An introduction to haemorrhoids (piles)
What are Haemorrhoids?
Haemorrhoids or Piles are “cushions” containing blood vessels and are located inside the anal canal. They are found in everyone and play an important role in maintaining a gas tight seal of the anal canal. The term haemorrhoid is used to describe the downward slide of the anal cushions which varies from minimal to full prolapse of the anal cushions. Haemorrhoids may be present for many years but remain undetected until symptoms appear. They affect over 50% of those over the age of 50 years.
What Symptoms do they cause?
- Itching and irritation
- Prolapse or a lump
Some of these symptoms associated with haemorrhoids are indistinguishable from other more serious bowel conditions such as cancer and if they persist medical advise should be sought.
Bleeding from other causes:
- Skin tags
- Anal fissure
- Anal fistula
- Polyps or cancer
Other causes of a lump:
- Diverticular disease
What causes haemorrhoids?
- Constipation and Straining
- Sedentary lifestyle
- More common during pregnancy because of hormonal changes
- Equally common in men and women but men are hospitalised more often the women
- Associated with genitourinary prolapse and prostatism
- More common in higher socioeconomic groups
How to avoid haemorrhoids
- Healthy lifestyle with increased physical activity
- High fibre diet
- Drink more water
- Avoid excessive straining at stool
Investigation of Haemorrhoids
- History and duration of symptoms and examination including rectal examination is important to exclude bowel cancer or inflammation which can present with very similar symptoms to those arising from haemorrhoids.
- To exclude serious conditions such as bowel cancer and inflammatory bowel disease which can sometimes present with symptoms similar to those related to piles, it is very important to examine the rectum and left colon with a special flexible camera about 60cm long and the width of a finger (performed under sedation or no sedation depending upon the patient request).
- Finally a very small telescope is inserted into the anal canal to fully assess the haemorrhoids.