Piles (Haemorrhoids)

Piles, also known as haemorrhoids, are swollen veins in the lower part of the anus and rectum. These swollen veins can form in the rectum (internal haemorrhoids) or form under the skin of the anus (external haemorrhoids).

Symptoms of haemorrhoids often include:

• Painless bleeding.
• Itching or irritation in the anal area
• Discomfort, pain, or soreness in the same area.
• Lumps and swelling in the anal region.
• Leaking faeces.

Symptoms can be unpleasant or alarming, but they are usually not a cause for concern.

You may get a haemorrhoid from increased pressure in the lower rectum if you strain during bowel movements, sit for long periods of time on the toilet, have chronic diarrhoea or constipation, are obese, pregnant, have anal intercourse, eat a low-fibre diet or regularly lift heavy weights or objects.

Enlargement of the veins around the anus causes haemorrhoids. They can occur for the following reasons:

• Haemorrhoids are more common in pregnant women because the baby's weight puts pressure on the rectum.
• Haemorrhoids are most common among adults aged 45 to 65 years.
• Haemorrhoids can occur after cases of chronic diarrhoea.
• Chronic constipation can put pressure on the walls of the blood vessels in the rectum and anus.
• Staying in a seated position for long periods of time can cause haemorrhoids.
• Repeatedly lifting heavy objects can lead to haemorrhoids.
• Anal intercourse can cause new haemorrhoids or worsen existing ones.
• Being overweight.
• Some people inherit a tendency to develop haemorrhoids.

• If you have bleeding during bowel movements or you have haemorrhoids that don't improve after a week of home care, talk to your healthcare provider.
• Don't assume rectal bleeding is due to haemorrhoids, especially if you have changes in bowel habits or if your stools change in colour or consistency. Rectal bleeding can occur with other diseases.
• Seek emergency care if you have large amounts of rectal bleeding, light-headedness, dizziness or faintness.

You can prevent haemorrhoids by keeping your stools soft and free-flowing in addition to reducing risk factors. You can keep your stools soft and free-flowing by ensuring your diet is rich in fruits (like oranges and watermelon), vegetables (like green leafy vegetables and carrots), fibre-rich foods (like groundnut, peas and beans), and by drinking a lot of water.

Symptoms can be relieved in the following ways. However, they will not eliminate the haemorrhoids:

• Over the counter (OTC) creams or suppositories, which contain hydrocortisone. There are also pads which contain witch hazel, which can reduce itching and pain.
• Applying ice packs and cold compresses to the affected area may help with swelling.
• Some pharmacies sell sitz bath that is placed over the toilet. Soaking your bottom in warm water in such a bath may relieve the burning or itching symptoms.
• Use moist towelettes as dry toilet paper may make the problem worse.
• Some painkillers, such as aspirin, ibuprofen, and acetaminophen may alleviate pain and discomfort.

The risk of developing haemorrhoids is greatly reduced when stools are kept soft. This can be helped in the following ways:

• Eat plenty of foods rich in fibre, such as fruits and vegetables, as well as whole grains that assist proper digestion. Similarly, drinking plenty of fluids helps keep stools soft.
• Avoid over-straining when using the toilet.
• Go to the toilet when you need to. You should not wait if you need to use the toilet. The longer the wait, the drier your stools will become.
• Avoid sitting or standing still for long periods as this puts pressure on the veins of your rectum.
• Maintain a healthy body weight.

Haemorrhoids are unpleasant and uncomfortable, but are seldom a cause for real concern. With self-care haemorrhoids tend to go away by themselves. It's possible to avoid haemorrhoids by changing your diet and behaviors.