Haemorrhoids

Learn more about Haemorrhoids

Haemorrhoids

Haemorrhoids (or ‘piles’) are the enlargement of a small network of blood vessels in the anal canal. They are extremely common – affecting between 25-50% of the population. 

When they enlarge, they can prolapse, or cause bleeding. Typically, haemorrhoids bleed as small volume, bright red or fresh blood, visible on the toilet paper, and occasionally in the toilet bowl or on the outside of the stool.

Whilst haemorrhoids are benign, it is important to exclude more worrying causes of rectal bleeding – this means you should see your Doctor about any bleeding that you see. 

Haemorrhoids can also prolapse, causing a lump when passing a motion, or lumps that are there all the time. These can flare and become irritated, uncomfortable, and they may contribute to soiling or ‘skid marks’. 

Unless they become stuck outside, hemorrhoids aren’t typically painful. Pain suggests an alternative diagnosis, and should be assessed by your doctor. 

The treatment of haemorrhoids should be tailored to you, and treatment is not necessarily painful. Dr Morris will assess your haemorrhoids, and discuss the possible options clearly with you, to help make an informed decision. 

 

 

Haemorrhoids diagram
Haemorrhoids diagram

The treatment for Haemorroids

The treatment for haemorrhoids depends on the severity of symptoms and the size of the haemorrhoids.

In minor degrees of haemorrhoids, it is important to avoid constipation and aid the passage of stool. This is done by behavioural measures such as increasing water intake, exercise, dietary fibre in the form of increased fruit and vegetables. A fibre supplement has been shown to reduce bleeding and symptoms by 50%. A fibre supplement eg metamucil, psyllium husk, is easily obtainable and palatable, and should be the first measure to reduce your symptoms. 

For haemorrhoids requiring intervention, there are options for treatment. Simple options include rubber band ligation – a technique that applies a tight band to the haemorrhoid within the anal canal. This blocks the blood supply, allowing the haemorrhoid to shrink and contract

A new technique called Haemorrhoid Energy Therapy (HET) is a painless option for many people, utilising the application of a low heat to coagulate the blood vessel supplying the haemorrhoid, allowing the haemorrhoids to shrink and contract.  

Higher grade haemorrhoids may require surgery, and Dr Morris discuss the options with you. 

HAL-RAR is a well tolerated (and often painless) technique, where an ultrasound is used to guide a stitch to tie off the haemorrhoidal artery. The prolapsing component of the haemorrhoid is then tightened, a little like a ‘facelift of the anus’. 

An excisional haemorrhoidectomy is reserved for the largest haemorrhoids, and the benefits and drawbacks of this operation will be discussed. 

Your colorectal surgeon will discuss with you a tailored approach, considering the degree of your symptoms, the type of haemorrhoids, and your personal preferences and requirements. 

Dr Morris has a special interest in conditions effecting the anus, and is enthusiastic about improving your haemorrhoids. 

Please consider rectal bleeding as a symptom requiring urgent assessment. There are many causes of rectal bleeding, and we can very quickly delineate the precise cause. Please consider this important symptom a potential warning sign, and see your GP and/or your Colorectal Surgeon. 

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