Understanding causes, symptoms of piles

Haemorrhoids (also known as piles) are swollen and inflamed veins in the rectum or anus.

Typical symptoms are pain, itching and bleeding around the anal area.

Treatment and prevention will often involve non-prescription ointments, other home treatments and lifestyle changes.

Haemorrhoids that don’t clear up may require a visit to your doctor and, in some cases, minor surgery.

Causes
The exact cause of haemorrhoids is unknown. However, they are associated with an increase in pressure in the lower rectum, which can cause the blood vessels in the lower rectum to become swollen and inflamed.

The following factors can increase pressure within the lower rectum and hence may increase the risk of developing haemorrhoids: Straining to have a bowel movement; Sitting for long periods of time, especially on the toilet; Chronic (long lasting) constipation or diarrhoea; Being overweight or obese; Pregnancy; Anal intercourse; Low-fibre diet; Spinal cord injury; Poor posture; and Family history of haemorrhoids.

Haemorrhoids are common and occur in most people at some stage during their lives. They tend to occur more frequently later in life due to age-related weakening and stretching of the tissues supporting the veins in the rectum and anus.

Signs and symptoms of haemorrhoids may include: Pain or discomfort, especially when sitting; Pain during bowel movements; Itching or irritation around the anal region; Bright red blood on your stools, toilet paper or in the toilet bowl; Swelling around the anus; and one or more lumps near the anus, which might be tender or painful.

Treatment
Most cases of haemorrhoids can be self-treated. More serious or repeat cases may require medication or a surgical procedure. Haemorrhoids can recur after treatment; hence, they are controlled rather than cured.

Self-treatment
Home treatment is often all that is required to relieve mild pain, swelling, and inflammation associated with haemorrhoids.

Home treatments include: Use of non-prescription haemorrhoid ointments, creams, suppositories, or pads containing a mild corticosteroid, e.g. hydrocortisone, or witch hazel extract; Soaking the anal area in warm water for 10 to 15 minutes two or three times a day; Using stool softeners, which help stools to be passed more easily; Ensuring that the anal area is kept clean by bathing or showering daily – soap is not necessary, and the affected area can be dried with a hair dryer; Using moist towels or wet toilet paper (that do not contain perfume or alcohol) rather than dry toilet paper, to help keep the anal area clean after passing a stool; Applying ice packs or cold compresses on the affected area can relieve swelling; Taking oral pain medication, such as paracetamol or ibuprofen, can help to relieve discomfort.

Prevention
Keeping your stools soft is the best way to prevent haemorrhoids from occurring.

The following steps can help to prevent haemorrhoids from occurring and reduce symptoms of existing haemorrhoids: Eat high-fibre foods; Drink plenty of fluids; Consider using fibre supplements; Avoid straining when on the toilet; Go to the toilet as soon as you feel the urge; and Get plenty of exercise.

• Lose weight if you are overweight

• Avoid sitting for long periods

• Avoid taking medication that can cause constipation, example codeine-based painkillers