Haemorrhoids

Haemorrhoids or ‘piles’ are swollen veins in the anus or bottom, usually just inside the external entrance of the bowel. Occasionally they can protrude or pop out, often immediately after or during a bowel motion. 

Piles are usually swollen and painful, particularly when external (outside the anus) but also when internal as the passage of bowel contents burns and irritates each time you pass a motion.

Haemorrhoids are caused by pressure being placed on the anus, by straining to pass bowel motions, especially when the motion is hard and dry and thus difficult to pass. Other causes include infections of the anus, some conditions affecting the liver and pregnancy.

Haemorrhoids occurring during and as a result of pregnancy are also from pressure on the veins - from the weight of the baby compressing the bowel area, and also from the exertion of childbirth.  

Piles are usually diagnosed after an examination from your doctor, who may use an instrument gently inserted to examine the lower bowel, or other diagnostic tests that rule out other conditions. People with haemorrhoids may notice a little blood on toilet tissue following a bowel motion, but if large amounts of blood are noticed in the toilet then it is important to consult your doctor at once as other more serious conditions can cause bleeding from the bowel. Most haemorrhoids cause only a small amount of blood loss – haemorrhoids that bleed frequently may need to be removed by surgery or other means.

Other symptoms of haemorrhoids include itching around the bottom, usually caused by the difficulty of cleaning away all bowel fluids after a motion because the area is tender, or from inflammation of the haemorrhoids as well as the surrounding skin.  
Most haemorrhoids are effectively treated with specific creams or suppositories that treat the inflammation, pain and swelling. It helps to ensure that bowel motions are soft, so initial treatment with medicines to ensure soft stools are used in order to ease the passage of bowel contents.

Once the initial symptoms of haemorrhoids are eased, then they are best treated and prevented by a high fibre diet and plenty of fluids, particularly water in the diet. Adding fibre supplements to the diet ensuring regular bowel movements each day is also helpful if there is a history of constipation. Using soft or moist toilet tissue helps with cleaning the anal area - be careful to choose flushable towelettes if you decide to use these.  If the haemorrhoids are extremely uncomfortable then soak in a warm bath for up to 15 minutes, then carefully dry the area and apply anaesthetic creams to numb the pain.

Medicines to treat and prevent haemorrhoids are available from your pharmacy. Consult your community pharmacist for advice regarding suitable medicines to treat haemorrhoids, and the best diet and lifestyle to ease the pain and discomfort. They can also advise you of the likely cause of your haemorrhoids, how to prevent their troublesome recurrence, or refer you for further help from a doctor or specialist if required.