Swollen veins inside the rectum and around the anus, also known as piles
- More common in adults
- More common in females during pregnancy and after childbirth
- Being overweight and a low-fibre diet are risk factors
- Genetics is not a significant factor
Haemorrhoids are a common problem, affecting up to half of all people at some time in their lives. In this disorder, veins in the soft tissues around the anus and inside the lower part of the rectum become swollen. Swellings around the anus are called external haemorrhoids, and those within the rectum are called internal haemorrhoids. Internal haemorrhoids that protrude outside the anus are called prolapsing haemorrhoids.
Haemorrhoids frequently cause bleeding, itching, and discomfort. However, these symptoms are usually intermittent, and the condition is not in itself serious.
What are the causes?
Haemorrhoids most often result from constipation, when a person strains to pass stools. Straining in this way increases the pressure inside the abdomen, which in turn causes blood vessels around the rectum to swell. Constipation is often due to a low-fibre diet. Excess weight also exerts pressure on blood vessels and thus increases the risk of haemorrhoids. During pregnancy, the growing fetus has the same effect, frequently resulting in haemorrhoids.
What are the symptoms?
The symptoms of haemorrhoids commonly develop following constipation. Symptoms may include:
Fresh blood on toilet paper or in the toilet after a bowel movement.
Increasing discomfort on defecation.
Discharge of mucus from the anus, sometimes leading to itching.
Visible swellings around the anus.
Feeling that the bowels have not been fully emptied.
A prolapsing haemorrhoid may protrude through the anus after a bowel movement and may then retract or can be pushed back inside with a finger. In some cases, a blood clot (thrombus) may form within a prolapsing haemorrhoid, causing severe pain and a visible, tender, blue, grape-sized swelling.
If you have bleeding from the anus, you should consult your doctor without delay, especially if you are over 40, since it may indicate a more serious disorder, such as colorectal cancer.
What might be done?
Your doctor will probably examine your rectum by inserting a gloved finger into it, and, if there has been bleeding that suggests a serious underlying disease, may arrange for colonoscopy.
Small haemorrhoids do not usually need treatment. Haemorrhoids due to pregnancy usually disappear soon after the birth. A high-fibre diet helps to prevent constipation, and laxatives may help to ease defecation. Over-the-counter topical corticosteroids and corticosteroid suppositories can reduce swelling and itching, and anaesthetic sprays may relieve pain. If these measures are not effective within a few days, you should consult your doctor, who may suggest surgery.
Small internal haemorrhoids may be treated by sclerotherapy, in which the affected area is injected with a solution that causes the veins to shrink. Alternatively, the doctor may place a band around the base of an internal haemorrhoid, causing it to shrink and fall off (see Banding haemorrhoids).
Persistent, painful, bleeding haemorrhoids can be destroyed by electrical, laser, or infrared heat treatment or be removed surgically. Treatment is usually successful, but haemorrhoids may recur.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.
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