Haemorrhoids or Piles

Haemorrhoids (also known as piles) occur when a vein or veins found in the anus (the lower end of the bowel) become dilated and inflamed. Haemorrhoids are similar to varicose veins, but occur in the region of the anus.

There are three types of haemorrhoids:
• External haemorrhoids - small spots of bleeding that occur under the skin around the anus that feel like hard lumps.
• Internal haemorrhoids - found inside the rectum and are usually painless but may bleed.
• Prolapsed haemorrhoids - a more severe and painful form of internal haemorrhoids. These haemorrhoids push through the anus and hang out of the body, especially after going to the toilet.

RISK FACTORS
Certain activities can weaken the tissue that provides support to the blood vessels in the anus and rectum and increase the risk of haemorrhoids developing.
These activities include:
• Increasing age
• Constipation
• Prolonged straining (e.g. long periods on the toilet, heavy manual labour)
• Pregnancy.

SYMPTOMS
• Bleeding (the blood is usually bright red and is usually noticed on toilet paper or in the toilet bowl). Note: haemorrhoids may not be the cause of rectal bleeding and it is important that patients with rectal bleeding visit their doctor to determine the cause.
• Lumps or prolapse (appearance of the internal lining of the anus outside the anal aperture) after defecation
• Pain or discomfort
• Itching
• Burning sensation
• Soiling of the underwear.
• Internal haemorrhoids may cause a feeling that a bowel movement was incomplete. Note: rectal tumours may also cause a feeling of incomplete evacuation, so it is important to see your doctor to rule out more serious conditions such as colorectal cancer.

TREATMENT OPTIONS
Consult your Doctor to diagnose and treat this condition. A procedure called sclerotherapy (where the haemorrhoid is injected with a chemical called phenol) is used to control bleeding from haemorrhoids. Larger haemorrhoids may require 'rubber band ligation', where a small rubber band is tightly applied to internal haemorrhoids and causes the haemorrhoid tissue to die.

DIET HINTS
• Increase the amount of fibre in the diet to make the stools softer and to reduce straining.
• Chronic constipation is considered a major cause for the formation of haemorrhoids. The diet should be high in vegetables, fruits, cereals and water to provide the fibre and fluids required to soften faecal matter.
• Increase soluble fibre intake. Soluble fibre is found in fresh, raw fruits and vegetables and rolled oats.
• Vitamin C and bioflavonoids are thought to strengthen the walls of blood vessels. Foods high in vitamin C and bioflavonoids are fresh raw fruits and vegetables, especially cabbage, green peppers, citrus fruits with the pith included, rosehips and blackcurrants and whole grains, seeds and nuts.
• Avoid packaged and refined foods. These promote dehydration and are low in fibre. Increase the consumption of fresh whole foods.
• Avoid constipating foods such as red wine, chocolate, tea, coffee, cocoa and cola.

VITAMINS/MINERALS/HERBS
• Vitamin C may strengthen rectal tissue and therefore be beneficial in treating haemorrhoids
• Bioflavonoids such as rutin and hesperidin have been shown to be effective in treating haemorrhoids. Bioflavonoids may reduce swelling and prevent bleeding of haemorrhoids.
• Butcher's broom is an herb that may constrict and reduce inflammation of haemorrhoidal tissue has anti-inflammatory actions and constricts blood vessels. Buther's Broom is particularly effective for the relief of burning and itching from haemorrhoids.
• Witch hazel can be applied directly to treat bleeding haemorrhoids and relieve inflammation and pain.
• Aloe vera can be applied directly to the haemorrhoid via a gel. This can relieve pain and soothe the burning sensation. Aloe vera can also be taken internally as a juice and can be healing and soothing to the digestive tract.
• Horse chestnut can improve circulation and reduce swelling of haemorrhoids. It can also make blood vessels more elastic.
• Flaxseed oil can assist in regularity of bowel movements and reduce straining. The essential fatty acids can promote tissue healing.
• Psyllium is a good fibre supplement, which can reduce the pain, and bleeding associated with haemorrhoids.
• Acidophilus a probiotic contains friendly bacteria such as lactobacillus, which can improve digestion and constipation.

PHARMACIST'S ADVICE
Ask your MedAux Pharmacist for advice.
1. Follow the Diet Hints
2. Keep the bowels regular and avoid constipation. Ask your Pharmacist about some fibre products if you are having any difficulty. Stool softeners are suggested for some patients.
3.If the pain is severe, there are pain-relieving tablets available. Be aware that codeine may cause constipation.
4. Your Pharmacist can recommend a suitable Haemorrhoid ointment. Ask for advice.
5.Use a mild soap and water after each bowel movement to clean the area and then pat dry to provide hygiene and help with the healing. Using a medicated wipe may also help.
6.Some dietary supplements may be taken if the diet is inadequate. Ask your Pharmacist for advice on dosages and interactions.
7. A gentle astringent such as witch hazel lotion has a soothing effect when applied to Haemorrhoids. The astringency of witch hazel helps to draw together and heal the veins, providing relief by cooling and relieving the inflammation. It can be applied icy cold or warm, depending on which is more effective for the individual.