Haemorrhoids

Haemorrhoids are a natural part of your body and play an important role in your anal function. They are a cushion-like ring of blood vessels inside the anus. Haemorrhoids may cause problems when they become enlarged and swollen.

What are the symptoms of enlarged haemorrhoids?

There are two types — internal and external. Internal haemorrhoids may not be painful. The first sign may be a small amount of bright red blood during or following a bowel motion and itching around the anus. The first symptom of external haemorrhoids is usually the awareness of a lump which can be very painful.

What causes haemorrhoids?

Contributing factors may include:

  • straining to pass a motion due to constipation
  • western diet which is typically high in processed food and low in fibre, resulting in constipation
  • obesity
  • pregnancy and childbirth
  • chronic coughing
  • vomiting

I think I have haemorrhoids, what shall I do?

Initially you should discuss your symptoms with your GP. The type of treatment depends on the severity and frequency of the symptoms and whether they are internal or external haemorrhoids. Your GP may then refer you to a specialist.

How are haemorrhoids managed?

Lifestyle changes may help to prevent haemorrhoids, such as:

  • controlling constipation
  • avoiding straining when passing a motion
  • adopting a low fat, high fibre diet
  • ensuring adequate fluid intake
  • using a fibre supplement

Smaller haemorrhoids are often treated without surgery. Measures such as salt or chamomile baths, soothing cream or ice packs may reduce swelling.

Discomfort and pain

Moderate discomfort is common, however, severe pain could be associated with a complication such as perianal thrombosis, acute prolapse or the presence of an anal fissure.

When are surgical interventions required?

The decision for surgical treatment should be discussed with the surgeon. The decision is yours and should not be made in a rush. Most surgical treatments for haemorrhoids can be performed in the surgeon’s office (without anaesthetic). More complex cases may be performed under general anaesthesia.

Minor surgical procedures include: injection sclerotherapy, where haemorrhoids are injected with a sclerosant causing blood vessels in the haemorrhoids to shrink, and rubber band ligation where a rubber band is placed around the base of the haemorrhoid causing it to drop off. Neither of these procedures are painful but may cause some discomfort and need to be repeated.

Surgical methods under general anaesthetic are indicated for haemorrhoids near the outside of the anus.

Do haemorrhoids lead to cancer?

No, there is no relationship between haemorrhoids and cancer. The symptoms however may be similar to that of bowel cancer so it is important to have any symptoms investigated by a practitioner specially trained in this speciality.