased pressure due to pregnancy, being overweight, or straining during bowel movements. By midlife, haemorrhoids often become an ongoing complaint and about half the population has experienced one or more of the classic symptoms, which include rectal pain, itching, bleeding, and possibly prolapse (haemorrhoids that protrude through the anal canal).
What causes haemorrhoids?
are associated with chronic constipation, straining during bowel movements, and prolonged sitting on the toilet these all interfere with blood flow to and from the area, causing it to pool and enlarge the vessels. Haemorrhoids are common during pregnancy, when the enlarging uterus presses on the veins.
There are two kinds of haemorrhoids:
1. Internal haemorrhoids, which occur in the lower rectum, and
2. External haemorrhoids, which develop under the skin around the anus.
External haemorrhoids are more uncomfortable. If a blood clot forms inside an external haemorrhoid, the pain can be sudden and severe. Often you might feel or see a lump around the anus. The clot usually dissolves, but the skin may itch or become irritated.
Internal haemorrhoids are typically painless, even when they bleed. You might, for example, see bright red blood on the toilet paper or dripping into the toilet bowl. Internal haemorrhoids may also prolapse or extend beyond the anus. When a haemorrhoid protrudes, it can collect small amounts of mucus and tiny stool particles that may cause an irritation called pruritus ani. Wiping constantly to try to relieve the itching can worsen the problem.
There are varying degrees of piles, which are classified by their size and severity.
First degree haemorrhoids cannot be seen outside the anus. They develop on the lining inside of the anus and are small in size.
Second degree haemorrhoids are larger in size. These swellings may protrude out from the anus when going to the toilet, before retracting back inside.
Third degree haemorrhoids comprise of one or more soft lumps that hang down from the anus. These can be pushed back inside, known as reducible.
Forth degree haemorrhoids differ from third degree haemorrhoids by being larger in size. They are also irreducible – they cannot be pushed back inside.
What are the symptoms of Haemorrhoids & Piles?
Piles often come and go without presenting any symptoms and aren’t generally painful. They tend to only cause pain if their blood supply is reduced or interrupted.
For those who have a higher degree of haemorrhoids, the following symptoms may present:
An itch, soreness or redness around your anus
A visible lump that hangs down outside the anus
A discharge of mucus or blood after passing a stool
If your symptoms are persistent and don’t respond to over-the-counter treatments then it may be necessary to see your doctor. If in any circumstance you are experiencing rectal bleeding then it’s advised to always seek medical advice.
What treatments are available for Haemorrhoids?
Lifestyle Changes
1) Eat more fibre e.g.
• Wheat bran and shredded wheat.
• Prunes. Prunes are dried plum. ...
• Apples. ...
• Pears. ...
• Barley. ...
• Corn. ...
• Lentils. ...
• Whole wheat bread, pasta, and cereals.
2) Exercise daily - Regular moderate speed exercise increases bowel movements
3) When you feel the urge to defecate, go to the bathroom immediately; don't wait until a more convenient time. Schedule a set time each day, such as after a meal, to sit on the toilet for a few minutes. This can help you establish a regular bowel habit.
4) Stay hydrated – drink lots of water!
Over the counter remedies
Over the counter rememdies for piles include ointments, creams, wipes and suppositories. Topical treatments include; Anusol, Preparation H and Rowatanal which are all treatments are designed to soothe irritation in and around the anus. They are zinc-based, which provides a barrier for the sore skin, to ease irritation and helping to prevent infection. Some also contain local anaesthetics to help to ease the pain of piles.
Click here for over the counter treatments
Prescription treatments
If there is severe inflammation around the anus then certain preparations, such as Scheriproct Ointment and Proctosedyl Ointment contain a steroid, which will help reduce inflammation. They also ease pain and irritation or act as a barrier. They are suitable for more serious cases of haemorrhoids (second and third degree) where over-the-counter treatments are ineffective. They are normally used in courses of 7-10 days at a time.
Additional help if piles are particularly sore
1. You can try applying an ice pack for short periods to help reduce inflammation. Sitting in a warm bath can help to ease symptoms of pain and discomfort.
2. Take some ibuprofen as pain relief and as an anti inflammatory.