Haemorrhoids are blood vessels that reside in the anal canal (in and around the bottom) in healthy individuals. When they can become inflamed or swollen they can cause a disease known as piles (haemorrhoid disease).
Classification of haemorrhoid disease
The haemorrhoid vessels exist in two groups: internal and external, separated by the dentate line.
Internal haemorrhoids lie deep within the rectum and in a diseased state, do not typically cause pain or discomfort, although they do bleed. This is because there are few nerves in this portion of the body. They are rarely visible from the surface of the skin.
External haemorrhoids lie within the anus, and are closer to the skin surface. In the diseased state, they can become visible from the body surface and can also cause significant discomfort, or pain.
Despite their apparent severity, swollen haemorrhoids are rarely problematic as the disease usually resolves itself within a matter of days.
Causes
Haemorrhoid disease is very common and as many as 50% of people experience them at one time or another. They are more common, however in:
Signs and symptoms
There are several signs and symptoms associated with haemorrhoid disease, including:
Diagnosis
Although haemorrhoid disease normally resolves within a few days, and is not especially serious it is important to speak to your doctor if you notice rectal bleeding as:
The doctor will normally ask a few questions before performing a physical examination, such as the length of time rectal bleeding has been present, the colour or shade of the blood and if you feel any discomfort when on the toilet.
The doctor may then perform a rectal examination. This will involve the doctor examining your bottom to see if there are any visible swellings. They may also examine you internally to assess for signs of inflammation or swelling – this is called a digital (finger) rectal examination.
The doctor may also use a proctoscope (a thin tube with a light on the end) to visualise better the inside of your anus. A small tissue sample (biopsy) may be performed so it can be tested in a laboratory.
Treatment
Haemorrhoid disease normally resolves within a matter of days, and does not cause any long-term issues. However, there are several treatments that may be used to ease the discomfort associated with it, including:
1) Cutting out the inflamed haemorrhoids under general anaesthetic
2) Haemorrhoidal artery ligation (HALO) to reduce the blood flow to the haemorrhoids – this will ultimately cause the inflamed vessels to shrink in size. We do not currently offer this treatment at the London Gastroenterology Centre. (Please also note that this treatment is entirely different to the HALO Radiofrequency ablation treatment for Barrett’s oesophagus, which we do offer!)
3) Laser surgery – the diseased blood vessels will scar and harden and no longer cause rectal bleeding or pain
Who can help me with haemorrhoid disease?
Our top private consultants at the London Gastroenterology centre have years of experience in dealing with gastrointestinal problems and are experts in the investigations needed such as colonoscopy. If you would like to book an appointment with us, please call 020 7183 7965.