Haemorrhoids are a benign condition of the anal canal. Haemorrhoid cushions are normal anatomical structures within the anal canal and serve as the last line of defence in continence protection. Haemorrhoids become problematic when the vessels within these cushions engorge and swell, potentially leading to a bulge through the anal canal. Haemorrhoids are often painless but can cause pain and discomfort when they enlarge.
Symptoms of Haamorrhoids
- Bleeding
- Discomfort/Pain
- Itching – Caused by mucus secreted from the mucosal lining, which irritates the anal skin.
- Acute Prolapse – Less common but can cause excruciating pain, often requiring emergency surgical intervention.
- Skin Tags – When problematic haemorrhoids resolve, patients may develop anal skin tags, which are often mistaken for haemorrhoids. Skin tags can interfere with proper cleaning after a bowel motion. Surgical excision may be necessary to treat this.
Treatment
Treatment depends on the severity of symptoms and patient preferences. Surgical interventions are most effective when combined with improvements in lifestyle and toileting habits.
Lifestyle
- Increase water intake to more than 2L per day.
- Consume sufficient fibre to maintain soft stools.
Toileting Habits
- Limit time spent on the toilet to less than 5 minutes per bowel motion.
- Avoid distractions such as mobile phones, magazines, or other reading materials while on the toilet.
Surgical Options
- Rubber Band Ligation – Typically effective for grade I and II haemorrhoids.
- Haemorrhoidectomy – Involves the surgical removal of haemorrhoids. This is a painful procedure, and recovery can take up to 6–8 weeks.
- Transanal Haemorrhoidal De-Arterialisation (THD) – A procedure that involves suturing the haemorrhoidal vessels to reduce blood flow, causing the haemorrhoids to shrink over time.
