GENERAL HEALTH CONCERN

Haemorrhoids

Also called: haemorrhoids, hemorrhoids, piles, anal fissure

Haemorrhoids, commonly known as piles, are enlarged or swollen blood vessels and supporting tissues in and around the anus and lower rectum.

TYPICALLY OCCURS

Straining, constipation, pregnancy and increased abdominal pressure

TREATED BY

Haemorrhoid surgery, banding and symptom management

ALSO LINKED TO

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Why it happens?

Haemorrhoidal tissue is a normal part of the anal canal and helps contribute to bowel control. Problems develop when the blood vessels and supporting tissues in this area become enlarged, swollen or displaced. Repeated straining during bowel movements and chronic constipation can increase pressure within these vessels, making haemorrhoids more likely to become symptomatic. Spending prolonged periods on the toilet and regularly passing hard stools may contribute by placing additional pressure on the anal region.

Other factors that increase abdominal or pelvic pressure can also contribute. Haemorrhoids are particularly common during pregnancy because hormonal changes, increased blood volume and pressure from the growing uterus affect the pelvic veins. Ageing can weaken the connective tissues supporting the anal canal, while excess body weight and repeated heavy straining may increase pressure in the area. Chronic diarrhoea can also irritate the anal canal and may contribute to haemorrhoidal symptoms in some people.

Haemorrhoids can be internal or external. Internal haemorrhoids develop inside the anal canal and commonly cause painless bright-red bleeding during or after a bowel movement. Larger internal haemorrhoids can prolapse, meaning they extend through the anus and may cause irritation, mucus or discomfort. External haemorrhoids occur beneath the skin around the anus and can become painful if a blood clot develops inside them, known as a thrombosed external haemorrhoid. Importantly, rectal bleeding should not automatically be assumed to be caused by piles, because other bowel and anal conditions can produce similar symptoms.

How far along is it?

Early

Haemorrhoids remain inside the anal canal. They may cause bright-red bleeding, itching or irritation but do not protrude through the anus.

Moderate

Haemorrhoids may protrude during a bowel movement. They may return inside by themselves or require gentle manual reduction, and bleeding, mucus, itching or discomfort can become more noticeable.

Advanced

Haemorrhoids remain prolapsed or become increasingly difficult to reduce. Significant swelling, recurrent bleeding or discomfort may occur. External haemorrhoids can also become acutely painful if thrombosed.

What addresses it?

Treatments that address this

Haemorrhoid surgery→Anal fissure treatment→

Professional assessment is worthwhile when haemorrhoid symptoms persist, repeatedly return or interfere with sitting, bowel movements or everyday activities. Recurrent prolapse, persistent itching or discomfort and significant or repeated bleeding are reasons to seek medical advice.

Rectal bleeding should not automatically be attributed to haemorrhoids. Seek medical assessment for new or unexplained bleeding, particularly if it occurs alongside a persistent change in bowel habits, unexplained weight loss, abdominal pain, unusual tiredness or other new bowel symptoms.

Seek urgent medical attention for heavy or continuous rectal bleeding, black or dark tar-like stools, fainting or dizziness associated with bleeding, or severe rapidly worsening anal pain with significant swelling or fever.

Quick Questions:

What are the most common symptoms of haemorrhoids?

Common symptoms include bright-red bleeding after passing stool, itching or irritation around the anus, swelling, discomfort and a lump or prolapse. External haemorrhoids may become particularly painful if a blood clot develops.

What causes haemorrhoids?

Haemorrhoids are associated with increased pressure on blood vessels and supporting tissues around the anus and rectum. Constipation, straining, pregnancy and ageing are common contributing factors.

Do haemorrhoids go away on their own?

Mild haemorrhoid symptoms can sometimes improve with changes that reduce constipation and straining. However, larger, prolapsing or repeatedly symptomatic haemorrhoids may persist and benefit from professional assessment.

Is rectal bleeding always caused by haemorrhoids?

No. Haemorrhoids are a common cause of bright-red rectal bleeding, but bleeding can also result from anal fissures, inflammation, bowel polyps and other gastrointestinal conditions. New, persistent or unexplained rectal bleeding should be appropriately assessed.