What are haemorrhoids?
Haemorrhoids or piles, are an enlarged bunch of blood vessels in and around the anus. They may be associated with pain, bleeding and itching.
What are the causes for their development?
Haemorrhoids are very common in men and women, especially after the age of 50. They are caused due to a raised pressure in the abdomen which may be because of:
a chronic constipation problem
a large uterus as in pregnancy
heavy lifting jobs
What are the symptoms?
Haemorrhoids are not dangerous and in most cases the symptoms go away in a few days. The most common symptom is fresh bleeding while passing stool. There may be pain and a bulge or lump around the anus. There may also be itching with bleeding.
What are the different kinds of haemorrhoids?
Internal haemorrhoids - are those that are formed inside the rectum. They are generally not painful and are often only noticed when they bleed.
Prolapsed haemorrhoids - are internal haemorrhoids that protrude through the anus when stool is passed or when a person stands or walks. They are usually painful.
External haemorrhoids (perianal haematoma) - are small, painful haemorrhages under the skin around the anus. They form a hard clot after 24 hours. When they resolve, they sometimes leave a small skin tag.
How is the problem diagnosed?
Presence of fresh blood in the stool requires thorough evaluation and diagnosis by the doctor. The doctor may examine the anus and rectum to look for swollen blood vessels, indicative of haemorrhoids. A hollow, lighted tube, known as a proctoscope, may be inserted into the anus to look for internal haemorrhoids.
What is the treatment?
Prevention is the best treatment in the case of haemorrhoids. It is important to get into the habit of answering the ‘call of nature’ so that stools are passed easily without much strain. A diet adequate in fibre, consisting of fresh fruits, vegetables, whole-grain cereals and bran should be taken. Drinking 8 to 10 glasses of fluid daily is advisable.
Gentle cleaning and wiping after each bowel action is recommended.
Special astringent ointments or suppositories may be used on doctor’s advice, to shrink the haemorrhoids.
If the problem persists, injections or surgery (haemorrhoidectomy) may be advised by the doctor in some cases. A number of methods may be used to remove or reduce the size of internal haemorrhoids.
Some of the techniques used for the reduction of the size of haemorrhoids are:
Sclerotherapy : a chemical solution is injected around the blood vessel to shrink the haemorrhoid.
Banding : a tight elastic band is placed around the stalk of the haemorrhoid.
Laser coagulation or infrared photo coagulation : In this case, special devices to block the circulation of haemorrhoidal tissues are used.
Haemorrhoidectomy : In this operation, the bunch of swollen blood vessels is removed. The operation is done under general or spinal anaesthesia. Following the operation, there may be pain on passing stool and some blood for a few days. But this usually resolves quickly. After the operation, constipation must be avoided.