HAEMORRHOIDS

Did you know….

• Haemorrhoids are one of the most common ailments known.
• More than half the population will develop haemorrhoids, usually after age 30.
• Millions of people currently suffer from haemorrhoids.
• The average person suffers in silence for a long period before seeking medical care.
• Today’s treatment methods make some types of haemorrhoid removal much less painful.

What are haemorrhoids?

Often described as “varicose veins of the anus and rectum”, haemorrhoids are enlarged, bulging blood vessels in and about the anus and lower rectum. There are two types of haemorrhoids: external and internal, which refer to their location.

External (Outside) haemorrhoids develop near the anus and are covered by very sensitive skin. If a blood clot develops in one of them, a painful swelling may occur. The external haemorrhoid feels like a hard, sensitive lump. It bleeds only if it ruptures.

Internal (inside) haemorrhoids develop within the anus beneath the lining. Painless bleeding and protrusion during bowel movements are the most common symptom. However, an internal haemorrhoid can cause severe pain if it is completely “prolapsed” – protrudes 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:

v     Aging

v     Chronic constipation or diarrhoea

v     Pregnancy

v     Hereditary

v     Faulty bowel function due to overuse of laxatives or enemas; straining during bowel movements.

v     Spending long periods of time (e.g. reading) on the toilet.

Whatever the cause, the tissues supporting the veins stretch. As a result, the veins dilate; their walls become thin and bleed. If the stretching and pressure continue, the weakened veins protrude.

What are the symptoms?

If you notice any of the following, you could have haemorrhoids:

Ø      Bright red bleeding during bowel movements or on wiping yourself

Ø      Protrusion during bowel movements which you need to push back

Ø      Itching in the anal area

Ø      Pain

Ø      Sensitive lump(s).

Do haemorrhoids lead to cancer?

NO. There is no relationship between haemorrhoids and cancer. However the symptoms of haemorrhoids, particularly bleeding, are similar to those of colorectal cancer and other diseases of the digestive tract. Therefore, it is important that a physician specially trained in treating diseases of the colon and rectum investigates all symptoms. Do not rely on over the counter medications or other self-treatments.

How are haemorrhoids treated?

Mild symptoms can be relieved frequently by increasing the amount of fibre (eg. Fruits, vegetables, breads and cereals) and fluids in the diet. Eliminating excessive straining reduces the pressure on haemorrhoids and helps prevent them from protruding. A sitz bath – sitting in plain warm water for about 10 minutes – can also provide some relief. With these measures, the pain and swelling of most symptomatic haemorrhoids will decrease in two to seven days, and the firm lump should recede within four to six weeks. In cases of severe, persistent pain, your surgeon may elect to remove the haemorrhoids containing the clot with a small incision. This procedure generally provides relief.

 

Severe haemorrhoids may require special treatment - 

  Ligation – the rubber band treatment – works effectively on internal haemorrhoids that protrude with bowel movements. A small rubber band is placed over the haemorrhoid, cutting off its blood supply. The haemorrhoid and the band fall off in a few days and the wound usually heals in a week or two. This procedure sometimes produces mild discomfort and bleeding.

  Injection and coagulation can also be used on bleeding haemorrhoids that do not protrude. Both methods are relatively painless and cause the haemorrhoids to shrivel up.

  Haemorrhoidectomy – surgery to remove the haemorrhoids – is the best method for the permanent removal of haemorrhoids. It is necessary when (1) clots repeatedly form in external haemorrhoids; (2) ligation or injection fails to treat internal haemorrhoids; (3) the protruding haemorrhoid cannot be reduced; or (4) there is persistent bleeding. A haemorrhoidectomy removes excessive tissue that causes the bleeding and protrusion. It is done under anaesthesia and may, depending upon circumstances, require hospitalisation and a period of inactivity. Laser haemorrhoidectomies do not offer any advantage over standard operative techniques. They are also quite expensive, and contrary to popular belief, are no less painful.

  Other treatments include cryotherapy, BICAP coagulation and direct current. Cryotherapy, popular 20 years ago, consists of freezing haemorrhoidal tissue. It is not recommended for haemorrhoids because it is very painful. BICAP and direct current are methods that shrink haemorrhoids. None of these treatments have gained widespread acceptance.