What are they?
Haemorrhoids (also called piles) are enlarged blood vessels around the anus and inside the rectum. Sometimes they can appear on the outside of the anus and can be pushed back in.
Haemorrhoids usually occur when one has to strain to pass faeces such as with constipation. Pregnancy is also an important predisposing factor to getting haemorrhoids, though they often resolve at the end of the pregnancy. This may be due to hormones which are produced in larger amounts during pregnancy.
What are the symptoms?
When haemorrhoids are quite small, little or no discomfort is felt. Larger ones however can be itchy, irritating or painful. Really large haemorrhoids on the inside of the rectum can also give a sensation of incomplete emptying even when the bowels have been completely emptied.
When haemorrhoids bleed, the blood is bright red in colour and its appearance on the toilet bowl is characteristically described as “a flash in the pan”.
What treatments work?
Several treatments are available for haemorrhoids. The doctor should determine the most appropriate for each case based on his assessment.
There are however simple things one can do on their own to manage the condition. They include:
- Eating plenty of fibre-containing foods or taking fibre supplements to prevent and treat constipation.
- Drinking plenty of water to help soften the stools.
- Frequent emptying of the bowel as often as the urge comes to avoid the stool hardening up.
- Avoiding straining to pass stool, and not sitting on the toilet for a long time.
- Applying ointments and creams on the area, and having warm baths to soothe the itch and pain.
Sometimes, these simple treatments may be all that is needed to take care of the haemorrhoids. If they fail, the doctor will go ahead and try other treatment options. These include:
- Banding (or rubber band ligation); which involves simply tying a rubber band around the base of the haemorrhoid to cut off its blood supply, making it drop off. It is effective in about 80 percent of the cases.
- When a haemorrhoid is too small for a rubber band ligation, a chemical can be injected directly into the enlarged blood vessels to shrink them. This is called sclerotherapy. This however may not work as effectively as banding after a while.
- Infrared rays may be used to burn away small haemorrhoids that are inside the anus.
- The arteries that supply blood to the haemorrhoids may also be stitched closed, shrinking the haemorrhoids.
- A surgery called a haemorrhoidectomy (‘-ectomy’ means ‘cutting out’) may be used to remove haemorrhoids outside the anus.
Even after successful treatment, haemorrhoids may appear again. However, they are unlikely to cause serious problems and their treatments are quite effective.