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Help, I’ve Got Haemorrhoids! Should I Be Worried?

Ouch, if you’ve got a haemorrhoid, you have our deepest sympathy, they are no fun at all.

Not only can haemorrhoids – also known as piles – be uncomfortable, painful, and itchy, but it can also feel very embarrassing to talk about them.

Thankfully, the likes of Made In Chelsea alumni Millie Mackintosh are sharing their own experiences with the dreaded piles to help normalise this very normal health condition.

In this article, we’re going to answer some of the main questions people ask about haemorrhoids and give you some treatment options.

Here’s what we’ll be deep diving into:

  • What are haemorrhoids, and why do you get them?
  • The symptoms of internal and external haemorrhoids
  • At-home treatments for piles
  • Non-surgical and surgical options for haemorrhoid removal
  • Why a high-fibre diet can help prevent piles

It’s normal to get haemorrhoids

Please know that having haemorrhoids is very normal.

According to studies, around one quarter of the adult population in the UK will have haemorrhoids in their lifetime.

In fact, this figure could be much higher because people are still shy about talking about haemorrhoids or seeking medical treatment.

That’s why when Millie described a “flare up” at her friend Binky’s wedding, she proved that it doesn’t matter how glamorous you are, piles can still be a problem.

What are haemorrhoids?

It’s thought that haemorrhoids occur when the blood vessels in your rectum or anus become enlarged due to increased pressure.

The swelling can happen internally or take the form of an external lump, known as a pile.

You might first notice the haemorrhoid because of the discomfort, the lump or blood in your stool.

What causes haemorrhoids?

According to the NHS, researchers don’t conclusively know what causes haemorrhoids, but there are several factors that increase the likelihood of developing them.

Here’s the NHS list:

  1.  Constipation and straining on the toilet
  2.  Being overweight or obese
  3.  Age – as you get older, your body’s supporting tissues get weaker, increasing your risk
  4.  Being pregnant – which can place increased pressure on your pelvic blood vessels, causing them to enlarge
  5.  Having a family history of haemorrhoids
  6.  Regularly lifting heavy objects
  7.  Chronic diarrhoea
  8.  A persistent cough or repeated vomiting
  9.  Sitting down for long periods of time

The symptoms of external haemorrhoids

If you’ve got external haemorrhoids, you are likely to experience several uncomfortable symptoms.

The US National Institute of Diabetes and Digestive and Kidney Diseases says you’ll probably have anal itching, feel several lumps or bumps on the anal cushions and pain when sitting down.

As the haemorrhoids are outside the body, you are more likely to notice them and seek treatment quickly.

It’s very important to get checked out by a doctor because some symptoms of haemorrhoids could also point to other health concerns.

The symptoms of internal haemorrhoids

According to Harvard University’s Health Publishing Department, internal haemorrhoids occur in the lower rectum.

While they are often painless, unlike external piles, you could discover you’ve got them because you notice bright red blood in the toilet or on toilet paper.

You might also find that an internal haemorrhoid briefly protrudes out of the anus when you pass stools and then goes back in.

Different types of piles

 Did you know there were four grades of piles?

According to BUPA’s Consultant Laparoscopic, Colorectal and General surgeon Mrs Sara Badvie, haemorrhoids are graded according to how much they protrude.

Here’s how BUPA describe the grades:

  • First-degree piles may bleed, but don’t come out of your anus.
  • Second-degree piles come out of your anus when you have a poo but go back inside on their own afterwards.
  • Third-degree piles come out of your anus and only go back inside if you physically push them back in.
  • Fourth-degree piles always hang down from your anus, and you can’t push them back in. They can become very swollen and painful if the blood inside them clots.

What happens during a consultation about haemorrhoids?

Some medical professionals will be able to diagnose haemorrhoids using a visual examination or a digital rectal exam with a gloved, lubricated finger.

More thorough examinations may be required, and they could include an anoscopy, colonoscopy or sigmoidoscopy.

These tests involve a small tube with a camera fitted at the top, which the doctor will use to examine the rectum and see the haemorrhoid up close.

Medics will usually opt for these more thorough tests if they are worried about your risk of gastrointestinal disease.

How do I treat my haemorrhoids?

You have several choices of how to treat piles, but the most important thing to note is that you should seek medical treatment if at-home remedies don’t work.

