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Haemorrhoids (Piles)

  • What are Haemorrhoids?

    Haemorrhoids, also called piles, are enlarged blood vessels around the anus. They are described as anal cushions. Haemorrhoids are present in everyone, but they are only considered abnormal when the haemorrhoidal cushions become enlarged.

    Haemorrhoids are classified as follows:

    • First degree piles – Internal piles that bleed
    • Second degree piles – Lump at the anus that sticks out after a bowel motion and then disappears straight away after
    • Third degree piles – Lump at the anus that sticks out after a bowel motion but needs to be pushed back by a finger into the anus after
    • Fourth degree piles – Lump that can’t be pushed back into the anus
  • There are different risk factors that lead to development of Haemorrhoids. The most common factors include:

    • Constipation or Diarrhoea
    • During pregnancy, due to the pressure exerted by the growing foetus and during labour on the blood vessels around the anus.
    • Excessive straining when passing stools
    • Sitting on the toilet for a long time

    There are also other risk factors that trigger the development of piles, and these include:

    • Being overweight
    • Having a family history of piles
    • Having an intra-abdominal or pelvic tumour (not a common cause)
    • Not having enough fibre in the diet
  • The most common symptoms of Piles include:

    • Changes in bowel habits (Constipation or Diarrhoea)
    • Changes in the motion of stools
    • Feeling that your bowel doesn’t empty completely
    • Finding blood in your stools
    • Finding your stools are narrower than usual
    • Itchiness at the anus
    • Obvious lump at the anus
    • Pain during and after bowel motion
    • Weight loss and appetite loss that can’t be explained

    It is important to note, though, that these symptoms resemble those of colorectal cancer and you need to consult your doctor for a full assessment before you attribute your symptoms to piles.

  • The treatment of Piles depends on the type and severity of your condition. You doctor may recommend simple preventative measures such as increasing your fibre intake and drinking plenty of water to allow regular bowel motions without straining. However if this doesn’t help, there are other treatments available:

    • A chemical solution injected into the Piles, causing them to shrink and fall off (works for first and second degree Piles)
    • A special device can be inserted into the anus to tie off the blood vessel that supplies blood to the Piles
    • Medication (tablets or suppositories) to treat small Piles
    • Rubber band treatment (ligation) to treat first or second degree piles. A rubber band is placed over the pile in order to cut off its blood supply.
    • Surgery (Haemorrhoidectomy) to cut out third- and fourth-degree piles, using various surgical techniques
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