Haemorrhoids

Haemorrhoids (piles) are swellings that develop from the lining of the anus and lower rectum (back passage).

What are haemorrhoids and what causes them?

• Constipation, passing large stools (faeces), and straining at the toilet. These increase the pressure in and around the veins in the anus and seem to be a common reason for haemorrhoids to develop.

• Pregnancy. Haemorrhoids are common during pregnancy. This is probably due to pressure effects of the baby lying above the rectum and anus, and the affect that the change in hormones during pregnancy can have on the veins.

• Ageing. The tissues in the lining of the anus may become less supportive as we get older.
• Hereditary factors. Some people may inherit a weakness of the wall of the veins in the anal region.

What is the treatment for haemorrhoids?
Avoid constipation and straining at the toilet

Keep the faeces (sometimes called stools or motions) soft, and don't strain on the toilet. You can do this by the following:

• Eat plenty of fibre such as fruit, vegetables, cereals, wholemeal bread, etc.
• Have lots to drink. Adults should aim to drink at least two litres (10-12 cups) per day. You will pass much of the fluid as urine, but some is passed out in the gut and softens faeces. Most sorts of drink will do, but alcoholic drinks can be dehydrating and may not be so good.
• Fibre supplements. If a high-fibre diet is not helping you can take fibre supplements (bulking agents) such as ispaghula, methylcellulose, bran or sterculia. You can buy these at pharmacies or get them on prescription. Methylcellulose also helps to soften faeces directly which makes them easier to pass.
• Avoid painkillers that contain codeine such as co-codamol, as they are a common cause of constipation.
• Toileting. Go to the toilet as soon as possible after feeling the need. Some people suppress this feeling and plan to go to the toilet later. This may result in bigger and harder faeces forming which are then more difficult to pass. Do not strain on the toilet. Haemorrhoids may cause a feeling of fullness in the rectum and it is tempting to strain at the end to try to empty the rectum further. Resist this. Do not spend too long on the toilet, which may encourage you to strain. (For example, do not read whilst on the toilet.)