Haemorrhoids are essentially varicose veins. They just happen to occur at a site most people would consider a sensitive area. Nothing could be more embarrassing than visiting the proctologist, but this problem occurs very frequently, especially in older people and in pregnant women. It does not make for very good dinner conversation but needs to be discussed.
WHAT IS A HAEMORRHOID?
A haemorrhoid is a collection of varicose veins either inside (internal) or just outside (external) the anus. These veins naturally occur at this site, but once they are enlarged, they are defined as hemorrhoidal tissue.
WHAT SYMPTOMS DO HAEMORRHOIDS CAUSE?
Most haemorrhoids do not cause symptoms. The most common symptom of internal haemorrhoids is bright red blood in the stool, on toilet paper, or in the toilet bowl. Sometimes, an internal haemorrhoid may stick out through the anus and can be difficult to push back in. They can become irritated, inflamed and painful. External haemorrhoids can also be painful, or even thrombose to form a hard, painful knot.
HOW DO YOU PREVENT HAEMORRHOIDS?
Maintaining good bowel habits is important in trying to prevent haemorrhoids. That means keeping the stool soft and bulky with a high fibre diet, and avoiding straining in the bathroom.
HOW ARE HAEMORRHOIDS TREATED?
Once the diagnosis has been established, then the medical management of haemorrhoids is initiated. The first goal is to reduce inflammation and pain. Various techniques to accomplish this goal include sitting in a bathtub several times a day in warm water for about 10 minutes. There are various hemorrhoidal creams or suppository that can be applied to sooth the area. Concomitantly, the second goal of medical management is to prevent recurrence of the inflammation and prolapsing of the internal haemorrhoids through the anus. Therefore, it is imperative to avoid constipation and straining by increasing fibre and fluids in the diet. A softer and bulkier stool makes emptying the bowels easier and lessens the strain on hemorrhoidal tissue. Sources of fibre include dietary intake, as well as psyllium (Metamucil) or methylcellulose (Citrucel).
Haemorrhoids that are large and cause recurrent symptoms might need to be treated more aggressively. There are numerous different ways of achieving this destruction of the hemorrhoidal tissue. These options can range from a simple office to a more aggressive approach.