Haemorrhoids

Haemorrhoids

• Dilated, twisted veins located in the wall that connect the rectum and anus, which is called the anal canal.
• Occur when the veins in anal canal become enlarged; they may eventually bleed and produce symptoms of itching, burning, swelling and discomfort in the rectum
• Swollen veins inside the anus are called internal haemorrhoids while external haemorrhoids are swollen veins hanging down outside the anus.

Signs & Symptoms

• Pain – worse when having a bowel movement
• Irritation – discomfort, burning sensation, itching
• Bleeding – bright red blood on toilet paper or on the surface of faeces
• Bulge or tag of skin around anus

Causes

• Constipation – may be due to medicines. Consult a doctor or pharmacist
• Diet – lack of dietary fibre and inadequate fluid intake
• Straining to pass a bowel motion or putting off going to the toilet
• Pregnancy – constipation in pregnancy which may put pressure on your abdomen
• Straining e.g. when doing heavy lifting or carrying
• Jobs done seated for a major part of the day
• Chronic or long lasting diarrhea
• Long lasting cough
• Family history
• Cancer or growth in the pelvis or bowel

Self care

• Eat more fibre, cereals, wholemeal bread, fresh fruit and vegetables – help keep bowel movements regular
• Drink at least 8 glasses of water each day – help ease bowel movements
• Ensure toilet hygiene – clean the area around the anus with warm water after passing motion – dab rather than rub dry to avoid more irritation. Moist towels such as nappy change towels are a better choice than toilet paper.
• Have a 15 minute warm bath (especially after going to the toilet)
• Apply a cold compress to the anus to shrink blood vessels
• Do not strain to pass motion
• Learn to lift properly to prevent straining
• Exercise to develop/maintain good muscle tone

Medicines

• Local anaesthetics (eg. lignocaine) – can help to reduce the pain and itching associated with haemorrhoids. There is a possibility that local anaesthetics may cause disensitization and their use is best limited to a maximum of 2 weeks
• Skin protectors (e.g. zinc oxide, kaolin) – form a barrier on the skin surface, helping to prevent irritation and loss of moisture from the skin
• Topical steroids (e.g. hydrocortisone, proctosedyl) – reduces inflammation and swelling to give relief from itching and pain
• Astringents (e.g. zinc oxide, hamamelis (witch hazel), bismuth salts) – help to relieve irritation and inflammation
• Counter-irritants (e.g. menthol, camphor) – gives a cooling and tingling sensation which relieves pain
• Wound healing (e.g. shark liver oil, live yeast) – to promote healing and tissue repair
• Vascular system (e.g. Daflon, Dioflex) - reduces venous distensibility and venous stasis. In microcirculation, it normalizes capillary permeability and reinforces capillary resistance.

Supplements

• Probiotic (eg. Biolife Probiotic, Total Health Concept Lacto-5, Enerflex Probiotic) – friendly intestinal bacteria to improve the gut flora balance and bowel movement.
• Fibre drinks (eg. Fybogel, Tocoma) – works by absorbing water and increasing the bulk of the food passing through the digestive system hence, improving bowel movement.
• Gingko Biloba – Promote blood circulation.