Things You Need To Know About Haemorrhoids

What are haemorrhoids?
Also known as piles, haemorrhoids are enlarged, bulging blood vessels in and about the anus and lower rectum. There are 2 types:
          - External haemorrhoids
          - Internal haemorrhoids

External (outside) haemorrhoids:

Developed near the anus and are covered by very sensitive skin. These are usually painless, but if a blood clot (thrombus) develops in an external haemorrhoids, it becomes painful and hard. It may bleed if it ruptures.

Internal (inside) haemorrhoids:
Developed within the anud beneath the lining. Present with painless bleeding and protrusion during bowel movements. It can cause severe pain if it is completely prolapsed from the anal opening and cannot be pushed back inside.


What causes haemorrhoids?
An exact cause is unknown; however, the upright posture of humans alone forces a great deal of pressure on the rectal veins, which sometimes causes them to bulge. Other contributing factors include:
     - Aging
     - Pregnancy
     - Hereditary
     - Chronic constipation or diarrhoea
     - Straining during bowel movement
     - Overuse of laxatives or enemas
     - Spening long period of time on the toilet (e.g. reading)

What are the symptoms?

     - Bleeding during bowel movements
     - Protrusion during bowel movements
     - Pain
     - Sensitive lump
     - Itching around the anal area

How are haemorrhoids treated?

Mild symptoms can be relieved by increasing amount of fiber and fluid in the diet. Prevent excessive straining during bowel movements. A sitz bath (sitting in plain warm water for 10 minutes) can also provide some relief. With these measures, the pain and swelling will decrease in two to seven days.

Persistent symptoms or severe haemorrhoids may require special treatment:

Rubber banding ligation:
Works effectively on internal haemorrhoids that protrude with bowel movements. Can be performed as outpatient setting. A small rubber band is placed over the haemorrhoids, cutting off its blood supply. The rubber band will fall off in a few days and the wound usually heals in a week or two. This procedure sometimes produce discomfort and bleeding and may need repeated banding for full effect.

Haemorrhoid stapling:

This is a technique that uses a special device to internally staple and excise internal haemorrhoid tissue. It may lead to shrinkage of internal haemorrhoids, but does not remove external haemorrhoids.  This procedure is performed under spinal or general anaesthesia.

Doppler-guided haemorrhoidal artery ligation:

·        An operative technique that employs Doppler ultrasound to ligate the haemorrhoidal blood flow. Relatively painless compared to stapler technique or excision as no cutting of tissues is performed.

               

      

v    Laser technique:

      A relatively new technique employing laser energy to shrink the haemorrhoids. Early reported results were good. Relatively painless compared to stapler technique.

          

    Haemorrhoidectomy:

     Surgery to remove the haemorrhoids. The most complete method to remove both internal and external haemorrhoids. Main disadvantage is severe pain after the operation.

               

  
 Do haemorrhoids lead to cancer?

      The answer is no. However, the symptoms of haemorrhoids, particularly bleeding are similar to those of colorectal cancer and other diseases of the digestive system. 

      Therefore, it is important that all symptoms are investigated by a surgeon specifically trained in treating diseases of the colon and rectum and that everyone 40 years or older undergo screening test for colorectal cancer.

      Do not rely on over-the-counter medications or other self-treatment. Visit a colorectal surgeon first so your symptoms can be properly evaluated and effective treatment prescribed.

Source: ASCRS