Your health with Pharmacist Advice

General Health - Haemorrhoids

DEFINITION

Haemorrhoids, which are commonly known as Piles, appear when the blood vessels of the haemorrhoidal plexus, which is found in the lower rectum or anus, become enlarged(1).

DESCRIPTION

Haemorrhoids is the name given to a condition where a vein or veins found in the anus (the lower end of the bowel) become dilated and inflamed. Haemorrhoids are similar to varicose veins, but occur in the region of the anus. There are three varieties of Haemorrhoids:(2).

  • External Haemorrhoids are small spots of bleeding that occur under the skin around the anus that feel like hard lumps.
  • Internal Haemorrhoids are found inside the rectum and are usually painless but may bleed.
  • Prolapsed Haemorrhoids are a more severe and painful form of internal Haemorrhoids. These Haemorrhoids push through the anus and hang out of the body, especially after going to the toilet.

Certain activities can weaken the tissue that provides support to the blood vessels in the anus and rectum and increase the risk of Haemorrhoids developing. These activities include increasing age, constipation, prolonged straining (e.g. long periods on the toilet, heavy manual labour) and pregnancy(3).

SIGNS AND SYMPTOMS

The blood vessels in Haemorrhoids are weak and easily broken, which causes bleeding. The blood is usually bright red and is usually noticed on toilet paper or in the toilet bowl(4). Haemorrhoids may not be the cause of Rectal bleeding and it is important that patients with rectal bleeding visit their Doctor to determine the cause. Lumps or prolapse (appearance of the internal lining of the anus outside the anal aperture) can occur after defecation. There may also be pain or discomfort, itching, burning and soiling of the underwear(5). Internal Haemorrhoids may cause a feeling that a bowel movement was incomplete(6). Rectal tumours may also cause a feeling of incomplete evacuation, so it is important to see your Doctor to rule out more serious conditions such as colorectal Cancer. See the colorectal Cancer topic on the Healthpoint for more information.

HEALTH MANAGEMENT

As with all conditions your Doctor should be consulted to diagnose and treat this condition. Ask your Doctor about the latest advice for the treatment of Haemorrhoids. The diagnosis of Haemorrhoids involves a careful physical examination that may require the Doctor to use equipment to see into the rectum and anus(7). Treatment may involve increasing the amount of fibre in the diet to make the stools softer and reduce straining(8). Patients should avoid sitting on the toilet for prolonged periods or straining excessively during defecation(9). Topical medications (treatment applied directly to the Haemorrhoid) can provide relief from some of the discomfort caused by Haemmorrhoids. A procedure called Sclerotherapy, where the Haemorrhoid is injected with a chemical called phenol, is used to control bleeding from Haemorrhoids(10). Larger Haemorrhoids may require 'rubber band ligation', where a small rubber band is tightly applied to internal Haemorrhoids and causes the Haemorrhoid tissue to die.

PHARMACIST

Ask your Pharmacist for advice.

  1. Follow the Diet Hints
  2. Keep the bowels regular and avoid constipation. Your Doctor may recommend stool softeners to moisten the faeces and make defecation easier. Ask your Pharmacist about some fibre products such as psyllium or methylcellulose if you are having any difficulty.
  3. Topical medication can help reduce pain and discomfort caused by Haemorrhoids. Ask your Pharmacist about products like Anusol, which contains anaesthetics, corticosteroids and antiseptics to dull pain and inflammation and disinfect the area.
  4. If the pain is severe, there are pain tablets available. Watch the codeine content as this may stop the normal bowel function.
  5. Your Pharmacist has some special pile ointments and suppositories.
  6. The Pharmacy may have some special Haemorrhoidal tablets which may help to strengthen the walls of the veins.
  7. Use a mild soap and water after each bowel movement to clean the area and then pat dry to provide hygiene and help with the healing. Using a medicated wipe may also help.
  8. A gentle astringent such as witch hazel lotion has a soothing effect when applied to Haemorrhoids. The astringency of witch hazel helps to draw together and heal the veins, providing relief by cooling and relieving the inflammation. It can be applied icy cold or warm.

DIET HINTS

  • Chronic constipation is considered a major cause for the formation of Haemorrhoids. The diet should be high in vegetables, fruits, cereals and water to provide the fibre and fluids required to soften faecal matter(11).
  • Increase soluble fibre intake. Soluble fibre is found in fresh, raw fruits and vegetables and rolled oats(12). See the Constipation Diet topic on the Healthpoint for further dietary advice.
  • Vitamin C and bioflavonoids are thought to strengthen the walls of blood vessels(13). Foods high in Vitamin C and bioflavonoids are fresh raw fruits and vegetables, especially cabbage, green peppers, citrus fruits with the pith included, rosehips and black currants and whole grains, seeds and nuts.
  • Avoid packaged and refined foods. These promote dehydration and are low in fibre. Increase the consumption of fresh whole foods.
  • Avoid constipating foods such as red wine, chocolate, tea, coffee, cocoa and cola.

VITAMINS/MINERALS/HERBS

  • Vitamin A, Vitamin C and Vitamin E are antioxidants that can help repair damaged tissue such as the membrane of the large intestines(14).
  • Plantain is a traditional Haemorrhoid treatment that can be applied directly to Haemorrhoids to soothe symptoms of pain and itching(15).
  • Butcher's Broom is a herb that has anti-inflammatory actions and constricts blood vessels(16). Butcher's Broom can be taken orally and is often drunk as tea, or the lotion can be applied directly to Haemorrhoids.
  • Witch Hazel can be applied directly to soothe and cool Haemorrhoids and relieve pain(17).
  • Aloe Vera can be applied directly to the Haemorrhoid to help the healing process, or aloe vera juice can be swallowed to promote bowel movements and soften faeces(18).