Haemorrhoids

Haemorrhoids or piles are swollen veins around the back passage. They can occur either on the inside of the back passage and/or on the outside skin. They develop gradually over a long period of time due to increased pressures around the back passage causing stretching and swelling of the veins around the area. Increasing straining to pass a motion, chronic constipation and diarrhoea, sitting for long periods on the toilet, pregnancy and increasing age are associated with the formation of haemorrhoids.

Symptoms

Haemorrhoids are very common and can occur in up to three in four adults from time to time in their life. The symptoms of haemorrhoids are usually:

• painless fresh bleeding,
• discomfort and
• itching

When they are large they can be felt as large lumps or swellings around the back passage when you clean your self. On occasions they can form a painful clot around the back passage (thrombosed haemorrhoid).

Diagnosis

A careful history of your symptoms will be taken at the clinic and you will be examined to confirm the diagnosis and exclude other conditions. Internal haemorrhoids are diagnosed with proctoscopy. As bowel cancer becomes more common over the age of 40 depending on your symptoms a flexible sigmoidoscopy or a colonoscopy may be requested in order to exclude this or other conditions as a cause of your symptoms. Once this has taken place and you have been given the all clear the management options in relation to your haemorrhoids will be discussed with you.

Treatment options

The treatment of haemorrhoids mainly depends on the symptoms they cause, their size and whether they are inside the back passage, outside or both and aims to relieve these symptoms. For minimally symptomatic haemorrhoids, increasing the fibre and fluid in your diet to improve the constipation and stop you from straining with the potential use of local creams with soothing agents and steroids are usually enough. If these measures fail or symptoms are significant the range of treatments we offer include banding of haemorrhoids, haemorrhoidal artery ligation or open (Milligan-Morgan) or closed haemorrhoidectomy The most appropriate treatment option will be discussed with you at an individual basis.