Hemorrhoids

What are hemorrhoids? 

Haemorrhoids (commonly known as piles), are swollen veins in the anus and lower rectum. Haemorrhoids inside the rectum are called internal haemorrhoids, and those under the skin around the anus are called external haemorrhoids.

How common are haemorrhoids?

An estimated 1 in 20 Americans has symptomatic haemorrhoids. They’re more common as you age, affecting more than half of people over age 50. 

Who can get haemorrhoids?

Anyone can get haemorrhoids. People with following conditions are at a higher risk of getting haemorrhoids:

• Pregnancy
• Consuming less dietary fiber
• Having chronic constipation or diarrhea
• Regularly lifting heavy objects
• Spending more time sitting on toilet
• Strain while having bowel movements (https://my.clevelandclinic.org/health/diseases/15120-hemorrhoids)

Obesity or being overweight

What are the symptoms of hemorrhoids?

• Internal hemorrhoids cannot be felt or seen, however while straining to pass stools you may feel:
  • Painless bleeding during bowel movements. You might notice small amounts of bright red blood on your toilet tissue or in the toilet.
  • A haemorrhoid to push through the anal opening, called a prolapsed or protruding haemorrhoid. This may result in pain and irritation.
• External haemorrhoids may cause: 
  • Severe pain
  • Swelling
  • Inflammation
  • Itching 
  • A hard, discoloured lump near the anus (https://www.mayoclinic.org/diseases-conditions/hemorrhoids/symptoms-causes/syc-20360268) 

How are hemorrhoids diagnosed?

A healthcare provider performs physical examination and require lab testing to diagnose hemorrhoids.

• Digital rectal examination maybe performed by your healthcare provider to palpate swollen veins with lubricated fingers. 
• Anoscopy can be done to view the lining of the anus and rectum using a light on a tube.
• Sigmoidoscope is a light and camera on a tube used to view the sigmoid (lower) part of colon and rectum.

These tests may be uncomfortable but aren’t painful. They typically take place in a doctor’s office or outpatient centre without anaesthesia. You go home the same day. A colonoscopy may also be performed to rule out colon cancer. This outpatient procedure requires anaesthesia. (https://my.clevelandclinic.org/health/diseases/15120-hemorrhoids) 

What are the complications of haemorrhoids?

• Anaemia: blood loss resulting from haemorrhoids may cause anaemia. 
• Strangulated haemorrhoid: When the blood supply to an internal haemorrhoid is cut off, the haemorrhoid is called strangulated. Strangulated haemorrhoids can cause extreme pain. 
• Blood clot: Sometimes a clot can form in a haemorrhoid. This is called a thrombosed haemorrhoid. Although not dangerous, it can be extremely painful and sometimes needs to be drained. 

Can haemorrhoids be prevented?

The best way to prevent haemorrhoids is to keep your stools soft so they pass easily. Lifestyle choices which can help prevent or reduce the pain of haemorrhoids are: 

• Eating high fibre foods which include fruits, vegetables and whole grains help softening stools. This will help you avoid the straining that can cause haemorrhoids.
• Drinking plenty of fluids helps to keep stools soft. Avoiding alcohol also may help.
• Avoid straining and holding your breath when trying to pass stool. This creates greater pressure in the veins in the lower rectum.
• Stay active to help prevent constipation and reduce pressure on veins. Exercise also can help you lose excess weight that might be causing your haemorrhoids or making them worse.
• Avoid sitting too long, especially on the toilet. This can increase the pressure on the veins in the anus.
• Go to the toilet when the urge hits — don’t delay bowel movements. (https://www.mayoclinic.org/diseases-conditions/hemorrhoids/symptoms-causes/syc-20360268) 

What are the treatment options for haemorrhoids?

• Rubber band ligation: A small rubber band placed around the base of a haemorrhoid cuts off blood supply to the vein.
• Electrocoagulation: An electric current stops blood flow to a haemorrhoid.
• Infrared coagulation: A small probe inserted into the rectum transmits heat to get rid of the haemorrhoid.
• Sclerotherapy: A chemical injected into the swollen vein destroys haemorrhoid tissue. 

Surgical treatments include: 

• Haemorrhoidectomy: Surgery removes large external haemorrhoids or prolapsed internal ones.
• Haemorrhoid stapling: A stapling instrument removes an internal haemorrhoid. Or it pulls a prolapsed internal haemorrhoid back inside of your anus and holds it there. (https://my.clevelandclinic.org/health/diseases/15120-hemorrhoids)