Piles (Haemorrhoids)

03 February 2016

Piles are more common than you think

It may come as a surprise that piles (haemorrhoids) are one of the most popular search terms online - here's why.

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Piles, formally referred to as haemorrhoids, are a hot topic online, and that's probably because they're so common.

The U.S. Food and Drug Administration reports that "haemorrhoids" was the top-trending health-issue search in the United States in 2012 and most people - up to 75 percent - will be affected by haemorrhoids at some point in their lives, according to the U.S. National Institutes of Health.

Haemorrhoids are swollen and inflamed veins in the rectum or anus. The good news is there are several ways to treat haemorrhoids and ease the pain, itching or other symptoms they may cause, according to an article posted on the FDA's "Consumer Updates" Web page.

The uncomfortable condition usually affects adults aged 45 to 65 and haemorrhoids are typically caused by increased pressure in the veins of the anus. Obesity and inactivity play a role in who develops haemorrhoids. Pregnancy and childbirth can also increase women's risk for these protrusions.

When haemorrhoids do form, they occur inside the rectum (internal haemorrhoids) or near the anal opening (external haemorrhoids).

"You often can't see or feel the internal ones," said Dr. Herbert Lerner, a colon-rectal surgeon and FDA medical officer, in an agency news release. "But straining during bowel movements and constipation can cause these haemorrhoids to bleed and occasionally push through the anal opening."

Taking the following steps can keep stools soft and prevent haemorrhoids:

  • Eat fibre-rich foods, such as fruits, vegetables and whole grains
  • Drink plenty of fluids
  • Exercise and avoid sitting in one place for too long
  • Take stool softeners or fibre supplements

When a haemorrhoid pushes through the anal opening, it is known as a protruding or prolapsed haemorrhoid, which can be irritating. Blood can pool in an external haemorrhoid and form a clot, which can cause severe pain, swelling and inflammation, Lerner said.

Other common symptoms of haemorrhoids include the following:

  • itching (especially when sitting)
  • bright red blood on toilet tissue, stool or in the toilet (Dark red or black blood could be a sign of a more serious condition.)
  • painful bowel movements
  • hard, sore lumps near the anus

Haemorrhoids can be treated with several over-the-counter creams and other remedies. "These products may help you feel more comfortable, but they won't get rid of the underlying haemorrhoids, such as internal haemorrhoids, that commonly cause bleeding," Lerner noted.

Soaking in a warm bath regularly for 10 to 15 minutes and using wet toilet paper after a bowel movement can also ease mild symptoms of haemorrhoids, according to Dr. Rajat Malik, a gastroenterologist with the FDA.

"With these measures, mild symptoms should decrease in two to seven days," advised Malik in the news release. "If your symptoms don't improve with these home treatments, and certainly if they get worse, it's time to talk to your health care provider."

There are a number of procedures doctors can perform to treat haemorrhoids. For instance, where a haemorrhoid has a blood clot (thrombosis), doctors can remove the clot with a small incision.

"You can do this under local anesthesia and as an outpatient," Lerner said. "I've had a lot of uncomfortable, unhappy patients walk into my office with a thrombosis, and then leave happy after it's been excised."

Other procedures used to treat haemorrhoids include:

  • Ligation: a haemorrhoid's blood supply is cut off with a rubber band.
  • Sclerotherapy: a chemical solution is injected into a haemorrhoid to shrink it.
  • Coagulation: a laser or infrared light is used to shrink a haemorrhoid.
  • Haemorrhoidectomy: a surgical procedure used in more extreme cases to remove large haemorrhoids.

"FDA is responsible for reviewing the devices used in both ligation and coagulation," Lerner noted.

Read more:

6 tips to reduce haemorrhoid pain

How a doctor would diagnose and treat piles

What to do if you have piles

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