What is Haemorrhoids?

Hemorrhoids (HEM-uh-roids), also called piles, are swollen veins in your anus and lower rectum, similar to varicose veins. Hemorrhoids can develop inside the rectum (internal hemorrhoids) or under the skin around the anus (external hemorrhoids).

Nearly three out of four adults will have hemorrhoids from time to time. Hemorrhoids have a number of causes, but often the cause is unknown.
Symptoms

Signs and symptoms of hemorrhoids usually depend on the type of hemorrhoid.
External hemorrhoids

These are under the skin around your anus. Signs and symptoms might include:

-Itching or irritation in your anal region

-Pain or discomfort

-Swelling around your anus

-Bleeding

Internal hemorrhoids

Internal hemorrhoids lie inside the rectum. You usually can’t see or feel them, and they rarely cause discomfort. But straining or irritation when passing stool can cause:

-Painless bleeding during bowel movements. You might notice small amounts of bright red blood on your toilet tissue or in the toilet.

-A hemorrhoid to push through the anal opening (prolapsed or protruding hemorrhoid), resulting in pain and irritation.
Thrombosed hemorrhoids

If blood pools in an external hemorrhoid and forms a clot (thrombus), it can result in:

-Severe pain

-Swelling

-Inflammation

-A hard lump near your anus

TREATMENT

A diet that consists of high-fiber foods. Doing so softens the stool and increases its bulk, which will help you avoid the straining that can worsen symptoms from existing hemorrhoids. Add fiber to your diet slowly to avoid problems with gas.

Doctor can prescribe the use topical treatments. Apply an over-the-counter hemorrhoid cream or suppository containing hydrocortisone, or use pads containing witch hazel or a numbing agent.

Sitz bath. Soak your anal area in plain warm water for 10 to 15 minutes two to three times a day. A sitz bath fits over the toilet.

Surgical procedures

Only a small percentage of people with hemorrhoids require surgery. However, if other procedures haven’t been successful or you have large hemorrhoids, your doctor might recommend one of the following:

Hemorrhoid removal (hemorrhoidectomy). Choosing one of various techniques, your surgeon removes excessive tissue that causes bleeding. The surgery can be done with local anesthesia combined with sedation, spinal anesthesia or general anesthesia.

Hemorrhoidectomy is the most effective and complete way to treat severe or recurring hemorrhoids. Complications can include temporary difficulty emptying your bladder, which can result in urinary tract infections. This complication occurs mainly after spinal anesthesia.

Most people have some pain after the procedure, which medications can relieve. Soaking in a warm bath also might help.

Hemorrhoid stapling. This procedure, called stapled hemorrhoidopexy, blocks blood flow to hemorrhoidal tissue. It is typically used only for internal hemorrhoids.

Stapling generally involves less pain than hemorrhoidectomy and allows for earlier return to regular activities. Compared with hemorrhoidectomy, however, stapling has been associated with a greater risk of recurrence and rectal prolapse, in which part of the rectum protrudes from the anus.

Complications can also include bleeding, urinary retention and pain, as well as, rarely, a life-threatening blood infection (sepsis). Talk with your doctor about the best option for you.

Minimally invasive procedures

Rubber band ligation of hemorrhoid
Rubber band ligation of hemorrhoid

For persistent bleeding or painful hemorrhoids, your doctor might recommend one of the other minimally invasive procedures available. These treatments can be done in your doctor’s office or other outpatient setting and don’t usually require anesthesia.

Rubber band ligation. Your doctor places one or two tiny rubber bands around the base of an internal hemorrhoid to cut off its circulation. The hemorrhoid withers and falls off within a week.

Hemorrhoid banding can be uncomfortable and cause bleeding, which might begin two to four days after the procedure but is rarely severe. Occasionally, more-serious complications can occur.
Injection (sclerotherapy). Your doctor injects a chemical solution into the hemorrhoid tissue to shrink it. While the injection causes little or no pain, it might be less effective than rubber band ligation.
Coagulation (infrared, laser or bipolar). Coagulation techniques use laser or infrared light or heat. They cause small, bleeding internal hemorrhoids to harden and shrivel. Coagulation has few side effects and usually causes little discomfort.