What are haemorrhoids?
Piles, or haemorrhoids, are locally dilated rectal veins that supply the anal
canal (anus) with blood. Piles are separated into two categories, namely internal
and external. Their position is normally four, seven and eleven o’clock on a
watch. Between these piles new ones, called secondary piles, may develop after
the original ones have been removed. There are various grades of piles.
Enlarged piles which are not prolapsed and are in the normal position.
Enlarged piles that prolapse with every defecation but move back spontaneously.
Enlarged piles that prolapse and do not move back spontaneously, but can be
pushed back by hand.
Enlarged piles that are prolapsed and irreducible.
Coagulated piles in grades 1, 2, 3 or 4 that form a thrombus.
Very painful and swollen and can become inflamed if not treated in time.
- Clear anal bleeding which can be seen when wiping.
- A feeling that something is hanging out.
- Normally piles are not painful but sometimes pain may be experienced. Trombolised
piles are inflamed and painful.
- In some cases an anal fissure may appear.
- Piles cannot always be seen unless they prolapse.
Patients should seek medical advice if they experience any pain in the region of their anus.
Causes of haemorrhoids
- A history of constipation.
- A history of long-term pressure with every defecation.
- Pregnancy – but in this case it usually clears up by itself.
- A low fibre diet.
- A low intake of fluids.
- Can be treated conservatively, i.e. with medication, depending on the grade
of the piles.
- Change of diet: high fibre, plenty of fluids.
- Good toilet habits: no pressure, regular visits to the toilet and no holding
back until later.
- Grades 1 and 2 can be successfully treated conservatively.
- Grades 3 and 4 need to be surgically removed under general anaesthesia in
Surgery and post-operative care
- The surgeon will make arrangements for the operation under general anaesthesia.
- The patient may not eat or drink anything for six hours before the operation.
- After the operation there may still be minimal bleeding for seven to eight
days or longer.
- Medication to keep defecation soft will be prescribed.
- Plenty of fluids must be taken.
- After the operation, the patient takes sitz baths in hospital.