Haemorrhoids

What are haemorrhoids?

Haemorrhoids (piles) are swollen blood vessels in the anal canal (back passage). This creates swellings, similar to the varicose veins that some people have on their legs. They are very common. One in three people experience haemorrhoids at some time in their life.

The most usual cause is constipation. This is because straining to open the bowels causes congestion of, and eventually enlargement of the veins in the anal canal. Haemorrhoids also seem to occur more frequently in some families and are more common during or after pregnancy. They can cause bleeding and discomfort and many protrude outside the anal canal. There are a number of different treatment options.

What operations can be done for haemorrhoids?

Once haemorrhoids develop they are permanent unless removed by a surgeon. Early small haemorrhoids can be effectively managed with increased dietary fibre.

When this fails, they are often best treated by surgery. The options for surgery include rubber band ligation, excisional haemorrhoidectomy or stapled haemorrhoidectomy. Banding can be done in the rooms without an anaesthetic but the other surgical options are done in hospital under general anaesthetic and require an overnight stay.

  • There is a small risk after surgery of bleeding. Rarely, this may require a second operation to control the bleeding. This occurs normally in the first 6-12 hours.
  • After your treatment you may feel that you want to open your bowels. Do not worry if you have to, but try to avoid straining.
  • You may see some minor spots of blood on your stools when you open your bowels, or on the toilet paper when you wipe yourself. You may also have a minor discharge or spots of blood from the anus for a couple of days.
  • Avoid strenuous exercise for the rest of the week. For example, avoid sport, jogging or riding a bike.
  • You can bath or shower as you wish.
  • You will be able to get back to your normal life as you feel well enough to do so. This may take 4-10 days.
  • Complications following surgery for haemorrhoids are rare. In the exceptional circumstance that you develop problems with the bladder or genital area shortly after surgery, particularly if you have a high temperature, you should consult your surgeon or attend your local doctor or casualty department.
  • You may be seen again in 4 weeks.

Can I prevent the haemorrhoids coming back?

Unfortunately, having your haemorrhoids surgically treated does not guarantee that they will never come back. You now know that you have a tendency to develop haemorrhoids, so it makes sense to try to avoid this happening in the future. Some doctors feel that the best way of preventing haemorrhoids is to avoid straining to open your bowels and to go when you feel the urge rather than putting it off because you are busy. Try to increase the amount of fibre and water in your diet. Fibre forms the structure of cereals, fruit and vegetables. It is not completely digested and absorbed by the body, so it provides bulk to the stools. This helps the movement of waste through the bowel, resulting in soft stools which are easy to pass.