- Internal haemorrhoids form inside the rectum. Usually, these types of haemorrhoids don’t cause much discomfort or pain, as there is not many pain-sensing nerves found in the rectum. They are not also visible. However, passing stools can cause bleeding, which can certainly be alarming in the first instance.
- Protruding haemorrhoids, also known as prolapsed haemorrhoids, are where the internal haemorrhoid breaks through the anal opening, typically due to straining. It is rare but it does occur.
- External haemorrhoids are related to the blood vessels around your anus and can cause itching or bleeding.
- Thrombosed haemorrhoids occur when an external haemorrhoid bleeds and forms a clot. This can be very painful as it causes inflammation and swelling near the anus.
There are several causes of haemorrhoids, however in many cases the cause isn’t apparent.
Causes may include:
- Straining during bowel movements
- Increased pressure on veins during pregnancy
- Increased vulnerability for older people
- Increased vulnerability for people with varicose veins is suspected but not confirmed
- 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.
Are you experiencing any of these symptoms?
- Pain when going to the toilet
- 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
Other methods of diagnosis include:
- Rectal exam. A doctor will insert a lubricated, gloved finger to assess your rectum, looking for growths or abnormalities.
- Proctoscopy or sigmoiodoscopy. A proctoscope, a sigmoidoscope or an anoscope may be used to examine inside your anal canal, including the last section of the colon. These scopes are thin tubes with a light and camera that enable gastroenterologists to exam internally.
- 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 disorder.
- Eat a diet high in fibre, which helps to soften stools.
- Drink plenty of fluids through the day to aid digestion
- Use a haemorrhoid cream, or suppository containing hydrocortisone to ease symptoms of pain and itching
- Witch hazel is also an effective numbing agent
- Take a 10-15 minute warm bath a few times a day 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.
- Use wet toilet paper, or wet-wipes that help keep the anal area moist, rather than using toilet paper, which is sometimes too coarse.
- Apply cold compresses, or ice packs to reduce swelling around the anus
- Oral pain relief can help manage symptoms temporarily, such as aspirin, ibuprofen or acetaminophen
For persistent haemorrhoids that are particularly painful or bleed regularly, there are several minimally invasive treatment procedures. These include:
- Rubber band ligation – which uses two 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 arise following the procedure, but it is rare.
- Sclerotherapy – uses a chemical solution, which is injected into the haemorrhoid, causing the tissue to shrink. Whilst pain is minimal, it often isn’t as effective as the rubber band litigation.
- Coagulation techniques – use laser, heat or infrared light to harden and shrivel the internal haemorrhoid. Again, there are little side effects to coagulation, however results show that haemorrhoids are more likely to return than when using the rubber band ligation.
Surgery is also an option for particularly large haemorrhoids, or recurring haemorrhoids. The surgery is called a haemorrhoidectomy and requires aesthetic, which may be local, spinal or general.
Haemorrhoid stapling is also an option for internal haemorrhoids.
- 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 poo
There are several treatments available for anal fistulas. The first step is diagnosis from a specialist gastroenterologist to determine the nature of your condition and then consider which treatment would be most effective for you.