Haemorrhoids are knobbly varicose veins of the rectal
or anal area, which can prolapse outside the anus and
hang as small grape-like lumps.

What are the different kinds of haemorrhoids?

Internal haemorrhoids are those that form inside the
rectum near the beginning of the anus. They are generally
not painful and often are only noticed when they
Prolapsed haemorrhoids are internal haemorrhoids
that protrude through the anus when the stool is passed
or when a person stands or walks. They are usually
External haemorrhoids are small, painful haemorrhages
under the skin around the anus. They form a
hard clot after 24 hours. Their proper medical name is
perianal haematoma. When they settle, they sometimes
leave a small skin tag.

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What causes haemorrhoids?

The most common cause is constipation, mainly due to
excessive straining at the toilet because of hard faeces.
Some experts say that sitting on the toilet for long periods
of time causes haemorrhoids, but this problem is related
to constipation.
It is important to get into the habit of answering the
‘call of nature’. The problem tends to run in families.
Other associations are heavy manual work, sitting for
long periods (such as bus driving) and pregnancy.

What are the symptoms?

Bleeding is the main and, in many people, the only
symptom. The word haemorrhoid means ‘flow of blood’.
The blood is bright red and appears when you defecate.
You may notice it as streaks on toilet paper or in the
Piles often cause a mucus discharge and itching
around the anus. Any consequent scratching makes the
irritation worse.

What is the treatment?

The best treatment is prevention, and softish bulky faeces
that pass easily are good for prevention. Train yourself to
have a diet with adequate fibre by eating plenty of fresh
fruit, vegetables, and wholegrain cereals or bran.
Try to complete your bowel action within a few
minutes and avoid using laxatives.
Clean yourself thoroughly
but gently after each bowel action (using soft toilet paper
and soapy water) and dry yourself carefully.
Special astringent ointments or suppositories (advised
by your doctor) may relieve the congestion and shrink the
haemorrhoids. Mild cases may clear up completely.
If the problem persists, your doctor may advise
injections or minor surgery. Occasionally surgery to
remove the piles—called haemorrhoidectomy—may be
the only answer.


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