Haemorrhoids (Piles)

What are Haemorrhoids?

Haemorrhoids or commonly known as piles are enlarged blood vessels around the anus. Described as anal cushions, they are present in everyone. Only when they are enlarged that they are considered abnormal.

Haemorrhoids are categorised into four degrees:

First degree piles – Internal piles that bleed.
Second degree piles – Lump at the anus that sticks out after a bowel motion and then disappears straight away after.
Third degree piles – Lump at the anus that sticks out after a bowel motion but needs to be pushed back by a finger into the anus after.
Fourth degree piles – Lump that can’t be pushed back into the anus.

What are the causes of haemorrhoids?

There are various risk factors that cause haemorrhoids including:

Constipation or diarrhoea
During pregnancy, due to the pressure exerted by the growing foetus and during labour on the blood vessels around the anus
Excessive straining when passing stools
Sitting on the toilet for a long time

Other factors that may trigger the development of haemorrhoids are:

Being overweight
Having a family history of haemorrhoids
Having an intra-abdominal or pelvic tumour (not a common cause)
Not having enough fibre in the diet

What are the symptoms of haemorrhoids?

Changes in bowel habits (constipation of diarrhoea)
Changes in the motion of stools
Feeling that your bowel doesn’t empty completely
Finding blood in your stools (rectal bleeding)
Finding your stools are narrower than usual
Itchiness at the anus
Obvious lump at the anus
Pain during and after bowel motion
Weight loss and appetite loss that could not be explained

IMPORTANT: The above symptoms are also signs of colorectal cancer. You are advised to seek a doctor’s opinion and undergo a full evaluation before attributing the symptoms to haemorrhoids.

How are haemorrhoids treated?

Treatment for haemorrhoids is dependent on the degree they are in:

The doctor may suggest to increase your fibre and water intake as a simple preventative measures to decrease strain during bowel movements.
Medication (tablets or suppositories) to treat smaller haemorrhoids
Rubber band treatment (ligation) to treat first or second-degree haemorrhoids. A rubber band is placed over the piles in order to cut off its blood supply.
A special device can be inserted into the anus to tie off the blood vessel that supplies blood to the haemorrhoids
Surgery (haemorrhoidectomy) to cut out third- and fourth-degree piles, using various surgical techniques.
A chemical solution injected into the haemorrhoids, causing them to shrink and fall off (works for first and second degree haemorrhoids).