Haemorrhoids & Piles

What are Haemorrhoids (Piles)?

Haemorrhoids (piles) are lumps in your anus and lower rectum. They are created blood vessels which swell up and enlarge. They can develop in blood vessels under the skin around your anus, which are known as external haemorrhoids, or inside the rectum (internal haemorrhoids).

Piles are a common problem, affecting nearly three out of every four adults at some point in their lifetime. Various things can cause haemorrhoids, but in many cases the cause is unknown.

The risk of getting haemorrhoids increases as you get older. This is due to the tissues supporting the rectal and anal veins can stretch and weaken. Pregnant women are also at a risk of piles, because the baby's weight adds pressure to the anal area.

Home treatments and certain lifestyle changes can help to treat and prevent haemorrhoids, but in some cases you may require medical advice from a doctor. Complete an online consultation with one of our doctors and they will issue you a prescription for a suitable treatment. You can then buy this medication from our online pharmacy; place your order by 2pm and we can also offer you next day delivery.

Haemorrhoid (piles) Symptoms

The symptoms of piles largely depend on the type of haemorrhoid you have. Some people may not have many symptoms, some may have mild pain, while others may have severe pain, bleeding and some may have an itchy bottom.

Symptoms of external haemorrhoids

External haemorrhoids appear under the skin around your anus. The symptoms of this problem may include:

• Swelling around the anus
• Rectal bleeding
• Itching or irritation around the anus
• Pain or discomfort

Symptoms of internal haemorrhoids

Internal haemorrhoids occur on the inside of the rectum. In most cases, they will not be painful and you cannot see or feel them.

However, if you strain or have irritation during bowel movements, they may cause:

• Painless rectal bleeding during bowel movements. There may be small amounts of bright red blood in the toilet or on the toilet paper.
• A haemorrhoid to push through the anus, which can cause pain and irritation.

Symptoms of thrombosed haemorrhoids

This form of piles occurs when blood pools in an external haemorrhoid and forms a blood clot. This may cause:

• Inflammation
• Swelling
• Severe pain
• A hard lump near the anus

When to seek medical advice

You should speak to a doctor if you have bleeding during a bowel movement, or if your piles have not gone away after one week.

Never just assume that rectal bleeding is always just the result of having haemorrhoids. If bleeding occurs alongside changes in your bowel habits, or the colour or consistency of your stools, it may be something more serious. Rectal bleeding can be a sign of a more severe condition, including anal or colorectal cancer.

Haemorrhoid (piles) Causes

The exact cause of piles is unknown, although we do know that increase pressure in the blood vessels in and around the anus. The blood vessels around the anal area often stretch when they are under pressure and may swell.

Haemorrhoids (piles) can form as a result of unusual pressure in your lower rectum as a result of:

• Obesity
• Straining when you have a bowel movement
• Sitting down for long periods of time
• Regular heavy lifting
• Pregnancy
• Persistent coughs
• Repeated vomiting
• A family history of haemorrhoids
• Not having enough fibre in your diet
• Chronic constipation or diarrhoea

Possible risks of piles

In rare cases, haemorrhoids can lead to several complications, including:

• Blood clots, which are not normally dangerous but can be very painful. Sometimes, they may need to be lanced and drained.
• Anaemia, which can sometimes occur as a result of chronic blood loss from haemorrhoids. This means you do not have enough healthy red blood cells to carry oxygen to other cells.
• If your blood supply to an internal haemorrhoid is cut off, you may experience a strangulated haemorrhoid, which can cause serious pain.

Haemorrhoids Diagnosis

Your doctor may be able to see external haemorrhoids. If they suspect that you have internal haemorrhoids, they may examine your rectum and anal canal.

They may use one or both of the following methods to diagnose your piles:

• They may perform a digital examination, where they wear a rubber glove and insert a lubricated finger into the rectum; they will then feel around for any abnormalities.
• A visual inspection may be required because haemorrhoids are often too soft to feel during a rectal examination. Visual inspections involve a doctor using an anoscope, proctoscope or sigmoidoscope to examine the lower colon.

