Haemorrhoids And Other Perianal Disease
Haemorrhoids are a very common condition that affect more than 50% of people by the age of 50.
This condition is usually caused by constipation that leads to excessive straining on bowel movement. It can be precipitate by childbirth, excessive coughing or abdominal distention.
Haemorrhoids are also called piles, they are swollen veins in the anal canal and lower rectum, similar to varicose veins. Haemorrhoids may result from straining during bowel movements or from the increased pressure on the veins during pregnancy. Haemorrhoids may be located inside the anal canal (internal haemorrhoids), or they may appear as redundant and stretched skin folds of the perianal region (external haemorrhoids).
1.Straining during bowel movement
2. Sitting for long periods of time on the toilet
3. Chronic constipation
7.Straining during urination
8. Heavy lifting
Occasionally excessive bleeding can lead to anaemia, excessive straining or lifting of a heavy object can lead to protrusion and strangulation of haemorrhoids that is a painful condition
The best treatment is prevention by a high fibre diet, adequate hydration, avoiding excessive straining on the toilet and avoiding prolonged sitting. If constipation remains a problem you can use a fibre supplement, there are many options available over the counter.
If you have painful prolapsed haemorhoids the following measure are very useful
- Salt bath three times a day
- Bed rest
- Pain killers
- Soothing ointment, available over the counter
There are many options available to treat haemorrhoids.
- High-fibre foods; Fruits, vegetables and whole grains usually are effective to soften the stool and increases its bulk and that helps to avoid the straining. Supplemental stool softeners can also be used
- Soothing ointments; over-the-counter haemorrhoid ointment or suppository that have hydrocortisone and a local anaesthetic.
- Salt bath; three times a day for 10 to 15 minutes is very helpful
- Moist toilet paper; to help keep the anal area clean after a bowel movement
- Ice packs; apply ice packs or cold compresses to relieve swelling and the pain.
- Oral pain killers; Panadol and Ibuprofen temporarily to help relieve your discomfort.
With these measures, haemorrhoid symptoms often settle down within about ten days.
You need to discuss with your doctor the option of surgery if there is excessive bleeding, pain, excessive discomfort or the presence of a lump
- Rubber band ligation; Rubber bands placed around the internal haemorrhoid to cut off their blood supply. They fall off within a week to ten days. This procedure is effective to control bleeding and reduce swelling. Haemorrhoid banding can be uncomfortable and may cause bleeding
- Injection (sclerotherapy); In this procedure, your doctor injects a chemical solution into the haemorrhoid tissue to shrink it.
- Surgical Excision; This is the most effective treatment for removal of large protruding haemorrhoids, in particular those with an external component. The operation is performed under general anaesthesia. The patient is expected to stay in the hospital for 2-3 nights. The operation is associated with significant pain because the anal skin is very sensitive.
- Recovery: The patient will require pain killers, stool softeners, salt baths and adequate rest; you will expect to resume normal activities in 2-3 weeks, but pain may persist for four weeks. Some bleeding is expected for the first few weeks.
- Complications of Surgery:
2. Excessive pain
4. Infection is a rare complication that may require antibiotics
5. Recurrence in the form of skin tags usually that can be uncomfortable, true recurrence of internal haemorrhoids usually due to excessive internal haemorrhoids that can not be removed in the original operation
6. Excessive scarring could lead to anal stenosis (narrowing of the anal canal) which may require further surgery.
After the operation if there is excessive bleeding, pain or you are feeling unwell or have a temperature you will need to consult with your doctor.