What should I do about my haemorrhoids (piles)?

Introduction
Most people are under the impression that having haemorrhoids (or piles) is a medical condition. The truth is that everybody has haemorrhoids, and simply some people have larger and more problematic haemorrhoids compared to others. Haemorrhoids are a part of our normal anatomy within the bottom (anal canal). They are swollen cushions made of blood vessels that contribute to the fine control of continence. Haemorrhoids exist in varying grades of severity (one to four) and the symptoms you may experience do not always accurately reflect the severity of your haemorrhoids. The tricky part is knowing what to do about it.

Symptoms
The most common symptoms associated with haemorrhoids are rectal bleeding, pain and swelling around the anus. Haemorrhoids are made worse from repeated straining on the toilet to pass stool, such as with chronic constipation. They are also very common during pregnancy due to the increased pressure in the pelvis from an enlarged uterus. It is also common to suffer with haemorrhoids with no predisposing factors. 

Investigation
Most people who experience recurrent rectal bleeding are anxious that they may be suffering with a bowel cancer, and this is usually the reason for seeking help from a doctor. Indeed rectal bleeding can be caused by a bowel cancer, however this is not as common as haemorrhoids. Simple examination will usually be quite informative and following this, initial investigation is likely to include either a flexible sigmoidoscopy or colonoscopy depending on the presenting symptoms. This test allows your doctor to look inside your rectum and colon and diagnose the problem.

Treatment
There are several treatments available for haemorrhoids and having a surgeon experienced in all available techniques means you can choose which treatment is best for you.

Simple haemorrhoids can be treated conservatively with lifestyle changes such as re-training not to strain on the toilet, or with the addition of simple medicines such as laxatives. If this does not improve the symptoms then the least invasive and safest treatment is banding.

https://www.nhs.uk/conditions/piles-haemorrhoids/treatment/#non-surgical-treatment

For larger and more symptomatic haemorrhoids there are intermediate treatments available such as a haemorrhoidal artery ligation operation. This technique reduces the flow of blood to the haemorrhoids and in turn reduces bleeding.  

https://www.nhs.uk/conditions/piles-haemorrhoids/surgery/#haemorrhoidal-artery-ligation

Surgical removal of haemorrhoids (haemorrhoidectomy) is reserved for the most troublesome haemorrhoids that have either not responded to less invasive treatments or are not suitable for them. Although effective, it can be a more uncomfortable treatment. 

Conclusion
Your investigation and subsequent treatment is an agreement between you and your surgeon and can only be achieved during your consultation. This is allows the treatment to be tailored to your individual needs.

Written by Mr Nicholas Stylianides

For more information or to book an appointment with Mr Nicholas Stylianides please contact 0161 447 6700 or email info@spiremanchester.com

The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional.