DID YOU KNOW
- Haemorrhoids are one of the most common ailments known.
- More than half the population will develop haemorrhoids, usually after age 30.
- Millions of Americans currently suffer from haemorrhoids.
- The average person suffers in silence for a long period before seeking medical care.
- Today's treatment methods make some types of haemorrhoid removal much less painful.
WHAT ARE HAEMORRHOIDS?
It is often referred as "varicose veins of the anus and rectum,” haemorrhoids are enlarged, bulging blood vessels in and around the anus and lower rectum. The rectum is the bottom section of your colon (large intestine). The tissues supporting the vessels stretch. As a result, the vessels expand, the walls thin and bleeding occurs. When the stretching and pressure continue, the weakened vessels protrude. The two types of haemorrhoids, external and internal, refer to their location.
External (outside) haemorrhoids form near the anus and are covered by sensitive skin. They are usually painless unless a blood clot (thrombosis) forms or they become very swollen.
Thrombosed external haemorrhoids are blood clots that form in an outer haemorrhoid in the anal skin. If the clots are large, they can cause significant pain. A painful anal mass may appear suddenly and get worse during the first 48 hours. The pain generally lessens over the next few days. You may notice bleeding if the skin on top opens.
Internal (inside) haemorrhoids form within the anus beneath the lining. Painless bleeding and protrusion during bowel movements are the most common symptoms. However, an internal haemorrhoid can cause severe pain if it is completely prolapsed. This means it has slid out of the anal opening and cannot be pushed back inside.
WHAT ARE THE CAUSES OF HAEMORHOIDS?
The exact cause of haemorrhoids is unknown. A lot of pressure is put on human rectal veins due to our upright posture, which can potentially cause bulging. Other contributing factors include:
- Aging
- Chronic constipation or diarrhea
- Pregnancy
- Heredity
- Straining during bowel movements
- Faulty bowel function due to overuse of laxatives or enemas
- Spending long periods of time on the toilet (e.g., reading)
WHAT ARE THE SYMPTOMS?
Any of the following may be a sign of haemorrhoids:
- Bleeding during bowel movements
- Protrusion of skin during bowel movements
- Itching in the anal area
- Pain in the anal area
- Sensitive lump(s)
HOW ARE HAEMORRHOIDS TREATED?
NONSURGICAL TREATMENT : It is important that symptoms are checked by a colon and rectal surgeon first before you try self-treatments. They will perform a thorough examination and recommend treatment. Mild symptoms can be relieved frequently without surgery. With nonsurgical treatment, pain and swelling usually decrease in two to seven days.
Treatment includes:
- Eating a high-fibre diet and taking over-the-counter fibre supplements (25-35 grams of fibre/day) to make stools soft, formed and bulky.
- Avoiding excessive straining to reduce the pressure on haemorrhoids and help prevent protrusion.
- Shortening time on the toilet to only 1 to 2 minutes to help prevent protrusion
- Drinking more water to help prevent hard stools and aid in healing.
- Taking warm tub baths (sitz baths) for 10 to 20 minutes, a few times per day to help the healing process.
SURGICAL TREATMENT : If pain from a thrombosed haemorrhoid is severe, your physician may decide to remove the haemorrhoid and/or clot with a small incision. These procedures can be done under local anaesthesia.
Rubber Band Ligation: This treatment works well on internal haemorrhoids that protrude during bowel movements. A small rubber band is placed over the haemorrhoid, cutting off its blood supply. The haemorrhoid and the band fall off in a few days. The wound usually heals in one to two weeks. Mild discomfort and bleeding may occur. This treatment needs to be repeated for complete treatment of the hemorrhoids depending on the size or if they return.
RUBBER BAND LIGATION OF INTERNAL HEMORRHOIDS:
- Bulging, bleeding, internal haemorrhoid
- Rubber band applied at the base of the haemorrhoid
- About seven days later, the banded haemorrhoid has fallen off, leaving a small scar at its base
Injection and Coagulation: This method can be used on internal haemorrhoids that do not protrude. Both methods are fairly painless and cause the haemorrhoid to shrivel. Several treatments may be needed. This cannot be used for external haemorrhoids.
Haemorrhoids stapled and sutured: These methods can shrink internal tissue but cannot be used for external haemorrhoids. These procedures are generally more painful than rubber band ligation but less painful than haemorrhoidectomy.
Haemorrhoidectomy: This is the most complete surgical method for removing extra tissue that causes bleeding and protrusion. It is done for both internal and external haemorrhoids under anaesthesia using sutures. Depending on the case, hospitalization and a period of rest may be required.
Haemorrhoidectomy is considered when:
- Clots repeatedly form in external haemorrhoids
- Ligation is not effective in treating internal haemorrhoids
- The protruding haemorrhoid cannot be reduced
- There is chronic bleeding
DO HEMORRHOIDS LEAD TO COLORECTAL CANCER?
Haemorrhoids do not increase the risk of colorectal cancer nor cause it. However, more serious conditions can cause similar symptoms. Even when a haemorrhoid has healed completely, your colon and rectal surgeon may request other tests. A colonoscopy may be done to rule out other causes of rectal bleeding. Every person age 45* and older should undergo a colonoscopy to screen for colorectal cancer.
WHO IS A COLON & RECTAL SURGEON?
Colon and rectal surgeons are experts in the surgical and non-surgical treatment of diseases of the colon, rectum and anus. They have completed advanced surgical training in the treatment of these diseases as well as full general surgical training. They are well-versed in the treatment of both benign and malignant diseases of the colon, rectum and anus and are able to perform routine screening examinations and surgically treat conditions.
