Ultimate Haemorrhoids/Piles Cheatsheet – Diagnosis, Treatment, Prevention

What are Piles/Haemorrhoids?

Piles or haemorrhoids are a bunch of inflamed veins in the lower anus and rectum area that also cause localized inflammation of the other tissues. The swollen veins inside the rectum area or outside the anus lead to pain, anal itching, and bleeding from the rectum area. Though it’s a lesser-known fact that we are all born with haemorrhoids but it doesn’t cause any trouble. It becomes troublesome only when they get inflamed, become large, and produce irritating symptoms.

Though piles are a fairly common problem, their symptoms aren’t always visible. The symptoms of haemorrhoids depend on the type and its location.

Haemorrhoids/Piles Risk Factors

Though anyone can get affected by haemorrhoids, it tends to get more common as you age with the risk increasing for those above the age of 50. You are considered more at risk if you have the following conditions:

• You’re obese or overweight
• Pregnant
• Consume a low-fibre diet on a regular basis
• Are suffering from chronic constipation or diarrhoea
• Your profession or routine requires you to lift heavy objects regularly
• Spend a significant time sitting on the toilet seat
• Strain your anus while having bowel movements

Types of Piles/Haemorrhoids

Piles or haemorrhoids can appear both on the inside or outside the rectum and the type of haemorrhoids largely depend on the area where the inflamed veins develop. Three types of haemorrhoids include:

• Internal Haemorrhoids – Internal haemorrhoids mean the affected person has swollen veins from inside the rectum. The Rectum, a part of the digestive system, functions by connecting the colon to the anus. Internal haemorrhoids may cause bleeding in some cases but usually, they aren’t that painful.
   
• External Haemorrhoids – External haemorrhoids mean the affected person has swollen veins forming underneath the skin circling around the anus. In simple words, your anus is a canal-shaped passage which your poop comes out from. External haemorrhoids can be extremely itchy, and painful, and may cause bleeding too in some cases.
   
• In some cases, external haemorrhoids can cause the swollen veins to fill with blood that can even cause clotting. Though it’s not a fatal condition but is definitely an uncomfortable and painful position to be in.
   
• Prolapsed Haemorrhoids – This applies to both the above categories as both internal and external haemorrhoids can prolapse. Prolapse means they can cause stretching and bulging outside of the anus. Such haemorrhoids may cause bleeding and can be painful.

Haemorrhoids/Piles Causes

Haemorrhoids are caused by straining that puts pressure on the anal and rectal veins. Straining of any kind that puts increasing pressure on your belly or lower extremities causes swelling and painful inflammation in the anal and rectal veins. Causes of haemorrhoids development include:

• Pelvic pressure caused by weight gain and obesity
• Pressure put on the pelvis during pregnancy
• Chronic constipation
• Straining excessively during pooping
• Straining while lifting heavy objects like weightlifting

Haemorrhoids/Piles Symptoms

Internal haemorrhoids, that don’t prolapse or stretch, rarely cause any pain and can’t be touched by hand. Most people with internal haemorrhoids don’t even know they have them as they don’t show any symptoms or cause pain. If you’re showing symptoms of internal haemorrhoids, you may notice some blood on the toilet seat, toilet paper, or on your stool. Such bleeding is known as rectal bleeding.

However, external haemorrhoids or piles have more noticeable symptoms like:

• Anal itching
• Sore or tender lumps near the anus that are palpable or can be felt
• A sore pain or ache in the anus while sitting
• Rectal bleeding

Internal or external haemorrhoids that get prolapsed are more painful, challenging for the patient, and make them uncomfortable. Those affected with prolapsed haemorrhoids can feel a bulging growth outside the anus that can be pushed back inside gently.

Haemorrhoids/Piles Diagnosis

Your treating physician or surgeon can easily diagnose haemorrhoids based on a physical and rectal exam followed by your medical history and symptoms. Haemorrhoids diagnosis is done by:

• Physical Rectal Exam – This examination is done by inserting a lubricated and gloved finger inside the rectum to check for swollen veins. This examination is performed by a qualified surgeon.
   
• Anoscopy – This examination is performed by inserting an anoscope (lighted tube) inside the rectum to examine the anal and rectum lining.
   
• Sigmoidoscopy – This is a detailed diagnostic exam to detect haemorrhoids or piles. This is done by a qualified surgeon by inserting a sigmoidoscope (lighted tube with a camera) to examine and view the lower part of the colon and the rectum. The procedure done under this category includes a flexible or rigid sigmoidoscopy (proctoscopy).

After the detailed examination and confirmation of the diagnosis, you may be asked to undergo certain tests like CBC to assess the blood picture and rule out bleeding.

Haemorrhoids/Piles Complications

Though haemorrhoids are painful and cause an uncomfortable feeling, they are rarely likely to cause any severe problems. People affected with haemorrhoids rarely develop the following complications:

• Anaemia
• Blood clots (in case of external haemorrhoids)
• Skin tags (tissue flaps that hang off the skin and are not painful)
• Infection
• Strangulated haemorrhoids

How to Treat Haemorrhoids/Piles at Home?

Most piles or haemorrhoids go away on their own without causing much trouble or requiring any treatment. A few cause symptoms like pain and bleeding that also subside within a week without doing much. Meanwhile, practising a few home remedies and treatments at home offers relief. here are a few home treatment remedies for haemorrhoids that are effective:

• Applying over-the-counter medications like witch hazel, lidocaine, and hydrocortisone to the affected area offers immense relief.
   
• Keeping yourself hydrated at all times helps significantly.
   
• Increasing the intake of fiber through diet and supplements is an effective home remedy for haemorrhoids. Make it a goal of consuming at least 20-40 grams of fiber in your everyday diet.
   
• Practising Sitz bath (sitting in a tub of warm/hot water) for 20-30 minutes a day helps.
   
• Consuming laxatives to soften the stools.
   
• Taking NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) to relieve pain and inflammation comes in handy.
   
• Use wet flush wipes or toilet paper smeared with lotion to avoid scratching your anus. You can also use a tissue moistened with normal water, avoid using dry tissues or toilet paper on the affected area.

Alternatively, if your haemorrhoids require surgical intervention, your doctor may advise you to undergo the following procedures after going through pre-surgical tests:

• Rubber Band Ligation
• Electrocoagulation
• Infrared Coagulation
• Sclerotherapy
• Haemorrhoidectomy
• Haemorrhoid Stapling

Haemorrhoids/Piles Prevention

• Avoid sitting for a longer duration.
   
• Avoid putting too much pressure while pooping.
   
• Keep yourself adequately hydrated throughout the day.
   
• Eat foods rich in fiber like whole grains, fruits with peels, and vegetables. You can also take supplements.
   
• Stay adequately physically active throughout the day to keep bowel movements healthy and going.
   
• Consume laxatives only when it is advised by your doctor. Taking laxatives too frequently and without your doctor’s advice makes your body forget how to control bowel movements and poop naturally.

Call your doctor if you experience the following:

• Abdominal pain
• Chronic constipation
• Diarrhoea
• Fever with rigours and chills
• Severe rectal bleeding followed by pain
• Vomiting and nausea