Definition Haemorrhoids are swollen blood vessels in and around the anus and lower rectum. They are classified as internal, meaning inside the anus, or external, meaning outside the anus. They may be present for years without causing any problems. Straining to have a bowel movement may cause swelling and pressure, leading to a haemorrhoid flare-up. Haemorrhoids are very common in men and women. They most often begin between the ages of 20 and 50.
What is going on in the body? The blood vessels around the anus become swollen and may bleed or cause other symptoms. The exact cause of haemorrhoids is not always clear.
What are the signs and symptoms of the condition? Some people don't even know they have haemorrhoids. But the most common symptoms are:
rectal bleeding, which may be seen as red streaks on the toilet paper or blood in the toilet bowl
rectal pain
itching
mucous-like discharge from the rectum
a lump around the anus
What are the causes and risks of the condition? Haemorrhoids are caused by:
occupations that require prolonged standing or sitting
straining due to constipation
chronic diarrhoea
frequent coughing and sneezing
a diet that lacks fibre
obesity
pregnancy
loss of muscle tone in the rectum due to older age, and rectal surgery
What can be done to prevent the condition? Haemorrhoids can often be avoided by preventing the pressure and straining of constipation. To do this, a person needs to:
eat a diet high in fibre
control his or her weight
drink 6 to 8 glasses of fluid each day
exercise regularly
How is the condition diagnosed? The doctor will diagnose haemorrhoids by examining the anus and rectum for swollen blood vessels. He or she also will feel for internal haemorrhoids by inserting a lubricated finger into the rectum. This is called a digital examination. Sometimes a hollow, lighted tube called an proctoscope is used to view internal haemorrhoids. It is very important to see a doctor whenever rectal bleeding is present to rule out other diseases, such as bowel cancer. Usually a sigmiodoscopic examination is carried out to exclude a cancer higher in the rectum.
What are the long-term effects of the condition? Anaemia, or low blood counts, may result from too much blood loss.
What are the risks to others? There is no risk to others.
What are the treatments for the condition? Treatment includes measures to ease pain, decrease swelling, and regulate bowel movements. These may include:
warm tub or sitz baths 3 to 4 times a day
ice packs to reduce the swelling
stool softeners or laxatives, such as coloxyl, to prevent constipation
pain control with applications of haemorroidal creams, lotions, or suppositories to the affected area
In more severe cases, surgery may be needed. In certain suitable cases, rubber banding of the haemorrhoids (an office procedure) may cure the condition.
What are the side effects of the treatments? The side effects of surgery include:
infection
bleeding
What happens after treatment for the condition? Symptoms may subside for a time if the person prevents straining due to constipation when having a bowel movement. However, flare-ups of haemorrhoids are not uncommon. Surgical removal of haemorrhoids may cure the problem permanently.
How is the condition monitored? The disease is monitored by regular rectal examinations. If bleeding persists, a colonoscopy (examination of the entire large bowel) may be indicated.
Author: Gail Hendrickson, RN, BS Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
