What are they?

Haemorrhoids, also called piles, are swollen veins in the anus (back passage) and lower rectum. Haemorrhoids are similar to varicose veins. Haemorrhoids can develop inside the anus, called internal haemorrhoids. They also can develop under the skin outside the anus, called external haemorrhoids. Large internal haemorrhoids may protrude (stick out) of your anus. This is a prolapse.

They happen when there is a weakness in the side of your anal canal that leads to thickening of the lining. The veins in the lining can enlarge to become a haemorrhoid. This causes symptoms such as bleeding, pain and discomfort.

Symptoms:

If you have haemorrhoids you may notice:

• Bright red blood on the toilet paper or in the toilet when you have a bowel motion (poo)

• Itchiness, discomfort or pain around your anus

• Sometimes there can be a lump that protrudes out of your anus (prolapse)

Many people experience no symptoms or very mild symptoms that disappear after a couple of days. For other people, haemorrhoids are more painful.

Causes:

Haemorrhoids are usually caused by constipation (having hard bowel motions that are difficult to pass). Constipation causes you to strain when you go to the toilet. This puts pressure on the blood vessels in your anus, making them swell.

Pressure in the rectum may also be caused by :

• Being overweight

• Heavy lifting

• Anal fissures (small tears in your anus that can cause pain when you poo)

• Coughing, vomiting, diarrhoea

Haemorrhoids are particularly common during pregnancy. This is because:

• Constipation is quite common in pregnancy

• The growing baby places pressure on your abdomen

• There is more blood flowing through your body

Treatment

There are several options available to treat haemorrhoids.

Controlling constipation

• Eat a high fibre diet to make the bowel motion softer and easier to pass

• Drink plenty of water

• Try not to strain when you go to the toilet

Optimise toilet positioning:

• Elevate feet a bit with a step stool as you sit on the toilet. This changes the position of the rectum to allow for easier passage of stools.

Medicines:

Pain and inflammation can often be relieved using over-the-counter haemorrhoid treatments from the pharmacy.