Haemorrhoids or piles, are swollen and inflamed veins in the lower part of the rectum and anus. In the normal state, they function as vascular “cushions” that protect the bowel wall during the passage of hard stools. They are quite common as about 50% of adults by the age of 50 present with signs and symptoms related to haemorrhoids.
They may be located inside the rectum (internal haemorrhoids) or they may develop at the anal verge (external haemorrhoids).
What are the causes of haemorrhoids?
The exact cause of symptomatic haemorrhoids is unknown. However, certain factors are believed to contribute to the development of haemorrhoids, namely:
- Chronic constipation or diarrhea
- Low-fiber diet
- Straining during defaecation
- Lack of exercise
- Family history of haemorrhoids
What are the symptoms of haemorrhoids?
Most people having haemorrhoids present with painless, bright red bleeding from the rectum during or after a bowel movement. The blood typically drips in the toilet basin or appears on the toilet paper. Some patients report of a palpable perianal lump that prolapses permanently or when bearing down. Other symptoms include itching, feeling of discomfort and mucous discharge around the anus.
Sometimes, a blood clot may form inside an external haemorrhoid (thrombosis) causing swelling and pain which usually resolves within 2-3 days.
How are haemorrhoids diagnosed?
Haemorrhoids are typically diagnosed by physical examination. Sometimes, endoscopy (anoscopy, rectoscopy) is required to exclude other causes of rectal bleeding, such as tumors, polyps, abscesses etc.