Despite popular belief, haemorrhoids are not the only anal condition that a person can suffer from, but they are usually the first that come to mind. Other common problems are anal fistula and anal fissure. These are the three most frequent conditions a proctologist deals with, so much so that it is estimated that about 40% of the population suffers from an anal problem.
What are haemorrhoids?
Haemorrhoids, commonly referred to as Piles are a condition that causes swellings in the rectum that contain blood vessels. In a lot of cases, haemorrhoids don’t cause any symptoms and people may not realise they have them. However, in the cases where there are symptoms, the following may occur:
Symptoms of haemorrhoids:
- Bright red blood or a mucus discharge after passing a stool
- Itchy bottom
- A lump hanging outside the anus
- Soreness, redness or swelling around the anus
The different grades of haemorrhoids
Haemorrhoids are graded into four classes and not all require a surgical cure.
Grade one - haemorrhoids that only bleed
Grade two - haemorrhoids that are prolapsed, that is, they exit and re-enter the anus during defecation.
Grade three - the patient needs to manually push them back in
Grade four – the haemorrhoids are unable to be pushed back into the anus Grades three and four are treated by corrective surgery.
- Milligan-Morgan's procedure: The most common technique, which gives excellent results and eliminates haemorrhoids permanently. However, it is a painful operation that must be treated with painkillers. The wounds can take up to 20 days to heal, but the patient stops feeling pain after 10 days – usually because the area is more relaxed.
- Rubber band ligation: This treatment technique is performed on an outpatient basis and consists of necrotising the haemorrhoids so they fall off after three or four days.
- Sclerosing agents can also be used to harden the haemorrhoids until they fall off. This procedure is more common with elderly patients who may not react well to rubber band ligation.
Confusion with anal fissure
Many people go to the proctologist's surgery with anal pain thinking that they have haemorrhoids when, contrary to widespread belief, haemorrhoids do not always hurt. If there is pain, the problem is usually due to an anal fissure, which is an exaggerated contraction of the internal sphincter that causes a lack of blood supply which in turn produces an ulcer.
The most frequent causes of anal fissure are stress, anxiety and also chronic constipation. This anal fissure can be resolved with a sphincterotomy, which consists of an incision that helps to relax the sphincter, thus solving the problem permanently.