Haemorrhoids

Piles, also called haemorrhoids, can make us feel uncomfortable and, in some cases, may even lead to bleeding. Though not life-threatening, haemorrhoids are capable of impacting our quality of life. Let's have a candid conversation on haemorrhoids, including their types, causes, symptoms, diagnosis, treatment options, and prevention strategies. 

What are Haemorrhoids?

Haemorrhoids are swollen and inflamed veins located in the lower rectum or anus. 

They can evolve inside the rectum (internal haemorrhoids) or under the skin around the anus (external haemorrhoids). These veins can become enlarged and irritated due to increased pressure, often due to straining during bowel movements, chronic constipation or diarrhoea, pregnancy, or sitting for prolonged periods. 

Types of Haemorrhoids

There are two main types of haemorrhoids: 

1. Internal haemorrhoids: These occur within the rectum and are not visible from the outside. Internal haemorrhoids can cause bleeding, but they are usually painless unless they prolapse (protrude) through the anus. 
2. External haemorrhoids: These develop under the skin around the anus. External haemorrhoids can be painful and itchy and may bleed if they become thrombosed (develop a blood clot). 

What Causes Haemorrhoids?

There are several causes of haemorrhoids, including: 

• Increased pressure: Straining during bowel movements, prolonged sitting or standing, pregnancy, and obesity can lead to increased pressure on the veins in the rectum and anus, resulting in swelling and inflammation. 
• Constipation and diarrhoea: Chronic constipation or diarrhoea can put additional strain on the rectum and anus, increasing the chance of haemorrhoids. 3. Ageing: As people age, the supporting tissues in their rectum and anus can get weakened, making them more susceptible to haemorrhoids. 
• Genetics: There may be a genetic predisposition to developing haemorrhoids, as they tend to run in families. 
• Lifting heavy objects: Lifting heavy weights or engaging in strenuous activities can increase intra-abdominal pressure and strain the veins in the rectum and anus. 

Symptoms of Haemorrhoids

The haemorrhoid symptoms can vary depending on their type and severity. Common symptoms include: 

• Bleeding haemorrhoids can cause bleeding during bowel movements (often visible as bright red blood spots on toilet paper or in the toilet pot) Itching, burning, or irritation around the anus 
• Swelling or a lump around the anus 
• Pain or discomfort while sitting or during bowel movements Leakage of faecal matter or mucus 

Diagnosis of Haemorrhoids

In most cases, a doctor can diagnose haemorrhoids through a physical examination. During the examination, the doctor may perform the following: 

• Visual inspection: The doctor will visually examine the anus and surrounding area for any signs of swelling, inflammation, or prolapsed haemorrhoids.
• Digital rectal examination: The doctor may insert their gloved, lubricated finger into the patient's rectum to feel for any abnormalities or internal haemorrhoids.
• Anoscopy or sigmoidoscopy: In some cases, the doctor may use a lighted. instrument (anoscope or sigmoidoscope) to examine the lower rectum and anus more closely. 

Treatment of Haemorrhoids

The haemorrhoid treatment depends on the severity of the condition and the individual's symptoms. Treatment options may include: 

• Over-the-counter (OTC) medications: Topical creams, ointments, or suppositories containing hydrocortisone or other active ingredients can help diminish inflammation, itching, and discomfort associated with haemorrhoids. 
• Prescription medications: Sometimes, your doctor may prescribe prescription- strength creams, suppositories, or oral medications to manage severe symptoms or complications. 
• Rubber band ligation: This procedure involves placing tiny rubber bands across the base of an internal haemorrhoid. The bands cut off the blood supply, causing the haemorrhoid to shrink and eventually fall off. 
• Sclerotherapy: During this procedure, your doctor injects a chemical solution into the haemorrhoid to shrink it. 
• Infrared coagulation: Here, the doctor uses infrared light to shrink and harden the haemorrhoid tissue. 
• Minimally invasive treatments: Doctors may prescribe minimally invasive procedures, such as hemorrhoidal artery ligation (HAL) or transanal hemorrhoidal dematerialisation (THD) for larger or more severe haemorrhoids. 
• Haemorrhoidectomy: For severe or recurring haemorrhoids, doctors may recommend surgical removal (haemorrhoidectomy). 

