­­­­­­­­What are haemorrhoids?

Haemorrhoids are veins around the anus or lower rectum, also known as “Piles” which may get swollen or inflamed. They are very common with almost half the population having them at the age of 50 years.  Haemorrhoids may result from constipation or straining to pass stool. Other contributing factors include pregnancy, family history, chronic constipation or diarrhea.  Haemorrhoids are either inside the anus (internal) or under the skin around the anus (external).

What are the symptoms of hemorrhoids?

Most people with haemorrhoids do not experience any symptoms at all.  Although some people pass bright red blood from their bottom, haemorrhoids may also cause itch and pain (which can be severe).  In most cases, symptoms resolve in a few days. 

How are hemorrhoids diagnosed?

Any rectal bleeding should be discussed with your doctor.  Haemorrhoids may be visualized or felt if external.  Sigmoidoscopy and colonoscopy (hyperlink) are diagnostic procedures that also involve the use of lighted, flexible tubes inserted through the rectum.

What is the treatment?

Medical treatment of hemorrhoids is aimed initially at relieving symptoms.  Measures to reduce symptoms include;

• baths several times a day in plain, warm water for about 10 minutes
• application of a haemorroidal cream or suppository to the affected area for a limited time (examples include; Rectinol, Anusol, Proctosedyl, Scheriproct, Xyloproct)

Preventing the recurrence of hemorrhoids will require relieving the pressure and straining of constipation. Increasing fibre & fluids in the diet may be helpful.  A bulkier and softer stool makes emptying the bowels easier and lessens the pressure on hemorrhoids caused by straining. Eliminating straining also helps prevent the hemorrhoids from protruding.  Good sources of fibre are fruits, vegetables, and whole grains. In addition, doctors may suggest a bulk stool softener or a fiber supplement such as psyllium (Metamucil) or methylcellulose (Citrucel).
In some cases, hemorrhoids must be treated endoscopically or surgically. These methods are used to shrink and destroy the hemorrhoidal tissue.   A number of methods may be used to remove or reduce the size of internal hemorrhoids. These techniques include:

• Rubber band ligation. A rubber band is placed around the base of the hemorrhoid inside the rectum. The band cuts off circulation, and the hemorrhoid withers away within a few days.
• Sclerotherapy. A chemical solution is injected around the blood vessel to shrink the hemorrhoid. 
• Infrared coagulation. A special device is used to burn hemorrhoidal tissue.
• Hemorrhoidectomy. Occasionally, extensive or severe internal or external hemorrhoids may require removal by surgery known as hemorrhoidectomy.

Haemorrhoid banding is a common treatment for grade 2 and 3 haemorrhoids.   A haemorrhoid is grasped with a suction device and a rubber band is then placed at its base. This cuts off the blood supply to the haemorrhoid which then ‘dies’ and drops off after a few days. The tissue at the base of the haemorrhoid heals with some scar tissue.

Banding of internal haemorrhoids is usually painless as the base of the haemorrhoid originates above the anus opening – in the very last part of the gut where the gut lining is not sensitive to pain. Up to three haemorrhoids may be treated at one time using this method. In about 8 in 10 cases, the haemorrhoids are ‘cured’ by this technique but in a small number of people they may recur.

More Information?

Contact GastroNorth