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Haemorrhoids (Piles)

  • What are Haemorrhoids?

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

    Haemorrhoids are grouped as follows:

    • 1st degree piles – internal piles that bleed

    • 2nd degree piles – lump at the anus that sticks out after bowel movement and then disappears straightaway after

    • 3rd degree piles – lump at the anus that sticks out after bowel movement but thereafter needs to be pushed back by a finger into the anus

    • 4th degree piles – lump that cannot be pushed back into the anus

  • Several risk factors lead to the development of haemorrhoids. The most common factors include:

    • Constipation or diarrhoea
    • During pregnancy, there is added pressure from the growing foetus and during labour on the blood vessels around the anus
    • Excessive strain when passing stools
    • Sitting on the toilet for too long

    Other risk factors that cause the development of piles include:

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

    • Changes in bowel habits (constipation or diarrhoea)
    • Changes in stool colour and texture
    • Feeling that the bowel does not empty completely
    • Finding blood in stools
    • Stools are narrower than usual
    • Itchiness at the anus
    • Obvious lump at the anus
    • Pain during and after bowel movement
    • Weight loss and appetite loss that cannot be explained

    It is important to note that these symptoms are similar to those of colorectal cancer so you need to consult your doctor for a full assessment before you assume that your symptoms are caused by piles.

  • Treatment depends on the type and severity of the piles. A doctor may advise simple preventive measures, such as increasing fibre intake and drinking plenty of water to allow regular bowel movement without excessive straining. However, if these measures do not help, other treatments include:

    • Injecting a chemical solution into the piles, causing them to shrink and fall off (for 1st and 2nd degree piles)
    • Inserting a special device into the anus to tie off the blood vessel that supplies blood to the piles
    • Medication – a doctor may insert a suppository / a pill into the rectum or anus to treat small piles
    • Ligation – rubber band treatment to treat 1st and 2nd degree piles. A rubber band is placed over the piles to cut off blood supply
    • Haemorrhoidectomy – a surgery to remove 3rd and 4th degree piles
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