Many people have haemorrhoids at some time during their lives. Although many people have haemorrhoids not all experience symptoms. The symptoms of haemorrhoids can be treated any even prevented by simple home measures.

What are Haemorrhoids?
Haemorrhoids are swollen veins in the anal canal. These swellings of the lining of the lower rectum (back passage) can become very painful, but is usually not serious.
Veins can swell inside the anal canal to form internal haemorrhoids, or they can swell near the opening of the anus to form external haemorrhoids. You can have both at the same time.

What causes haemorrhoids?
Many individuals develop haemorrhoids for no apparent reason. Haemorrhoids can be caused by too much pressure on the veins in the pelvic and rectal area causes hemorrhoids. Normally, tissue inside the anus fills with blood to help control bowel movements. If you strain to move stool, the increased pressure causes the veins in this tissue to swell and stretch. This can cause hemorrhoids.
Diarrhea or constipation also may lead to straining and can increase pressure on veins in the anal canal.
Pregnant women can get hemorrhoids during the last 6 months of pregnancy. This is because of increased pressure on the blood vessels in the pelvic area. Straining to push the baby out during labor can make hemorrhoids worse.
Being overweight can also lead to hemorrhoids.

What are the symptoms?
The most common symptoms of both internal and external hemorrhoids include:
• Bleeding during bowel movements. You might see streaks of bright red blood on toilet paper after you strain to have a bowel movement.
• Itching.
• Rectal pain. It may be painful to clean the anal area.

Internal hemorrhoids
With internal hemorrhoids, you may see bright red streaks of blood on toilet paper or bright red blood in the toilet bowl after you have a normal bowel movement. You may see blood on the surface of the stool.
Internal hemorrhoids often are small, swollen veins in the wall of the anal canal. But they can be large, sagging veins that bulge out of the anus all the time. They can be painful if they bulge out and are squeezed by the anal muscles. They may be very painful if the blood supply to the hemorrhoid is cut off. If hemorrhoids bulge out, you also may see mucus on the toilet paper or stool.

External hemorrhoids
External hemorrhoids can bleed, and then the blood pools, causing a hard painful lump. This is called a thrombosed, or clotted, hemorrhoid.
How are hemorrhoids diagnosed?
Your doctor can tell if you have hemorrhoids by doing a physical exam.
You may not need many tests at first, especially if you are younger than 50 and your doctor thinks that your rectal bleeding is caused by hemorrhoids.
Rectal bleeding can be a sign of a more serious problem, such as colon, rectal, or anal cancer. So if the first exam does not show a clear cause of your problems, your doctor may use a lighted scope (sigmoidoscope) to look at the lower third of your colon. Or your doctor may use another kind of scope (colonoscope) to look at the entire colon to check for other causes of bleeding.

What is the treatment for haemorrhoids?
Avoid constipation and straining at the toilet
Keep the faeces (sometimes called stools or motions) soft, and don’t strain on the toilet. You can do this by the following:
• Eat plenty of fibre by eating plenty of fruit, vegetables, cereals, wholemeal bread, etc.
• Have lots to drink. Adults should aim to drink at least two litres (10-12 cups) per day. You will pass much of the fluid as urine, but some is passed out in the gut and softens faeces. Most sorts of drink will do, but alcoholic drinks can be dehydrating and may not be so good.
• Fibre supplements. If a high fibre diet is not helping, you can take bran, or other fibre supplements (‘bulking agents’).
• Avoid painkillers that contain codeine such as co-codamol, as they are a common cause of constipation.
• Toileting. Go to the toilet as soon as possible after feeling the need. Some people suppress this feeling and plan to go to the toilet later. This may result in bigger and harder faeces forming which are then more difficult to pass. Do not strain on the toilet. Haemorrhoids may cause a feeling of ‘fullness’ in the rectum and it is tempting to strain at the end to try and empty the rectum further. Resist this. Do not spend too long on the toilet, which may encourage you to strain. (For example, do not read whilst on the toilet.)
The above measures will often ease symptoms such as bleeding and discomfort. It may be all that you need to treat small and non-prolapsing haemorrhoids. Normally, tissue inside the anus fills with blood to help control bowel movements. If you strain to move stool, the increased pressure causes the veins in this tissue to swell and stretch. This can cause hemorrhoids.
Diarrhea or constipation also may lead to straining and can increase pressure on veins in the anal canal.
Pregnant women can get hemorrhoids during the last 6 months of pregnancy. This is because of increased pressure on the blood vessels in the pelvic area. Straining to push the baby out during labor can make hemorrhoids worse.
Being overweight can also lead to hemorrhoids.

Specific treatment options
For most external hemorrhoids, home treatment is all you need. This includes slowly adding fiber to your meals, drinking more water, and using over-the-counter ointments for a limited time to stop itching. You also may use stool softeners. The same home treatment can be used for most internal hemorrhoids.
If your hemorrhoids are severe, you may need other treatment. The doctor may tie off the hemorrhoids with rubber bands, scar the tissue around the hemorrhoids, or put a shot of chemicals in them. These treatments reduce the blood supply to the hemorrhoids so that they shrink or go away.
Surgery to remove hemorrhoids may be done if other treatments don’t work.

Conclusion
Haemorhoids or Piles are very common and it is estimated that approximately half of the population has haemorrhoids by age 50. The rectal bleeding associated with haemorhoids can be scary to some but in the vast majority of patients haemorrhoids are not serious and can be successfully treated.

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