Haemorrhoids, also known as 'piles', are swollen blood vessels in and around the anus (back passage). Internal haemorrhoids are blood vessel swellings inside the anus, they do not usually present many symptoms other than the appearance of blood on toilet paper. If the haemorrhoids begin to protrude outside the anus, a condition known as 'external', 'prolapsed' or 'protruding' haemorrhoids, other symptoms may occur including pain, irritation, itching, tenderness, pain on going to the toilet and an uncomfortable bulging feeling.

Haemorrhoids can affect men and women. They are particularly common amongst the elderly.

Causes

Increased pressure inside the abdomen causes the blood vessels around the anus to become swollen with blood. Any of the following may lead to an increase in pressure:

  • constipation: increased pressure can be caused by straining to go to the toilet
  • pregnancy: pregnant women often suffer from haemorrhoids because during pregnancy an unborn baby can cause pressure
  • obesity: excessive body fat can also cause pressure so anyone who is overweight may therefore be more at risk from developing haemorrhoids
  • lifting, standing & sitting: frequently lifting heavy objects and spending long periods of time either standing up or sitting down may increase pressure

Avoiding Haemorrhoids

Eating a well balanced diet will reduce the risk of constipation. Your diet should consist of wholemeal bread, cereals, wholemeal pasta, pulses such as chickpeas, lentils and beans (including baked beans) and at least five portions of fruit and vegetables each day. One portion equates to one medium sized piece of fruit such as an apple or a banana, a slice of a large piece of fruit such as a melon or pineapple, two small pieces of fruit such as plums, a cupful of grapes or berries, 2-3 tablespoons of fruit salad, 2-3 tablespoons of stewed or tinned fruit, two tablespoons of vegetables, a dessert bowl of salad or a 150ml glass of fruit juice.Drink at least four pints of water every day. Fruit juices are also a great source of fibre.Take regular exercise.Do not resist the urge to go to the toilet.Try not to strain when you go to the toilet. If you are overweight, your doctor may advise you to try and lose weight.ยท

Treatment

Applying an ice pack or taking a warm bath can help to ease symptoms.Use soft toilet paper to help prevent further irritation. Do not scratch.Haemorrhoids usually disappear without treatment within a few days. However, soothing creams, ointments, suppositories and foams can be bought over the counter at a pharmacy. These preparations usually contain a combination of astringents which cause the haemorrhoids to dry out and shrink, vasoconstrictors which narrow the blood vessels, lubricants which make the faeces softer and easier to pass, antiseptics to fight infection or anaesthetics to numb pain. Corticosteroids in combination with other ingredients can be used to reduce swelling. Some mild forms are available over the counter from a pharmacy but most are only available from a doctor on prescription.

In certain cases, the haemorrhoids have to be removed. This can be done by one of three ways. Rubber band ligation can be used which is when small elastic bands are stretched over the haemorrhoids. This stops the blood circulating properly and causes the haemorrhoids to wither away. Haemorrhoids can also be injected with a sclerosant which is a chemical which has a similar effect to the rubber band. Laser or infra-red treatment can be used to stop circulation, causing the haemorrhoids to wither away. Haemorrhoids can also be removed by surgery under a general anaesthetic.

When To See A Doctor

If you develop any of the following symptoms, make an appointment to see your doctor: severe abdominal pain, blood in your faeces, weight loss, faeces which look tar-like or unusual/unexplained constipation.

Additional Information

For additional information about haemorrhoids, contact the Digestive Disorders Foundation, 3 St Andrews Place, London NW1 4LB. Tel: 0171 486 0341. Fax: 0171 224 2012. Website address: www.digestivedisorders.org.uk.