Internal Haemorrhoids / Internal Hemorrhoids
It has been estimated that fifty per cent of the population
suffer from this problem by the time they are fifty years old. Although haemorrhoids
contain many blood vessels, they are not varicose veins. They are the result
of a sliding down of the lining of the bowel caused by straining.
SYMPTOMS
The commonest early symptom is bleeding.
Bright red blood is seen in the toilet or on the paper. As
the haemorrhoids enlarge, they may prolapse during a bowel action,
causing discomfort. Later, further swelling can develop, causing
pain. A discharge may cause moisture on the buttocks with resulting
irritation. This is often caused by additional thrush infestation.
With very large haemorrhoids, there can be a feeling of the need
to “hurry to go again”.
WARNING
If you see blood on the toilet paper or in the toilet
OR
If you have any other symptoms suggesting
haemorrhoids, SEE YOUR GENERAL PRACTITIONER.
TREATMENT
Operation was invariably the treatment
for all but the smallest piles. This is now rarely performed,
as they can
be managed by simple office procedures, causing less
discomfort and inconvenience for the patient. The
commonest method of treatment is rubber band ligation.
A small rubber ring is stretched over the pile and when it
springs back it stops blood supply to the pile (see photo
and illustration below). The pile dies and eventually
falls
off. Most patients can return to work immediately. No
anaesthesia is required.
It is vital for a doctor performing rubber band ligation
to ensure that there are no other more serious disorders
present in the bowel. This is most effectively done by
either partial (sigmoidoscopic) or total (colonoscopic)
inspection of the bowel.
PREVENTION
Straining at stool on repeated occasions
should be avoided. A diet to soften the bowel content with
vegetable fibre is indicated. The addition of unprocessed
bran to the diet is sometimes necessary. Purgative
medicines should be avoided as they can aggravate the
condition and in the long term harm the bowel.
Above: Treatment
of internal
haemorrhoids is by rubber
band ligation. The band is
painlessly applied to the
haemorrhoid.
Above: Haemorrhoid after
treatment with rubber band.
DANGER
Getting rid of haemorrhoids is usually simple
and can be done on an in-out basis. However,
every symptom of haemorrhoids can be
mimicked by cancer of the bowel, the
commonest cancer in Australia, and danger
lies in misdiagnosis and failure to distinguish other conditions
that may be present.
Return to Colonoscopy Information for Patients
Read about PPH and Stapled Hemorrhoidectomy Treatment
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