Managing haemorrhoids can be an uncomfortable task. If you're among the 50% of individuals who will experience symptoms such as rectal pain, itching, or bleeding by age 50, rest assured, we have you covered. In this comprehensive guide, we'll delve into the causes of both internal and external haemorrhoids and present easy treatment options to alleviate your symptoms.
Causes of Internal and External Haemorrhoids and Easy Treatment Options
Typically, haemorrhoids arise from factors such as pregnancy, obesity, or straining while defecating. These factors result in increased pressure on the anal veins. In midlife, haemorrhoids often become a persistent issue. About 50% of individuals experience one or more common symptoms, such as rectal pain, itching, bleeding, or prolapse (haemorrhoids protruding through the anal canal) by age 50. Although haemorrhoids are not life-threatening, they can be recurrent and uncomfortable. The good news is that there are several ways to alleviate haemorrhoid symptoms.
What are haemorrhoids?
Haemorrhoids, or piles, are clusters of veins located beneath the mucous membranes in the rectum and anus that are present in everyone. Haemorrhoids become a medical condition when veins become swollen and distended, like varicose veins in the legs. Some people believe that haemorrhoids are an inevitable result of bipedalism, as the blood vessels involved in haemorrhoids must work against gravity to pump blood back to the heart.
Haemorrhoids are classified into two types: internal and external. Internal haemorrhoids develop in the lower rectum and generally do not cause pain, even when bleeding occurs. Bleeding may be visible on toilet paper or in the toilet bowl. Internal haemorrhoids may also protrude outside the anus, causing pruritus ani, irritation due to mucus and small stool particles. Wiping constantly to relieve itching can exacerbate the issue.
External haemorrhoids are the more uncomfortable type of haemorrhoid as they develop under the skin surrounding the anus. The overlying skin may become irritated and erode, leading to pain. In the event of a blood clot formation within an external haemorrhoid, the pain can be sudden and severe. The resulting clot typically dissolves, but a skin tag may remain, causing itching or irritation.
What causes haemorrhoids?
Haemorrhoids are typically linked to chronic constipation, straining while defecating, and prolonged sitting on the toilet. These activities disrupt blood flow to and from the area, causing blood to accumulate and the vessels to enlarge. This also explains why haemorrhoids are common during pregnancy, as the growing uterus puts pressure on the veins.
Recent studies indicate that individuals with haemorrhoids tend to have a higher resting anal canal tone. This means the smooth muscle of the anal canal is tighter than normal even without straining. Constipation exacerbates the issue, as pushing during a bowel movement increases pressure in the anal canal and pushes the haemorrhoids against the sphincter muscle. Furthermore, with ageing, the supportive connective tissues of the haemorrhoids may weaken, leading to their bulging and prolapse.
Typically, a medical history and physical exam are sufficient for diagnosing haemorrhoids. External haemorrhoids are often visible, particularly when a blood clot has formed. A clinician may conduct a digital rectal exam to check for blood in the stool. In addition, they may use an anoscope to examine the anal canal with illumination. If rectal bleeding or microscopic blood in the stool is evident, a flexible sigmoidoscopy or colonoscopy may be necessary to rule out other causes of bleeding, including colorectal polyps or cancer, particularly in individuals aged 45 or older.
Simple home remedies can relieve most haemorrhoid symptoms. To prevent occasional flare-ups, consider the following:
Increase fibre intake: Consuming more fibre from food sources or supplements can soften stools and ease bowel movements, reducing haemorrhoid pressure. High-fibre foods like broccoli, beans, wheat and oat bran, whole-grain foods, and fresh fruits are nutritious sources. Gradually increase your fibre intake to 25-30 grams per day, while drinking enough fluids to avoid bloating and gas.
Exercise: Moderate aerobic exercise like brisk walking for 20-30 minutes a day can help stimulate bowel function.
Don't wait: When you feel the urge to defecate, go to the bathroom immediately to avoid backing up stool which could lead to increased pressure and straining. Establish a regular bowel habit by scheduling a set time each day, such as after a meal, to sit on the toilet for a few minutes.
Use a sitz bath: Soak the buttocks and hips in warm water to relieve itching, irritation, and spasms of the sphincter muscle. A 20-minute sitz bath after each bowel movement and two or three times a day is recommended. Gently pat the anal region dry.
Consider seeking topical relief by using over-the-counter creams for haemorrhoids that contain local anaesthetics, which can provide temporary relief from pain. Witch hazel wipes like Tucks are also helpful. Applying a small ice pack to the anal area for a few minutes can reduce pain and swelling. Sitting on a cushion instead of a hard surface can prevent the formation of new haemorrhoids and reduce the swelling of existing ones.
Treat the clot: When an external haemorrhoid forms a blood clot, it can be very painful. Applying home treatments can relieve symptoms while waiting for the clot to resolve on its own. If the clot has been present for more than two days and the pain is tolerable, you can wait for it to resolve on its own. Otherwise, a minor office procedure performed by a surgeon can withdraw the clot from the vein or remove the haemorrhoid surgically.
While haemorrhoids can be an uncomfortable and recurrent issue, understanding their causes and effective treatment options can help manage and even prevent them. Simple home remedies and lifestyle changes can significantly alleviate most symptoms. However, remember, if you're dealing with consistent discomfort or notice bleeding, it's crucial to contact your doctor for a thorough evaluation and appropriate treatment plan. Don't let haemorrhoids disrupt your daily life. Reach out to a medical professional today and take the first step towards comfort and relief.
Don't hesitate if you're experiencing any symptoms of haemorrhoids. Contact your doctor today for proper diagnosis and treatment. Your comfort is important, and professional help is just a call away.