Haemorrhoids, often known as piles, are enlarged veins in the lower rectum and anus that resemble varicose veins.1
There are four different types of haemorrhoids:
Haemorrhoids are quite typical. The National Institutes of Health estimates that about 1 in 20 Americans suffer from them.
However, if your haemorrhoids are making you uncomfortable, interfering with your daily activities or bowel movements, you should seek medical attention immediately.
How do haemorrhoids appear?
Sometimes haemorrhoids are not noticeable. However, when they enlarge, they may present themselves as red or blue lumps or bumps .
The four primary forms of haemorrhoids are described here in terms of how they appear:
These are outgrowths from the rectum or anal canal wall and can manifest as lumps or a lengthy protrusion depending on their severity. They are usually too deep in your anus to be seen, thus they aren't always visible.
This is when an internal haemorrhoid enlarges and lengthens to the point that it protrudes from your anus. When you strain, less significant prolapsed haemorrhoids emerge from the anus, but when you relax, they automatically retract. More severe prolapsed haemorrhoids, however, continue to protrude from the anus.
Appear on and around the anus as one or several bumps. These are visible from the outside and can be uncomfortable.
These are haemorrhoids, either external or internal, in which the blood that had been pooling inside has clotted.2
Symptoms of haemorrhoids
The type of haemorrhoid will often determine the signs and symptoms.
These are located beneath the skin near the anus. Some warning signs and symptoms include:
- Inflammation or itching in the anal area
- Any discomfort or pain
- Swelling near anus
Internal haemorrhoids are inside the rectum. They rarely cause discomfort and are typically impossible to see or feel. But straining or irritation during excretion can result in:
- Bleeding that is painless during bowel motions. Small amounts of bright red blood may be seen on your toilet tissue or in the bowl.
- A prolapsed or projecting haemorrhoid that pushes through the anal orifice, causing discomfort and irritation.
An external haemorrhoid that has collected blood and developed a clot (thrombus) may cause:
- Extreme pain
- A rough bump next to your anus1
What other illnesses have symptoms similar to haemorrhoids?
Numerous gastrointestinal conditions can result in haemorrhoid-like symptoms, including rectal bleeding. Some of these illnesses pose a serious risk to life so it is crucial to inform a healthcare professional when you experience these symptoms. .
Gastrointestinal conditions that can result in bleeding include:
- Colon cancer
- Crohn's illness.
- Inflammatory colitis3
Causes of haemorrhoids
The veins may enlarge as a result of any pressure or tension placed on the anus or rectum. Typical causes and risk factors include:
- Straining a lot with bowel movements
- Experiencing irregular bowel movements
- Pregnancy or labour
- Spending a lot of time sitting
- Not obtaining enough fibre in your diet
- Abusing laxatives
- Ageing, as tissues become less elastic and strong with time
If you keep doing any of the actions that could have led to the development of your internal haemorrhoids , they could prolapse or become thrombosed.2
Additionally, keep an eye out for any risk factors that can raise your risk of having haemorrhoids. These are a few of the most typical causes of haemorrhoids.
As you age, the support structures in the anal area (blood vessels and muscular tissues) become weaker, increasing your risk of developing piles.
People assigned female at birth (PAFAB) who are pregnant are more likely to experience haemorrhoid problems. According to the majority of specialists, hormonal changes and physical pressure on the abdomen during pregnancy increase a woman's risk of getting piles. Most women can resume their prior symptomatic state after giving birth.
Having a low-fibre diet
Eating fibre-rich, nutritious foods is crucial for maintaining good digestive health. However, a lot of people are getting piles because they don't consume enough fibre in their diets. Consuming low-fibre foods might make you constipated, which is a major factor in pile formation. Red meat, processed foods, chips, cheese, frozen dinners and snack foods are a few examples of foods with low fibre content. So, attempt to cut out these from your diet and replace them with foods high in fibre.
Lack of regular activity
Regular exercise and physical inactivity can lead to loss of muscular tone, notably in the anal and rectal muscles. As a result, you can experience constipation and have trouble passing faeces, which could raise your chance of getting piles.
Obesity can put an excessive amount of strain on the muscles of the pelvic floor. The haemorrhoid cushion may then become stretched, which may result in piles.
Haemorrhoids can develop for a variety of reasons, including genetics. Ehlers-Danlos syndrome [EDS] is one of these genetic diseases, and the deficiency in collagen deficiency can affect the tissues of the pelvic floor. Haemorrhoids are a typical EDS symptom.4
Complication of haemorrhoids
Although haemorrhoids can be annoying and painful, they rarely result in major issues. People who have haemorrhoids rarely experience:
- External haemorrhoids which forms blood clots
- Skin tags (flap of tissue that hangs off skin)
- Haemorrhoids with strangulations (muscles in the anus cut off blood flow to a prolapsed internal hemorrhoid).3
Prevention of haemorrhoids
Maintaining soft stools that pass smoothly is the greatest approach to avoid haemorrhoids. Following these recommendations can prevent haemorrhoids and lessen their symptoms:
Consume fibre-rich foods
Eat more whole grains, fruits, and veggies. By doing this, the stool will become softer and more voluminous, preventing the straining that might result in haemorrhoids. To avoid issues with gas, gradually incorporate more fibre into your diet.
