Dealing with haemorrhoids

Bleeding from your rectum is a scary symptom. It is even more worrying and embarrassing when the bleeding is accompanied by itching, mucus discharge and burning pain in the anus.

If you experience these symptoms, it is likely that you are suffering from piles, medically known as haemorrhoids, which are pillow-like clusters of veins that are just beneath the mucous membranes lining the lowest part of the rectum and anus.

The condition people know as haemorrhoids develop when these delicate veins get swollen and distended – just like varicose veins in the legs.

By the age of 50, about half of the population has experienced haemorrhoids. The condition is especially common during pregnancy and among people who are overweight.

You are also at high risk of developing haemorrhoids if you strain during a bowel movement, which mostly happens if you are constipated. 

Recent studies show that people who suffer from haemorrhoids tend to have higher resting anal canal tone. Simply put, this means that the smooth muscle of the anal tends to be tighter than average. Being constantly constipated, pregnant, or overweight only adds to the problem.

Additionally, as we age, the connective tissues that support the delicate blood vessels tend to weaken, which can lead to haemorrhoids bulging or prolapsing.

The good news is that haemorrhoids are rarely dangerous. However, they can be a recurrent, painful and embarrassing nightmare. Fortunately, there’s a lot that can be done to manage and treat haemorrhoids.

Types of haemorrhoids

There are two types of haemorrhoids – internal and external.

Internal haemorrhoids occur in the lower rectum while external haemorrhoids affect the skin around the anus.

Internal haemorrhoids are mostly painless, even when they result in rectal bleeding. But internal haemorrhoids can prolapse (extend beyond the anus), causing more irritation and pain.

However, patients with external haemorrhoids report the most discomfort. This is because the skin overlying the anus becomes irritated and erodes.

In some cases, a blood clot can form in an external haemorrhoid, which can cause sudden and severe pain. Usually, such clots dissolve, leaving behind skin tags which may itch and become irritated.

Diagnosis and treatment

Haemorrhoids are easy to diagnose from a simple medical history and physical exam. If external haemorrhoids have resulted in a clot, they can be especially apparent.

For internal haemorrhoids, your doctor might perform a digital rectal exam or examine the anal canal with an anoscope to check for blood. The doctor might also decide to perform a colonoscopy or a flexible sigmoidoscopy to rule out cancer or colorectal polyps.

 Haemorrhoid Removal

If home remedies don’t work, talk to your doctor about medical procedures to remove haemorrhoids.

There are minimally invasive procedures including rubber band ligation, laser or infrared coagulation, sclerotherapy, and cryosurgery.

If you have large, protruding haemorrhoids, you might require a surgical procedure known as a haemorrhoidectomy to remove them. This procedure is very effective, curing 95 per cent of cases. Your doctor might also go for a procedure known as stapled haemorroidopexy. This procedure is used to treat prolapsed internal haemorrhoids by stapling them back into their normal position.