What are haemorrhoids?
Haemorrhoids, also known as piles, are lumps that occur inside and around the anus (back passage) due to congested blood vessels. They are very common and can cause symptoms such as bleeding, pain, discomfort, and itchiness around the anus. If you have haemorrhoids, it is important to get checked out by a doctor to make sure your symptoms are not a sign of something more serious.
How are haemorrhoids treated?
The risk of haemorrhoids can be increased by constipation, straining, heavy lifting, increased abdominal size including pregnancy, having diarrhoea (toileting and wiping more often), and spending longer than necessary on the toilet.
For most patients, symptoms can resolve with simple measures such as adequate hydration (with water), fibre supplements (like psyllium), high-fibre diets, limiting time on the toilet and avoiding straining. Patients with diarrhoea are likely to need this investigated and managed to see improvement in their haemorrhoid symptoms.
Some patients find relief with topical, over-the-counter therapy, though there is little evidence to support their use, and these should not be used without excluding more serious problems and not for long periods of time.
For most patients who have not responded to simple measures, endoscopic management such as rubber band ligation can offer a low risk and effective treatment when the haemorrhoids are mainly internal (these may be felt externally on occasion).
When the issue is mainly external haemorrhoids, surgical management may need to be considered, though it is associated with more pain and a high rate of complications. Regardless of the approach, addressing the underlying cause and sticking to the simple measures above can reduce the chances of haemorrhoids returning.
