Haemorrhoids Definition & Overview Haemorrhoids, commonly known as piles, are swollen blood vessels in or around the anus and rectum. They can be internal (inside the rectum) or external (outside the anus). Epidemiology Common condition, affecting both men and women. Incidence increases with age, especially in individuals aged 45-65. Causes & Risk Factors Increased intra-abdominal pressure due to: Constipation. Pregnancy. Heavy lifting. Straining during bowel movements. Low fibre diet. Chronic diarrhoea. Clinical Presentation Internal Haemorrhoids: Painless rectal bleeding during bowel movements (bright red blood). Protrusion during bowel movement, often self-reducing. May cause mucus discharge, sensation of incomplete evacuation, and rectal itching. External Haemorrhoids: Pain and swelling around the anus. Possible blood clot formation leading to a painful, bluish lump (thrombosed external haemorrhoid). Investigations Clinical examination: Inspection and digital rectal examination. Proctoscopy: For internal haemorrhoids. Additional investigations if concerned about other colorectal conditions (e.g., sigmoidoscopy or colonoscopy). Management Conservative: High-fibre diet. Topical treatments: creams, ointments, and suppositories to relieve pain and inflammation. Warm baths. Interventional: Band ligation for internal haemorrhoids. Injection sclerotherapy. Infrared coagulation or electrocoagulation. Surgical haemorrhoidectomy for large or persistently symptomatic haemorrhoids. Prognosis Many individuals experience relief with conservative measures. Surgical procedures have a high success rate but may be associated with complications like pain, urinary retention, and infection.
