Three quarters of adults will experience problems with haemorrhoids from time to time, and whilst they are not dangerous they can be uncomfortable, itchy and on occasion also painful. Whether your symptoms are recent or you have been suffering with haemorrhoids over the longer term, specialist healthcare is available to help reduce, or relieve the discomfort you are experiencing. Like many gastrointestinal conditions, haemorrhoids can be treated successfully following diagnosis.
- Internal haemorrhoids: Form inside the upper anal canal/distal rectum. These types of haemorrhoids don’t tend to cause much discomfort or pain, as there are not many pain sensing nerves found here. They are not also visible. However, passing stools can cause bleeding, which can certainly be alarming.
- Protruding haemorrhoids: Also known as prolapsed haemorrhoids, are where the internal haemorrhoid pushes through the anal opening, typically due to straining.
- External haemorrhoids: Are probably due to development of externalised components due to straining and constipation. They may cause itching or bleeding.
- Thrombosed haemorrhoids: Occur when an external haemorrhoid bleeds into itself and forms a clot.
- Straining during bowel movements, and a tendency towards constipation
- Increased pressure on veins during pregnancy
- Increased vulnerability for older people
- Increased vulnerability for people with varicose veins is suspected
- Obesity, due to added abdominal pressure
- Sitting or standing for long durations
- Excessive sneezing and coughing
Consultation with a specialist that can conduct the necessary diagnosis tests is the first step.
- Small amounts of blood on the toilet paper, or in the toilet bowl, typically bright red in colour.
- Itching or discomfort in your anal area.
- Swelling around your anal opening.
- A sensitive or painful lump near your anus.
- Pain when going to the toilet, but this is rare and can be a sign of an alternative diagnosis.
- Rectal exam. A doctor will insert a lubricated, gloved finger to assess your rectum, looking for growths or abnormalities.
- Proctoscopy or rigid sigmoiodoscopy. A proctoscope or a sigmoidoscope may be used to examine inside your anal canal, including the last section of the colon. These scopes are thin rigid plastic tubes with a light and camera that enable the surgeon to look at the lining of the rectum and back passage.
- Flexible sigmoidoscopy. A flexible sigmoidoscope looks at the distal colon and rectum to establish there is no other untoward cause for bright red rectal bleeding. This should rule out conditions such as polyps which need to be removed.
- Colonoscopy. If there are any abnormalities that need further investigation, your doctor may also refer you for a colonoscopy, which uses an endoscope to view the entire length of your colon. This would only be relevant if your symptoms, and anything discovered in the other examinations, suggest that you may have a related digestive tract disorder.
- Eat a diet high in fibre, which helps to soften stools.
- Drink plenty of fluids through the day to aid digestion
- Taking a 10-15 minute warm bath can soften the anal area. If you don’t have a bathtub, or don’t want to run a proper bath, invest in a sitz bath, which fits over the toilet.
- Ensure the anal area is clean by showering more regularly whilst focusing on the cleanliness of the anus.
- Avoid perfumed wipes.
- Apply cold compresses, or ice packs to reduce swelling around the anus
This is most effective if carried out within 72 hours of the clot developing, so if you notice a hard painful lump close to your anus, then seek the advice from a doctor as soon as possible. For persistent haemorrhoids that are particularly painful or bleed regularly, there are several minimally invasive treatment procedures. These include:
- Rubber band ligation – which uses tiny rubber bands to cut of the circulation of the haemorrhoid. It can be uncomfortable and cause bleeding but it is an effective treatment for many people. Occasionally, other symptoms (pain) arise following the procedure, but it is rare.
- Coagulation techniques – use laser, heat or infrared light to harden and shrivel the internal haemorrhoid.
Surgery is also an option for particularly large haemorrhoids, or recurring haemorrhoids. The surgery is called a haemorrhoidectomy and requires anaesthetic, which may be local, spinal or general. Options for surgery, which can be offered by our team include:
- A full or partial open haemorrhoidectomy
- THD haemorrhoidopexy utilising a Doppler ultrasound to tie off the haemorrhoidal artery branches
- The Rafaelo procedure for internal haemorrhoids which involves radio-frequency ablation of the haemorrhoids
GI Doctors are able to offer this procedure due to our extensive experience in colorectal surgery.
- A small amount of sedative may be administered, to help you relax
- A local anaesthetic is used to the haemorrhoid area
- A safe and painless radio frequency is then applied to the stem of the haemorrhoid, causing it to contract
- Symptoms should disappear instantly
- Most procedures just take a few minutes
Benefits of Rafaelo Procedure:
- Minimal discomfort
- Safe treatment
- Return to daily life immediately
- No aftercare
- Minimal chance of symptoms returning
Anal fissures are common and about 1 in 10 people will get an anal fissure at some point in their life, most common in 15-40 year olds. Anal fissures are small tears or open sores in the skin around the opening of your anus. Most will clear up within 4-6 weeks but if they last longer they are known as chronic fissures.
- A burning pain around the anus after going to the toilet, which may last a few hours
- Spasms in your anus
- Rectal bleeding, after going to the toilet
- A sentinel pile, which is a flap of skin that can form under the fissure.
Diagnosis is essential as these symptoms may also relate to other similar conditions.
An anal fistula is a small that forms between the end of the anus and the skin of the anus. It is usually the cause of an infection or following surgery to drain anal abscesses.
- Bleeding or discharge when going to the toilet
- Pain when passing stools
There are several treatments available for anal fistulas. The first step is diagnosis from a specialist colorectal surgeon to determine the nature of your condition and then consider which treatment would be most effective for you.