Haemorrhoids
Haemorrhoids are the last part of the large intestine before it joins the skin of the anus. They are normal and they are an essential part of our continence/bowel control mechanism. Haemorrhoids are soft and compliant and help make the anal sphincter keep gas and liquid from leaking from our bowel.
Haemorrhoids or piles can become troublesome including;
Bright painless bleeding
Perianal lumps which may be prolapsing haemorrhoids or anal skin tags
Itchy or mucous due to their size
Very painful if one prolapses and then is strangled by the anal sphincter mechanism.
If you have bleeding it is important to seek specialist advice because any PR bleeding is not normal and requires investigation. Most patients require blood tests, a physical examination and then a colonoscopy or a sigmoidoscopy.
Simple haemorrhoids problems are frequently cured by attention to detail with defecation including a good diet with adequate fibre( 20-30g per day), plenty of hydrating fluids (eg 2L of water), avoidance of excessive caffeine or alcohol, being physically active and the use of a foot stool next to the toilet to create a squatting position all help. Some patients use fibre supplements including water soluble supplements like pysillium husk, Metamucil or Benefibre or insoluble fibre supplements such as Normafibe.
If simple measures don’t fix the problem surgical options include:
Band ligation of the internal haemorrhoid or sclerotherapy
Excisional haemorrhoidectomy (which is typically quite painful)
Other techniques including stapled haemorrhoidectomy or Doppler guided haemorrhoid artery ligation
Skin tags can be separately excised but even this small operation can be painful
After assessment and appropriate treatment your surgeon will advise you which technique is best for you particular case.