What are haemorroids?
Haemorrhoids or piles occur when the veins around the anus and lower rectum become swollen. They are extremely common in people of all ages, particularly pregnant women. At least half the population is likely to suffer from them at some stage in their lives. They are not dangerous but can be highly irritating.

Symptoms of piles
The most common symptoms are experiencing a discharge of blood from your anus which may be noticed in the toilet, on the stool or on toilet paper.

Other symptoms include a mucus discharge or pain when going to the toilet.

Types of piles
Piles look like pink swellings and can be either inside the anus or outside.

Internal piles fall into different categories: smaller swellings on the inside of the anal canal; those that protrude when you go to the toilet and then return; those that hang out and can only be returned when pushed back and finally those that hang out at all times.

External piles are small lumps that develop just outside the anal canal and are not as common as internal haemorrhoids.

What causes piles?
The reason why piles form is not an exact science however it is generally agreed that pressure on the rectum and anus may play a major role. Other factors include straining on the toilet, pregnancy, varicose veins, family history or simply vulnerable veins in that area of your body.

Haemorrhoid examination
This is likely to involve the insertion of a gloved finger into your anus to check for abnormalities. In some cases a proctoscope, or small telescope, is inserted to allow the doctor to see what problems you may be encountering in your rectum or large bowel.

Treating piles at home
Haemorrhoids are irritated by the pressure of constipation and straining so it is important to go to the toilet regularly, eat plenty of fibre such as brown rice, fruit or wholemeal bread and drink six to eight glasses of water a day. A softer stool makes emptying the bowels easier and prevents potential pile problems.

There are also plenty of pile creams and suppositories available on the market which can be used to relieve symptoms. Additionally, taking a warm bath a couple of times a day will help.

If self-treatment doesn’t work and you continue to suffer from piles it is important to seek medical attention. Procedures include:

Banding: Here an elastic band is placed around the base of the pile so the blood supply is reduced and the haemorrhoid eventually drops off.

Sclerotherapy: This requires the injection of a solution usually containing phenol into the haemorrhoid which causes them to shrink.

Cyrosurgery: This involves the freezing of piles which again causes them to wither and drop off.

Light coagulation: Here infrared rays are used to restrict the piles’ blood flow and force them to shrink.

Surgery: In serious cases of piles, usually those that cannot be returned inside the anus, a surgeon will make an incision in the pile, remove excess tissue and stitch up the wound. This procedure is known as a haemorrhoidectomy.

Deciding on surgery
Complications are rare and depend greatly on individual circumstances such a person’s health and the extent of the procedure. Your surgeon will be able to explain how the risks apply in your circumstances.

Prior to the procedure you may want to know:

• About the surgeon’s qualifications.
• How many operations of your procedure are carried out each year.
• How you prepare for the surgery.
• What realistic results can be expected and when.
• How long the results will last.
• About the side-effects and possible complications.
• How long it will take to recover.
• What happens if anything goes wrong.