Complications from Haemorrhoids

While most haemorrhoids are not serious, they can lead to complications, or there are some side effects of haemorrhoids if left untreated, including: 

• Thrombosed haemorrhoids: The formation of a blood clot within an external haemorrhoid can cause severe pain, swelling, and inflammation. 
• Anaemia: Bleeding haemorrhoids can lead to iron deficiency anaemia. 
• Strangulated haemorrhoids: In rare cases, a prolapsed internal haemorrhoid can become trapped outside the anus, thus cutting off the blood supply and causing severe pain in the region. 

When to See a Doctor?

It is essential to seek healthcare guidance if you experience any of the following: 

• Severe or persistent bleeding 
• Prolapsed haemorrhoids that cannot be pushed back in 
• Excessive pain or discomfort 
• Symptoms that do not improve with home treatment 
• Suspected complications, such as thrombosis or strangulation 

How can I Prevent Haemorrhoids?

While not all cases of haemorrhoids can be prevented, there are several steps you can take to lower your risk: 

• High-Fibre diet: A fibre-rich diet from whole grains, vegetables, fruits, and legumes can help prevent constipation and promote regular, soft bowel movements. 
• Hydration is key: Drinking adequate water and fluids can soften stools and prevent constipation. 
• Exercise: A physically active lifestyle can help promote healthy bowel movements and prevent constipation. 
• Avoid excessive straining during bowel movements: Straining can cause increased pressure on the rectal and anal veins, leading to haemorrhoids.
• Maintain healthy body weight: Excessive body weight can cause additional pressure on the rectal and anal veins, thus increasing the possibility of haemorrhoids. 
• Avoid prolonged sitting or standing: Regular breaks and moving around your working bay can help reduce pressure on the veins in the rectum and anus. 

Home Remedies for Haemorrhoids

Numerous home remedies can help relieve the symptoms of haemorrhoids, such as: 

• Sitz baths: Soak your anal area in warm water for 10-15 minutes several times a day. This can reduce inflammation and discomfort. 
• Cold compresses: The application of cold compresses or ice packs to the affected area can diminish swelling and alleviate pain. 
• Witch hazel: Applying witch hazel, a natural astringent, to the affected body area helps reduce inflammation and promote healing. 
• Aloe Vera: When applied topically, the soothing properties of aloe vera can help alleviate the discomfort associated with haemorrhoids. 

Conclusion

Haemorrhoids are a common ailment that can cause significant discomfort and, in some cases, bleeding. While they are not life-threatening, it is essential to seek medical intervention if symptoms persist or worsen. By understanding the causes, symptoms, and treatment modalities, people can take proactive measures to manage and prevent haemorrhoids, improving their overall quality of life. 

FAQs

1. How common are haemorrhoids?

Haemorrhoids are a very common ailment affecting millions of people worldwide. It is estimated that close to 50% of adults may experience haemorrhoids at some point in their lives. 

2. How long do haemorrhoids last?

The duration of haemorrhoids can vary and depends on the severity and treatment approach. In some cases, haemorrhoids may resolve on their own within a few days or weeks with proper self-care and home remedies. However, if left untreated or if complications arise, haemorrhoids can persist for months or even years. 

3. Can haemorrhoids fall off naturally?

Yes, in some cases, internal haemorrhoids can fall off naturally. This process, known as "sloughing," occurs when the haemorrhoid tissue dies and separates from the surrounding healthy tissue. However, it is essential to note that this process can be accompanied by bleeding and discomfort, and it is recommended to seek medical attention if it occurs. 

Dr. Prashant Dayalrao Bhowate

MS, FAMS
Ganga CARE Hospital Limited, Nagpur

To Book an Appointment, call:

+91 406 810 6585

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