Patient Guide

Haemorrhoids

What are Haemorrhoids (Piles)?

Haemorrhoidal veins are normal anatomic structures located in the lower rectum. However, when enlarged and engorged, haemorrhoids (commonly known as piles) are one of the most common ailments of the anorectal region. They are found around the anus and lower rectum.

External haemorrhoids develop near the anus. If a blood clot develops in one of them, a painful swelling may occur. Internal haemorrhoids develop within the anus. They are usually painless because the upper anal canal has no pain nerve fibres. Painless bleeding and protrusion during bowel movements are often observed.

External haemorrhoids develop near the anus. If a blood clot develops in one of them, a painful swelling may occur. Internal haemorrhoids develop within the anus. They are usually painless because the upper anal canal has no pain nerve fibres. Painless bleeding and protrusion during bowel movements are often observed.

Causes

  • Chronic Constipation or Diarrhoea: Continuous straining of the anus increases the pressure around the veins, resulting in haemorrhoid formation
  • Pregnancy: Pressure of the foetus lying above the rectum and anus, as well as a change in hormone levels can have an effect on the veins
  • Ageing: Tissue lining of the anus may become less supportive as we get older. Piles are more common after the age of 30
  • Hereditary factors: Some people may inherit a weakness of the wall of the veins in the anal region
  • Medical factors: Loss of muscle tone due to an episiotomy, or rectal surgery can promote haemorrhoids.
  • Lifestyle factors: Individuals with bad habits such as reading in the toilet for prolonged periods, standing or sitting for long periods, are more prone to piles

Symptoms

  • Bleeding during bowel movements
  • Lump at the anus coming out during bowel movements - A haemorrhoid can hang down (prolapse) and can be felt outside the anus.
  • Itching in the anal area
  • Pain

Treatment

In many cases, piles are small and symptoms settle down without treatment. If required, treatment is usually effective.

Non-surgical cures

  • Stool softeners, fibre supplements to ease bowel movement
  • Creams, ointments and cold packs to soothe the pain
  • Oral medication can improve venous tone and reduce bleeding

Other treatment methods include:

  • Ligation: Works effectively on internal haemorrhoids that protrude with bowel movements. A small rubber band is placed over the haemorrhoid, cutting off its blood supply. The haemorrhoid and the band fall off in a few days and the wound usually heals in a few weeks.
  • Injection: Used on bleeding haemorrhoids that do not protrude. This method causes the haemorrhoid to shrivel up.
  • Haemorrhoidectomy: Surgery to remove the haemorrhoids permanently

Prevention

  • Eat plenty of fibre
  • Keep hydrated
  • Practise proper bowel habits. Go to the toilet as soon as possible after feeling the need. Also, do not sit on the toilet bowl for long periods.

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