Haemorrhoids (piles) are lumps inside and around your bottom (anus). Usually, they get better on their own but there are occasions where patients need hospital treatment.
We spoke with the founder of the Birmingham Haemorrhoid Clinic and general and colorectal curgeon Mr David McArthur. He shared with us some lifestyle changes and home remedies that can reduce symptoms.
What exactly are haemorrhoids?
Haemorrhoids, also called ‘piles’, are enlarged and engorged blood vessels in the anal cushions of the upper portion of the anal canal. The anal cushions normally serve an important role in the maintenance of continence and we are not normally aware they are there. However, when they become enlarged they may exhibit symptoms, and in this case, they are known as haemorrhoids. Most people will, at some stage in their life, get symptoms from haemorrhoids.
What symptoms do haemorrhoids cause?
Haemorrhoids can give mild intermittent symptoms, or the problems can be more persistent and severe. Symptoms include rectal bleeding, perianal discomfort, anal seepage, pruritis (anal itch) and the sensation of something coming out of the bottom.
What causes haemorrhoids?
Haemorrhoids can develop from increased pressure in the lower rectum due to:
- Straining during bowel movements
- Sitting for long periods of time on the toilet
- Chronic diarrhoea or constipation
- Anal intercourse
- Low-fibre diet
How are haemorrhoids diagnosed?
- Digital examination: During a digital rectal exam, your doctor inserts a gloved, lubricated finger into your rectum. The exam can suggest to your doctor whether further testing is needed.
- Visual inspection: Because internal haemorrhoids are often too soft to be felt during a rectal exam, your doctor may also examine the lower portion of your colon and rectum with a proctoscope or sigmoidoscope.
How are haemorrhoids graded?
Haemorrhoids are classified into four grades:
- Grade I haemorrhoids are also known as internal piles; they do not prolapse (push out) out of the anal canal. They usually bleed as the patient goes to the toilet; typically, the blood is fresh and red and seen to be separate from the stools, usually on the paper.
- Grade II haemorrhoids are larger, and sometimes prolapse from the anus during defaecation; however, the piles return inside once the patient stops defaecating.
- Grade III haemorrhoids prolapse from the anus during defaecation and the patient is able to push them back inside using a finger.
- Grade IV haemorrhoids can permanently protrude from the anus and cannot be pushed back inside.
What lifestyle changes can I make to relieve my haemorrhoids?
You can often relieve the mild pain, swelling and inflammation of haemorrhoids with home treatments. Often these are the only treatments needed.
- Eat high-fibre foods and drink plenty of fluid to avoid passing hard stools and needing to strain.
- Use over-the-counter topical treatments that contain local anaesthetic.
- Soak regularly in a warm bath.
- Keep the anal area clean and dry.
- Don't use dry toilet paper, rather use moist towelettes.
- Apply ice packs or cold compresses to relieve swelling.
- You can use Paracetamol temporarily to help relieve your discomfort.
With these treatments, haemorrhoid symptoms often go away within a week.
What home remedies are available for haemorrhoids?
In addition to simple lifestyle changes, there are a number of other home remedies that can be effective:
- Witch Hazel. A natural anti-inflammatory, witch hazel can reduce the itching and pain associated with haemorrhoids. It can either be purchased in a liquid form or found in wipes or soaps.
- Aloe vera. Another natural anti-inflammatory, some patients find pure aloe vera gel helps relieve the distressing discomfort and itching caused by haemorrhoids.
- Epsom salts. Bathing with Epsom salts can help reduce the irritation. They can either be added to bath water, or used as a Sitz bath (a small plastic bowl placed on the toilet), and the area should be soaked for up to 20 minutes.
- Over-the-counter preparations. A number of over-the-counter preparations are available as either creams or suppositories. They contain local anaesthetic, plus or minus hydrocortisone (a steroid); the latter should only be used for a week at a time as it can affect the skin in the area.
Can I completely get rid of haemorrhoid flare-ups by following these home remedies?
Haemorrhoids can naturally settle down, either with no treatment or with the simple lifestyle modifications and home remedies described above. However, if patients have ongoing symptoms they might require surgical intervention that is offered by seeing a colorectal surgeon.
When does surgery become necessary?
There isn’t an absolute reason to ever have surgical treatment of haemorrhoids; rather, if and when a person has symptoms caused by their haemorrhoids that they find distressing then this is the time to seek advice. If there are symptoms that could be caused by something else in the bowel, such as rectal bleeding, it is also sensible to get checked out.
What are the different types of surgery options that you offer at The Birmingham Haemorrhoid Clinic?
At the Birmingham Haemorrhoid Clinic , we offer a full range of treatment options for haemorrhoids, and try to tailor the treatment to the nature of the problem and what the person wants to achieve through treatment. Where possible, we employ minimally-invasive treatments as much as possible, with the intention of causing as little discomfort, whilst still offering an effective treatment. Options include:
- Rubber band ligation
- Transanal Haemorrhoidal Dearterialisation (THD)
If you have persistent symptoms of haemorrhoids book an appointment via Mr David McArthur’s Top Doctor’s profile today or have a look on his website for more information.