Haemorrhoids

Haemorrhoids or piles are anal cushions. They consist of enlarged blood vessels in and around the anus and lower rectum. They are sometimes known as the ‘varicose veins of the anus and rectum’.

The cause of haemorrhoids are usually multifactorial. About half the population over the age of 30 yrs will develop haemorrhoids. Haemorrhoids are often associated with ageing, pregnancy, chronic straining, constipation and a family history of haemorrhoids

Symptoms

Bleeding-Typically, bleeding occurs during bowel movement. It is usually bright red and seen on the toilet tissue on wiping. Occasionally if bleeding is severe, blood can be seen in the toilet bowl.

Prolapse- Depending on the severity, haemorrhoids may prolapse (come out) during bowel movement and this may cause discomfort and even pain if the haemorrhoids remain prolapsed for a long time.

Pain- Majority of people do not get pain unless the haemorroids come out and remains out for some time. Blood within the haemorroids may then clot  (thrombosed piles) and the haemorrhoids become extremely painful. This can last for a few weeks.

Itch- This often occurs due to a combination of poor hygiene, prolapse and mucus discharge.

Treatment

High fibre diet- majority of the symptoms can be improved simply by increasing fibre intake (vegetables and fruit). This will increase stool bulk and soften faeces.

Banding – This procedure is often carried out by midland gut clinic surgeons in the outpatient clinic. The aim of banding is to tie off the blood vessels supplying the haemorroids and make the haemorroids  shrink. This procedure can be carried out in less than a minute and most patients only have mild discomfort after the procedure.

Surgery

HALO/THD- These are relatively new methods of treating haemorrhoids when banding has not helped. It involves a short general anaesthetic and is often done as a day case. The vessels feeding the haemorroids are detected using a Doppler device and are then stitched. This will shrink the haemorrhoids and prevent any further prolapse. Most patients will have discomfort following this procedure but much less pain compared to haemorroidectomy.

Haemorrhoidectomy-This is surgery to remove the haemorroids as well as the skin tags associated with the haemorrhoids.  This surgery is often done when the haemorrhoids are advanced or when other treatments have failed.  It is carried under general anaesthetic and patients often will have pain for a few weeks.