• What are haemorrhoids?

Haemorrhoids are vascular cushions in the lower rectum. Haemorrhoidal cushions do have a physiological function – to maintain continence against liquid stools and air. As such, having haemorrhoidal cushions is entirely normal and physiological – but sometimes they can give rise to symptoms.

• What are the common symptoms and signs of haemorrhoids?

The symptoms from haemorrhoids do arise when someone is constipated. The hard stools will push them down to anal canal and protrude them outside the anus (you will feel these as soft lumps) and cause damage to the lining mucosa and cause bright red blood in the stools. Sometimes the lining layer of the haemorrhoids can produce excess mucus that can lead to a slimy discharges through the anus and itching around the anus. Rarely the blood vessels inside the haemorrhoids can clot (thrombose) or strangulate, leading to pain.

• What are the different types of haemorrhoids, and how are they identified?

Broadly haemorrhoids can be internal of outside. They are categorised as grades I to IV, in relation to where they are in the anal canal and whether they have caused any complications.

• What are the potential causes and risk factors associated with developing haemorrhoids?

Constipation is the most common risk factor for developing haemorrhoids. Rarely, someone can be susceptible to haemorrhoids due to a family history. It is common for pregnant women to suffer with haemorrhoids; however, they tend to settle once after the delivery.

• How can haemorrhoids be treated, and what are the available treatment options?

Often haemorrhoids are treated conservatively. Drinking plenty of water and eating lots of fibre will keep the bowel motions soft. Over the counter laxatives will help with constipation when conservative measure fails. If there are prolapsing haemorrhoids, then they can be returned with gentle pressure with the fingers. If the haemorrhoids are painful, regular usual pain killers and a warm bath will help. A warm bath and an ice pack will help with pain and discomfort. Over the counter haemorrhoidal creams will help shrink the haemorrhoids and will give a soothing effect as well.

When haemorrhoids are persistent or when they recur other treatment option should be considered. Options depend on the grade of haemorrhoids and their positions. Grade II and III haemorrhoids can be treated with banding or injections in a clinic room. However, when they are grade III+, often an operative intervention is needed (a haemorrhoidectomy). This can be performed as a traditional open haemorrhoidectomy or a stapled haemorrhoidopexy (when they are circumferential and prolapsing) or a haemorrhoidal artery ligation technique. These are performed as day cases under general anaesthesia.

• Are there any lifestyle changes or home remedies to alleviate haemorrhoid symptoms?

Avoiding constipation and straining by keeping your bowel motions soft will prevent you having symptoms from haemorrhoids. Best way to achieve this is drinking plenty of water and eating plenty of fibre.