What are Haemorrhoids? (Piles)
Piles or Haemorrhoids are caused when anal cushions, which contain blood vessels, become engorged and cause rectal bleeding.
Haemorrhoids can be caused usually by factors that lead to difficulty in passing bowel motions, chronic constipation, intense exercise, increasing age and any increase in abdominal pressure such as during pregnancy.
What are the symptoms?
Bleeding is the commonest symptom and usually occurs after the passage of bowel motions. Stools. Other symptoms that patients describe include anal itching/ irritation, some anal discomfort - this can represent a painful thrombosed pile.
Blood on toilet paper - most patients describe this as their first symptom
Excessive bleeding can also occur as well as painful prolapsed piles (when the haemorrhoids come down and are too inflamed/ swollen to push back)
How are they Diagnosed?
A good history usually helps diagnose haemorrhoids, but you surgeon will need to examine your anus an occasionally use a small instrument called a proctoscope. This examination is not too uncomfortable and is undertaken in outpatient clinic.
Haemorrhoids are classified as:
First degree - minor (small with occasional bleeding)
Second degree - moderate (may prolapse but can be reduced)
Third degree - severe (prolapsed, painful and usually cannot be pushed back)
How can they be treated?
Patients are advised on preventative measures such as avoiding straining when passing bowel motions, the use of laxatives and a high fibre diet.
Rubber band ligation can help with the majority of patients (see banding of haemorrhoids)
Stapled Haehorrhoidectomy and HALO procedure are procedures reserved for more symptomatic haemorrhoids