Haemorrhoids

Epidemiology of haemorrhoids 1,2,3

Haemorrhoids, also called piles, are swollen veins in your anus and lower rectum, similar to varicose veins.

Haemorrhoids can develop inside the rectum (internal haemorrhoids) or under the skin around the anus (external haemorrhoids).

How does it look like?

A thrombosed haemorrhoid will appear as a lump at the anal verge, protruding from the anus and will be dark bluish in colour because of the blood clot contained inside the swollen blood vessel.
A non-thrombosed haemorrhoid will appear as a rubbery lump.
Often more than one swollen haemorrhoid appears at the same time.

Although haemorrhoids are rarely dangerous, they can be a recurrent and painful intrusion.

Nearly 3 out of 4 adults will have piles from time to time. 1 Symptomatic hemorrhoid disease is one of the most prevalent ailments associated with significant impact on quality of life. 2

​​Haemorrhoids can usually be diagnosed from a simple medical history and physical exam.

External haemorrhoids are generally apparent, especially if a blood clot has formed perform a digital rectal exam to check for blood in the stool or may also examine the anal canal with an anoscope, a short plastic tube inserted into the rectum with illumination. If there’s evidence of rectal bleeding or microscopic blood in the stool, flexible sigmoidoscopy or colonoscopy may be performed to rule out other causes of bleeding, such as colorectal polyps or cancer, especially in people over age 45.

Causes:

The veins around your anus tend to stretch under pressure and may bulge or swell.
Haemorrhoids can develop from increased pressure in the lower rectum due to:

  • Straining during bowel movements
  • Sitting for long periods of time on the toilet
  • Having chronic diarrhoea or constipation
  • Being obese
  • Being pregnant
  • Having anal intercourse
  • Eating a low-fiber diet
  • Regular heavy lifting

Prevention

  • Eat high-fiber foods
  • Consider fiber supplements
  • Drink Water
  • Don’t strain on the crapper
  • Go when you need to.
  • Exercise
  • Avoid long periods of sitting

How do piles go away?

There is no set duration for haemorrhoids.
Small haemorrhoids may clear up without any treatment within a few days.
Large, external haemorrhoids need treatment e.g. anti-haemorrhoidal gel. It may take longer to heal and can cause significant pain and discomfort.

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References: 1. Lohsiriwat V (2012) World of Gastroenterology; 18(17): 2009–2017.2. Sun, Z (2016) Clin Colon Rectal Surg; 29(1): 22–29 3. Ulladull endoscopy and Medical Centre. Haemorrhoid treatment. Available on http://www.ulladullaendoscopy.com.au/haemorrhoid-treatment/. Accessed October 2019