What are Haemorrhoids?

Haemorrhoids are a common problem, affecting more than half of all adults by the age of 50. They may cause discomfort and bleeding. Happily, there are many effective treatment options available for haemorrhoids, including making some simple lifestyle changes. They can arise in a variety of situations, and are often associated with constipation or pregnancy.

Haemorrhoids, also known as ‘piles’, are soft packets or clusters of swollen veins lying just beneath the surface of the anus. These veins are normally present, and haemorrhoids develop when they become swollen. Haemorrhoids may be located inside the rectum (internal haemorrhoids), or under the skin around the anus (external haemorrhoids). Haemorrhoids are often painful, and may be accompanied by burning. They typically lead to bleeding from the anus, leading to blood in the toilet bowl, on the toilet paper, or in your stool.

What are the causes of Haemorrhoids?

Haemorrhoids may be caused by a number of factors including:

1. Straining during bowel movements.
   This increases the pressure in the rectal veins.
2. Chronic diarrhoea.
   Haemorrhoids ay arise from overuse of the muscles and increased pressure from sitting for extended periods.
3. Constipation.
   This is the most common cause, and occurs when increased pressure exerted to pass stools fills and stretches the veins.
4. Obesity and/or pregnancy.
   Extra pressure on the rectum and pelvic region can contribute to haemorrhoid formation.
5. Childbirth.
   Extreme pressure and force related to a vaginal delivery can also cause haemorrhoids.
6. Extended periods of sitting or standing.

How can Haemorrhoids be prevented or minimised? 

1. Eat more fibre.
   This can be done via food (whole-grain foods, beans, fruit), a fibre supplement (such as Metamucil), or both. Fibre softens the stools and makes them easier to pass, reducing the pressure that causes haemorrhoids.
2. Drink plenty of fluids.
   By drinking ample water, constipation is minimised.
3. Regular exercise.
   This may contribute to keeping your bowel movements regular. For example, a brisk 20– 30-minute walk each day can help stimulate bowel function.
4. Minimise or avoid straining.
   Pushing too hard while using the bathroom, as well as heavy lifting activities, can also contribute to increased pressure and haemorrhoids.

What are the treatment options for Haemorrhoids?

Minor haemorrhoids can often be treated with over-the-counter products, such as anti-inflammatory medications to reduce the pain. Warm sitz baths — your hips and buttocks are seated in warm salty water — can provide temporary relief. Stool softeners, aloe wipes, and certain creams may also be beneficial. Drinking large quantities of water may also improve symptoms.

For haemorrhoids which do not respond to the above, the following treatment options may be available:

1. Surgery (haemorrhoidectomy).
   This is a relatively straightforward surgical procedure which involves removing the haemorrhoids.
2. Rubber band ligation.
   This is an older technique that causes very minimal pain. Constricting bands are carefully placed around the haemorrhoids to restrict its blood supply, The haemorrhoid shrivels up and falls off over the next week or two.