In some cases, a colonoscopy may be required to diagnose your symptoms. This may be the case if any of the below apply to you:

• There is a risk of colorectal cancer
• You are middle-aged and have not had a colonoscopy recently
• Your symptoms suggest that you might have a different disease of the digestive system

Piles (Haemorrhoid) Treatment

Piles treatment at home

Mild pain and swelling can often be treated with self-care and home treatments.

• Eating a high-fibre diet can help to prevent constipation, softening your stools and increasing their bulk. Try to eat more fruits and vegetables each day, as well as plenty of whole-grains like quinoa and brown rice. Fibre supplements can also help.
• Drinking plenty of fluids, especially water can help to reduce the risk. However, you should also cut down on how much alcohol and caffeine you drink.
• Taking oral painkillers like ibuprofen can help to relive some of the pain and discomfort that comes with piles. Ibuprofen and other painkillers are available at Medicine Direct.
• Topical treatments which contain a numbing agent, hydrocortisone such as anusol plus ointment for haemorrhoids (piles) or witch hazel can also relieve discomfort. These are available to buy from Medicine Direct.
• Many people find that regularly soaking the anal area in warm water for between 10 and 15 minutes two or three times a day can relieve the discomfort. You can do this in the bath or a sitz bath, which goes over the toilet.

Many people will find that these treatment methods can resolve their symptoms within a week. If they have not helped you after this time, you should seek medical advice; you may be suffering from something more serious than haemorrhoids.

Medical treatments

In many cases, piles will go away on their own after a few days. However, there are various medical treatments to ease the pain, itching and discomfort that often comes with this condition. These treatments include the likes of creams, ointments and suppositories. Medicine Direct stocks various treatment products for haemorrhoids, which you can buy after an online consultation.

Many piles treatments contain ingredients like witch hazel or hydrocortisone, which work to soothe the pain and discomfort that comes with this condition. If you are prescribed a steroid treatment, you should not use it for longer than you are instructed as topical steroids can cause thinning of the skin.

Medical procedures

If you have persistent bleeding or pain, your doctor may recommend a minimally invasive procedure to treat the problem. These can be done as an outpatient in a doctor's office and can include:

• Injection (sclerotherapy), where a chemical is injected into the haemorrhoid in order to shrink it
• Rubber band ligation, where tiny rubber bands are placed around the base of an internal haemorrhoid to cut off the circulation. This causes it to fall off within a week of the procedure. Rubber band ligation may be uncomfortable and cause bleeding or, in rare cases, more serious complications.
• Coagulation techniques make an internal haemorrhoid that is small and bleeding to shrivel and go hard. This procedure is may cause mild discomfort but rarely brings and side effects.

Surgical treatments

It is very rare that people need surgery for haemorrhoids, but your doctor may recommend it if other forms of treatment have been tried and not proven to be successful.

If your doctor deems this necessary, they will speak to you about the various surgical treatments available and advise on which they believe would be the most suitable for you.

They may recommend you undergo a haemorrhoidectomy, which will remove the haemorrhoid. This is the most effective method of treatment for severe or recurring piles. There are various techniques for this to be carried out, some of which can be done under local anaesthesia combined with sedation. Some will require general anaesthesia.

Some people may have difficulty emptying their bladders after having this procedure, which can lead to urinary tract infections. It is not uncommon to suffer pain after having this procedure, but medication can help to alleviate this, as can soaking in a warm bath.

Another procedure, which is mostly used in cases of internal haemorrhoids, is stapled haemorrhoidopexy (haemorrhoid stapling). This procedure is normally less painful than a haemorrhoidectomy, but there is a greater risk that the problem may come back; you may also suffer from rectal prolapse, where part of the rectum sticks out from the anus.

Possible side effects that come with haemorrhoidopexy include:

• Urinary retention
• Bleeding
• Sepsis