Haemorrhoids

Haemorrhoids

The term haemorrhoid refers to a condition in which the veins around the anus or lower rectum are swollen. When they become inflamed, haemorrhoids can itch, bleed, and cause pain. A haemorrhoidal condition tends to get worse over the years. 
Haemorrhoids have plagued mankind since time immemorial. They caused Napoleon to sit side-saddle and sent President Jimmy Carter to the operating room. Over two-thirds of all healthy people reporting for physical examination have haemorrhoids. Haemorrhoids are common both in men and women. 

Types of Haemorroids 

Broadly speaking, haemorroids are of two types.

Internal haemorrhoids occur higher up in the anal canal and therefore are not visible. In mild cases bleeding is the most common symptom of internal haemorrhoids, and often the only symptom. 

External haemorrhoids are visible as they occur outside the anus. They appear blue. Usually they do not produce any symptoms. However when they get inflamed, they become red and painful. 

Internal haemorrhoids come out through the anal opening when patients strain strongly to move the bowels. This is called prolapsed internal haemorrhoid. It is often difficult to ease back the prolapsed haemorrhoids into rectum. 

When a blood clot forms inside an external haemorrhoid, it becomes occluded or thrombosed. This thrombosed external haemorrhoid can be felt as a firm, tender mass about the size of a pea in the anal area. It often produces severe pain. 

Causes of Haemorrhoids

Low-fibre diets cause hard stools, which require straining to be passed. This increased pressure causes engorgement of the haemorrhoids by interfering with venous return. 
Prolonged sitting on a toilet ( e.g. reading in the toilet) is believed to cause problems in the blood circulation in the area around the anus ( perianal area), resulting in enlarged haemorrhoids. 

Ageing causes weakening of the supporting structures of the rectum and anal canal, which facilitates prolapse of the haemorrhoids. Weakening of support structures can occur as early as the third decade of life, especially in people who do not get any exercise. 

During pregnancy the pressure of the foetus in the abdomen, as well as hormonal changes, cause the haemorrhoidal vessels to enlarge. Haemorrhoids which develop during pregnancy disappear after delivery. 

Symptoms of Haemorrhoids

Haemorrhoids generally do not cause any symptoms except when enlarged, inflamed, thrombosed or prolapsed. In some cases symptoms disappear within a few days. But in most cases, haemorrhoidal symptoms eventually return and are often worse than they were before. 

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