What are haemorrhoids?
Haemorrhoids, also known as piles, is the name of a common condition in which blood vessels swell up and appear as small lumps inside or around the bottom. This swelling can cause the area to become itchy, sensitive, and even painful, particularly during a bowel movement. If you are suffering from piles, you may feel a small bulge when wiping your bottom or see bright red blood on the tissue after going to the toilet, among several other symptoms.
Symptoms of haemorrhoids may include:
- Bright red blood after a bowel movement
- An itchy bottom (anus)
- The feeling of still needing to go to the toilet
- Mucus on underwear or after wiping
- Lumps or pain around the anus.
Approximately 75% of people will experience haemorrhoids at some point in their life and often more than once. So if you’re currently suffering, or have suffered from piles in the past, it’s good to know you’re not alone.
Different types of haemorrhoids
There are different types of haemorrhoids that range from causing mild discomfort to more severe pain and itching that can make everyday activities like walking or sitting very bothersome.
Internal haemorrhoids, as the name suggests, occur deeper inside the bottom so tend not to cause too much pain or discomfort. However, they can still bleed and this is how you can usually identify them.
In rare cases, internal haemorrhoids can become bigger so that they protrude outside of the bottom and become prolapsed haemorrhoids.
Internal haemorrhoids are classified according to whether they come out of the bottom and how far they protrude:
- First degree piles may bleed but don’t come out
- Second degree piles come out after a bowel movement but go back inside on their own
- Third degree piles come out and don’t go back inside unless you push them in
- Fourth degree piles always come out, are very painful and can’t be pushed back in.
External haemorrhoids can also be very sensitive and painful as they occur close to the skin around the anus where there are more pain-detecting nerve endings. If they are prolapsed, you may be able to feel these as bulges near your bottom when going to the toilet.
A thrombosed haemorrhoid occurs if the blood inside a haemorrhoid clots which can also feel very painful and uncomfortable.
What causes haemorrhoids?
In their normal state, haemorrhoids are actually ‘cushions’ around the bottom filled with blood vessels that act as buffers to help us pass our stool with greater ease and comfort. They also help us control our bowel movements. However, they are quite delicate and prone to swelling if there is too much pressure on them, for example during pregnancy, when overweight, or due to too much straining (e.g. on the toilet or even at the gym).
The most common causes of haemorrhoids include:
- Excessive straining and heavy lifting
- Low fibre diet
- Spending a long time on the toilet (e.g. due to constipation or diarrhoea)
- Older age.
Excessive straining and heavy lifting
One of the leading causes of haemorrhoids is straining too much on the toilet. When we push too hard during a movement, this can cause the blood vessels or veins beneath our skin around the anus to fill up and swell, causing haemorrhoids to develop.
Although exercise is generally good for you, heavy lifting (much like straining too much) puts increased pressure on the muscles and blood vessels around the bottom and may cause piles to develop.
Constipation and diarrhoea
Constipation is one of the main reasons that we might find ourselves straining too much on the toilet. If you haven’t had three or more bowel movements in the last week or the stool is difficult to push out you might be suffering from constipation.
On the other hand, going to the toilet too frequently because of diarrhoea can also lead to haemorrhoids, again, due to increased pressure and tension around the bottom.
Low fibre diet
A healthy, balanced diet is important for maintaining a good digestive system among many other bodily functions. Including enough fibre in our diet helps to keep our stools soft, which minimises constipation and keeps things moving through the digestive system.
If we don’t eat enough fibre, our stools can become hard and difficult to pass, causing us to strain more than usual when going to the toilet. It’s this straining and pressure on the bottom that can result in piles.
Carrying excess body weight in obesity can also contribute to the development haemorrhoids due to the added pressure it causes on the blood vessels round the bottom. If you feel weight may be having an affect on your health, speak to a doctor about losing weight in a healthy manner.
During pregnancy the female body undergoes hormonal changes and some of these hormones can relax the veins, including those around the anus, making them more susceptible to developing haemorrhoids. Additionally, the added weight of the baby and pushing during childbirth is thought to put more pressure on the blood vessels around the bottom.
You can find out more about piles during pregnancy here.
As we get older the ageing process causes general wear and tear on our bodies, and the weakening of our tissues and blood vessels can cause the unpleasant side effect of piles. It’s no surprise that piles are most common between the ages of 45 and 65, however, as we’ve read so far, they can occur at any point in our lives and can be caused by a number of reasons.
Unfortunately, piles can reappear particularly if their cause hasn’t been fully addressed. However, there are a number of things you can do to help manage the symptoms if they do come back again.