Drink a lot of water
To keep stools soft, drink six to eight glasses of water daily in addition to other liquids (avoid alcohol).
Suggestions for fibre supplements
The average person's diet falls short of the 20 to 30 grams of fibre per day that are advised. According to studies, over-the-counter fibre supplements including methylcellulose (Citrucel) and psyllium (Metamucil) can reduce haemorrhoid bleeding and general discomfort.
Drink as least eight glasses of water or other fluids each day if you take fibre supplements. Otherwise, the supplements can cause you constipation or make it worse.
Pressure in the veins in the lower rectum increases when you stop your breathing and strain to pass a stool.
When the urge strikes, act immediately
Your faeces may dry out and become more difficult to pass if you wait to have a bowel movement after the urge has passed.
Staying active can help prevent constipation and ease the pressure that prolonged standing or sitting can put on veins. Exercise can also assist you in losing weight which may be a factor in your haemorrhoids.
Try to limit your sitting time
Too much time spent sitting, especially on the toilet, might put more pressure on the rectal veins.1
How are haemorrhoids handled by health care providers?
If your symptoms worsen or start to affect your regular activities or sleep, you should visit your healthcare practitioner. Additionally, if symptoms don't get better after a week of home remedies, get assistance. Haemorrhoids may be treated by your doctor using:
Rubber band ligation
This procedure stops blood flow to a vein by wrapping a short rubber band around the base of a haemorrhoid.
Blood flow to a haemorrhoid is stopped by electrocoagulation.
A tiny probe that is put into the rectum transfers heat to destroy the haemorrhoid using infrared coagulation.
Hemorrhoid tissue is destroyed by injecting a chemical into the enlarged vein.
Hemorrhoidectomy: This operation eliminates prolapsed internal haemorrhoids or big external haemorrhoids.
Stapling for haemorrhoids: A stapling tool is used to remove an internal haemorrhoid. Alternatively, it repositions and holds a prolapsed internal haemorrhoid inside of your anus.3
How can I treat haemorrhoids at home?
Haemorrhoids frequently disappear without medical intervention. Pain and bleeding symptoms could last a week or even longer. You can do the following actions in the meantime to reduce symptoms:
- To the affected area, apply over-the-counter drugs containing witch hazel, hydrocortisone, or lidocaine
- Increase your water intake
- Boost your consumption of fibre through diet and supplements. Make an effort to consume 20 to 35 grams of fibre every day
- Spend ten to twenty minutes every day soaking in a warm bath (sitz bath)
- Utilise laxatives to soften stools
- For pain and inflammation, take nonsteroidal anti-inflammatory medications (NSAIDs)
- After excretion, gently pat and clean your bottom with toilet paper infused with lotion or flushable wet wipes. You can also use a washcloth or tissue that has been dampened with water. (Do not flush wipes; instead, discard them in the garbage). To prevent the transmission of illnesses frequently present in faeces, washcloths should be washed separately in hot water3
When to seek medical attention
Consult your doctor if you have haemorrhoids that don't go away after a week of home treatment or bleeding during bowel movements.
If your bowel habits alter or if the colour or consistency of your faeces changes, you shouldn't assume that your rectal bleeding is the result of haemorrhoids. Other illnesses including colorectal cancer and anal cancer can cause rectal bleeding.
If you experience heavy rectal bleeding, fainting, dizziness, or lightheadedness, you should seek emergency medical attention.1
Large protruding veins in and around the rectum and anus are called haemorrhoids. They are highly prevalent and are brought on by pressure on the rectal veins. Chronic constipation, straining during bowel movements, a family history of haemorrhoids and pregnancy are all risk factors.
Haemorrhoids typically disappear on their own. Treatments often target symptom relief and may involve taking warm baths, applying hydrocortisone, haemorrhoid cream, or swallowing a suppository. Exercise, consuming more fibre-rich foods, and drinking lots of water can all help to relieve constipation and stop haemorrhoids from developing in the future.
- Hemorrhoids - Symptoms and causes [Internet]. Mayo Clinic. [cited 2023 Jan 24]. Available from: https://www.mayoclinic.org/diseases-conditions/hemorrhoids/symptoms-causes/syc-20360268
- What do hemorrhoids look like: types and more [Internet]. Healthline. 2021 [cited 2023 Jan 24]. Available from: https://www.healthline.com/health/types-of-hemorrhoids
- Hemorrhoids treatment, symptoms, causes & prevention [Internet]. Cleveland Clinic. [cited 2023 Jan 24]. Available from: https://my.clevelandclinic.org/health/diseases/15120-hemorrhoids
- Chronicle D. Top causes and risks factors of hemorrhoids [Internet]. Deccan Chronicle. 2021 [cited 2023 Jan 25]. Available from: https://www.deccanchronicle.com/in-focus/020921/top-causes-and-risks-factors-of-hemorrhoids.html