Haemorrhoids

What are haemorrhoids?

Haemorrhoids (also known as "piles") are caused by enlarged blood vessels which cause small swellings, either inside or outside your rectum ("back passage"). The blood vessels become enlarged when subjected to pressure, for example, when straining to pass stools when constipated or during childbirth.


Who suffers from haemorrhoids? 

Haemorrhoids are particularly common among pregnant women, because the pressure of the baby, as well as hormonal changes, can cause the blood vessels to enlarge. Haemorrhoids are also more likely to occur if you are overweight, constipated or elderly.

Haemorrhoids are usually a minor and temporary inconvenience. However, if symptoms are persistent your doctor should be able to offer advice and medication to help.


What are the symptoms?


The main symptoms of haemorrhoids are swelling and irritation, in or around your rectum. Haemorrhoids are painful and sometimes there is bleeding when you pass a stool.

Internal haemorrhoids usually cause less severe symptoms. Ordinarily they cannot be seen or touched, but they can cause pain and bleeding during a bowel movement. Fresh, bright red blood on the toilet paper is a sign of an internal haemorrhoid.

External haemorrhoids tend to be more uncomfortable and are more troublesome. These too can bleed, usually when rubbed by toilet paper or tight fitting underwear.

Sometimes a blood clot can form into a haemorrhoid (thrombosed piles). This will feel like a painful lump, about the size of a grape, sticking out through your rectum.


Should I see a doctor?


In most cases haemorrhoids are nothing more than a temporary problem. If they are uncomfortable you may want to ask your pharmacist for a haemorrhoid cream, ointment or suppository (tablets that you push gently into your rectum). You can also take steps to reduce the chance of a recurrence (see below).

If you notice dark blood mixed with your stools, experience pain or suffer excessive irritation or mucus leakage, you should make an appointment to see your doctor.

Your doctor will examine you and may want to feel inside your rectum. Although this may seem embarrassing, it is very important to exclude any serious illnesses such as cancer.


How are haemorrhoids treated?


Most haemorrhoids get better within a few days without any specific treatment. Simple measures such as bathing in warm water, applying ice packs, or using a haemorrhoid cream, ointment or suppository obtained from your pharmacist, can relieve some of the discomfort.

For serious or prolonged irritation it may be necessary for your doctor to prescribe a treatment. Creams or ointments containing a combination of a local anaesthetic and a steroid may be prescribed to treat pain, inflammation and itching. You should use your treatment as directed by your doctor and make another appointment if your symptoms last for more than seven days. If you are constipated your doctor may prescribe a laxative. He or she may also recommend that you take a painkiller such as paracetamol when needed.

Your doctor may refer you to hospital for treatment if you do not respond to treatment or suffer from recurring haemorrhoids. The haemorrhoids can usually be treated by a doctor in the hospital's out-patient department. The most common treatments include placing a rubber band around the haemorrhoid cutting off the circulation so it withers away (rubber band ligation), or an injecting a chemical to shrink it (sclerotherapy). Only really difficult or severe cases will require surgery.


Help yourself

  • Try to avoid becoming constipated by eating plenty of fibre, including fresh fruit, vegetables, wholemeal bread and cereals
  • Drink plenty of fluids to prevent constipation. Drink more during hot weather or if you are exercising
  • Try to take regular exercise. This will also help to prevent constipation and ease the pressure on the haemorrhoids
  • Avoid using hard toilet paper, use soft paper or medicated wipes instead
  • Reduce discomfort by washing gently with warm water or sitting in a bath of warm water for 10 minutes several times each day. Using an ice pack can also help reduce the pain and swelling
  • Do not scratch the area as this will make it more painful and uncomfortable
  • Wear loose fitting underwear made from natural materials such as cotton
  • If you are overweight, try to lose weight
  • Do not put off going to the toilet and take your time when you do go

Fact sheet provided by MIMS

Date last reviewed: October 2014


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