The over-the-counter remedies – including topical creams and suppositories – are designed to reduce the swelling, pain and bleeding you could be experiencing.

The National Institute for Health and Care Excellence (NICE) has a good guide to the different topical preparations and how effective they can be.

Their advice is to use these remedies as a short-term solution and be sure to see your GP if the haemorrhoids are still causing you problems after seven days of trying at-home treatments.

Other ways to relieve haemorrhoid symptoms

To manage the pain relief, you can rely on our trusty friends paracetamol, ibuprofen or aspirin for help.

You can also take warm baths for at least ten minutes a day to soothe the area.

Some people use cold or hot compresses to remove swelling and stop bleeding.

Here’s a guide to making a cold compress to treat the inflamed area.

Non-surgical treatments for haemorrhoids

In their paper The Non-Surgical Management of Hemorrhoidal Disease, authors Cocorullo et al. looked at several different treatments.

– Rubber band litigation

This treatment for internal haemorrhoids involves placing a rubber band around the base of the pile to cut off the blood supply.

Following the procedure, the haemorrhoid should shrink, die and then fall off within a week.

The study found that while the patients did experience post-operative bleeding and pain, they also reported subjective improvements ranging from 73-84%.

– Infrared Coagulation

Medics sometimes use the infrared coagulator to treat internal and external piles.

The instrument delivers heat to the impacted area for 1.5 seconds at a time to destroy the tissue, which can then be removed.

Once again, patients reported pain and bleeding post-treatment, but the success rate was 62%.

– Injection Sclerotherapy

During this treatment, the doctor will inject a chemical solution into the area around each haemorrhoid.

By damaging the blood vessels supplying the haemorrhoid, the procedure helps to harden the tissue around it so scar tissue forms and the pile shrinks.

Doctors can treat 2 – 3 piles at a time using sclerotherapy, and the Cocorullo study found that the post-treatment pain was minimal.

– Electrotherapy

If you opt for electrotherapy, the medical team will use a gentle electric current on the haemorrhoids.

Usually, the area will be numbed prior to the procedure, and then the current is used to shrink the piles.

As with the other non-surgical options, electrotherapy is an outpatient treatment, and you will remain awake throughout.

Under what circumstances would I need surgery to treat haemorrhoids?

You may need to undergo surgery if your haemorrhoids are so enlarged that you cannot get relief from the symptoms from other options.

The NHS offers these three routes for surgery:

  • haemorrhoidectomy: your piles are cut out
  • stapled haemorrhoidopexy: your piles are stapled back inside your anus
  • haemorrhoidal artery ligation: stitches are used to cut the blood supply to your piles to make them shrink

How to make good lifestyle choices to manage or prevent haemorrhoids

When it comes to the fight against haemorrhoids, fibre and water are your very best friends.

The goal is to make it much easier to move your bowels so you don’t end up straining so hard you develop piles.

You can do this by drinking plenty of water and eating a diet that is rich in dietary fibres such as whole wheats, legumes, vegetables and fruits.

The Association of UK Dieticians recommends you aim for around 30g of dietary fibre every day.

The benefits of a fibre-rich diet

OK, so your new aim is to eat around 30g of dietary fibre daily – comprising of soluble (fruits and oats), insoluble (wheat bran and nuts), resistant starch (bananas, grains, pulses) and prebiotics (onions, garlic).

A combination of these sources of fibre can have multiple benefits, including:

  • easier bowel movements
  • immunity boost
  • more diverse microbiota in the gut
  • Reduced gut inflammation

Long story short, a fibre-rich diet provides many health benefits, and if it helps to reduce the risk of haemorrhoids, it’s definitely worth a try.

You can also take fibre supplements to soften your stools, so you don’t need to strain so much when going to the toilet.

Never be embarrassed to ask for help

Hopefully, you’ve now got a better idea of why haemorrhoids occur and how to treat them.

However, we cannot stress enough how vital it is to see your doctor if your symptoms persist.

Some people still find it embarrassing to talk about piles, but a consultation could save your life.

Don’t forget that some of the symptoms of haemorrhoids could also be indicative of other health issues.

By getting a proper examination from a medical professional, you can rule those out and seek the right treatment for you.

Evidence Based
This article has been reviewed by our Kari Health Experts and Editorial Board to ensure accuracy and reliability of the information presented. However, please note that the content provided is for informational purposes only and should not replace advice from your medical professional.

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