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What are haemorrhoids?
Haemorrhoids (also known as ‘piles’) are enlarged and engorged blood vessels in the anal cushions of the upper portion of the anal canal. The anal cushions serve an important role in the maintenance of continence, and we are not normally aware they are there. However, when they become enlarged, they may exhibit symptoms, and in this case, they are known as haemorrhoids.
What causes haemorrhoids?
Haemorrhoids can develop from increased pressure in the lower rectum due to:
- Straining during bowel movements
- Sitting for long periods on the toilet
- Chronic diarrhoea or constipation
- Anal intercourse
- Low-fibre diet
Adults of any age can get haemorrhoids, and approximately 50 percent of people suffer with them at some time in their lives. You may be more prone to getting haemorrhoids if other members of your family have had them.
Symptoms of haemorrhoids
Haemorrhoid symptoms vary from person to person. They may be mild and intermittent, or the problems can be more persistent and severe. Common symptoms include:
- Rectal bleeding
- Perianal discomfort
- Anal seepage
- Pruritis (anal itch)
- Sensation of something coming out of the bottom
Following GP referral or self-referral, we can usually see you within 3-4 days of contacting the clinic.
On the day of your appointment, you will meet with the consultant who will discuss your clinical history with you in detail. You will also have a physical examination, described below. The initial consultation and examination usually take 20 minutes.
During a digital rectal exam, your doctor inserts a gloved, lubricated finger into your rectum. The exam can suggest to your doctor whether further testing is needed. The procedure is quick and painless.
If your internal haemorrhoids are too soft to be felt during a rectal exam, your doctor may also examine the lower portion of your colon and rectum with a small tool called a proctoscope or sigmoidoscope. This procedure should not be painful. You may experience mild cramping, a sensation of fullness and an urge to empty your bowels during the test.
Patients with haemorrhoids can have symptoms that can relate to other bowel conditions, so we may need to perform further investigations to rule out these alternative diagnoses. We can usually book you in for these day case procedures within a week of your initial consultation.
The most common investigations that you may require are:
Colonoscopy - an examination of the lining of the colon (large bowel) using a narrow, flexible, tube-like telescope called a sigmoidoscope.
Flexible Sigmoidoscopy – a test that allows your doctor to look inside the rectum and lower part of your bowel using a narrow, flexible, tube-like telescope called a colonoscope.
We will offer you light sedation or Entonox (gas and air) to maximise comfort during the test. You will receive your results on the same day.
If you need treatment, your consultant will talk you through the options so that you can make an informed decision. Treatments are usually arranged within two weeks of the consultation.
Diagnosis may reveal that you do not have haemorrhoids but another colorectal condition that presents with similar symptoms, such as:
• Anal fissure - a split in the lining of the anal canal.
• Anal fistula - an abnormal connection between the anal canal and the skin around the anus.
• Anal abscess - a relatively common condition that most often occurs as the result of infection of an anal gland.
• Anal skin tags - excess pieces of skin at the external opening of the anal canal.
• Anal cancer - malignant tumours of the anal canal are rare. The majority are squamous cell carcinomas, but other even rarer types are recognised, such as malignant melanoma, adenocarcinoma (cancer that originates in glandular tissue), carcinoid or lymphoma.
Mr McArthur can treat these conditions at our sister clinic, The Birmingham Colorectal Clinic.