What are haemorrhoids?

Haemorrhoids, commonly known as piles, are swollen, enlarged veins located inside the lower part of the rectum (internal) or under the skin around the anus (external).

What causes haemorrhoids?

Haemorrhoids occur when veins in the back passage become swollen, because the flow of blood through them slows down or is obstructed - similar to varicose veins in the legs. If they become very large they may be felt outside the back passage as soft tender lumps. Experts believe haemorrhoids are caused by continuous high pressure in the veins, which occurs because humans stand upright.

Some people are more likely to develop haemorrhoids than others. Many factors increase the chances of you developing haemorrhoids, they could include any of the following:-

• If either of your parents had haemorrhoids.
• Pregnancy - this is because the veins are more relaxed.
• If you are elderly.
• Being overweight.
• If you strain when going to the toilet.
• A unhealthy diet - especially one which is low in fibre.
• If you suffer from chronic constipation or diarrhoea.

Despite what you might hear people say, haemorroids are not caused by sitting on hot radiators or cold floors.

What are the symptoms of haemorrhoids?

Some people with haemorrhoids will have no symptoms. However, the most common symptoms of haemorrhoids are as follows:-

• Fresh bright red bleeding from the back passage - the blood may be present on toilet paper or in the toilet bowl.
• Itchiness in the area around the anus.
• A pain or ache around the anus and lower rectum.
• Sometimes a lump may be felt in the anus and large haemorrhoids will give you the feeling that the bowel hasn't been emptied properly.

Internal haemorrhoids usually cause less symptoms. External haemorrhoids tend to be more uncomfortable and can often be felt sticking out through your back passage, especially when passing a motion (stools).

Haemorrhoids are the most common cause of rectal bleeding, but on rare occasions it might be due to a more serious condition. If over the counter remedies don't help, or you are unsure of your symptoms, you should consult your doctor for proper diagnosis and advice.

How common are haemorrhoids?

Haemorrhoids are very common in both men and women. At least half the population will suffer from haemorrhoids by the time they are 50.

How are haemorrhoids diagnosed?

A doctor will usually be able to diagnose haemorrhoids by a rectal examination. However, if symptoms persist you may be referred to a hospital for further examinations. A hollow, lighted tube known as a proctoscope may be used to examine the inside of the rectum.

How are haemorrhoids treated?

Haemorrhoids are not dangerous, though they can be quite painful and irritating. The treatment you require will depend on the type of haemorrhoids you have. If the haemorrhoids are small and there are no symptoms then treatment is not necessary.

If the only symptoms are itching and discomfort, a cream, which you rub on the affected area will help relieve the discomfort (available over the counter at your local pharmacy). Do not use this cream for more than a week. You should also try sitting in a shallow bath of plain hot water, several times a day for about 10 minutes to help relieve your symptoms or apply a cold compress to the anal area to help reduce swelling and ease the itching. Do not allow the ice to come in direct contact with the skin.

Doctors will usually recommend that you increase the amount of fibre in your diet, this makes the stool softer and therefore makes emptying the bowels easier.

If the haemorrhoids are persistent and cause you a great deal of discomfort your doctor may refer you to a specialist. There are a number of operations that will remove haemorrhoids, most of which can be performed in a hospital out-patients department. The specialist will discuss all treatment options with you.

How are haemorrhoids prevented?

If you suffer with haemorrhoids, try the following to prevent them returning :-

• Empty bowels as soon as possible, after the urge occurs.
• Avoid straining on the toilet.
• Drink plenty of fluids.
• Take regular exercise, this will help prevent constipation.
• Eat a diet high in fibre to keep stools regular and soft. Foods high in fibre include fruits, vegetables and whole grains.
• Avoid sitting on the toilet for a long period of time.