Download Haemorrhoids - Yeovil District Hospital

If you have any other questions or need advice, please contact:
Colorectal/Stomacare Nurse
Between 8.30am - 5.00pm
01935 384352
Day Surgery Unit
Between 8am and 7pm
01935 384339
Haemorrhoids
After 7pm, the Senior Sister on duty
(Clinical Site Manager)
01935 384525
Day Surgery Unit
If you need this leaflet in another format,
e.g. large print please telephone:
01935 384256
Leaflet No: 82111013
02/13 Review date: 02/15
www.yeovilhospital.nhs.uk
Haemorrhoids (sometimes called piles) are swellings of the lining of the
anus and lower rectum (back passage). There is a network of small veins
(blood vessels) in the lining of the back passage and it
is thought that these veins become wider and swell with blood if the
pressure in and around them is increased. The veins and the
overlying tissue may then form into one or more small swellings which
are referred to as haemorrhoids.
Consequences and complications of haemorrhoidectomy,
excision or stapling
What causes haemorrhoids?
 Infection - often causes bleeding and worsening pain. May need antibiotics to treat this (relatively common).
An exact cause is unknown; however the upright posture of humans
alone forces a great deal of pressure on the rectal veins, which
sometimes causes them to bulge.
Other contributing factors include:
 Ageing
 Chronic constipation or diarrhoea
 Pain - often severe for 2-3 weeks and can last for several weeks. We
will give you painkillers and laxatives to reduce this
(very common after surgery).
 Bleeding - initially and 5-7 after surgery (relatively common).
 Recurrence - with surgery, over 5 years , at least 10% will get
recurrence of piles (relatively common).
 Anal stenosis (narrowing of the anus) - caused by excess
scarring, problems with emptying bowels (infrequent).
 Incontinence - leakage of faeces (infrequent complication).
 Pregnancy
 Heredity
 Obesity
 Faulty bowel function due to overuse of laxatives or enemas
 Straining during bowel movements
 Spending long periods of time on the toilet (e.g. reading)
Whatever the cause, the tissues supporting the veins stretch.
As a result, the veins dilate - their walls become thin and can bleed.
If the stretching and pressure continue, the weakened veins will
start to protrude.
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Haemorrhoidectomy - surgical removal of the haemorrhoids
There are two types of haemorrhoids:
Is a permanent way to remove haemorrhoids. It may become
necessary if:
External (outside) haemorrhoids - develop near the anus and are
covered by very sensitive skin. If a blood clot develops in one of them, a
painful swelling may occur. The external haemorrhoid feels like a hard
sensitive lump. It bleeds only if it ruptures.
 Clots repeatedly form in external haemorrhoids
 Ligation fails to treat internal haemorrhoids
 The protruding haemorrhoid cannot be reduced
 There is persistent bleeding
A haemorrhoidectomy removes excess tissue that causes the bleeding
and protrusion. It is done under anaesthesia and may, depending
on circumstances, require a stay in hospital and a period of inactivity.
Laser haemorrhoidectomies do not offer any advantage over
standard operative techniques. They are also expensive and contrary to
popular belief, no less painful.
Doctors are studying a new procedure that uses a stapling technique to
remove haemorrhoidal tissue and close the wound. No incision is made.
More studies are needed before the long term effects of this technique
are known.
Internal (inside) haemorrhoids - develop within the anus beneath the
lining. Painless bleeding and protrusion during bowel movements
are the most common symptom. However, an internal haemorrhoid can
cause severe pain if completely ‘prolapsed’ - which means it is
protruding from the anal opening and cannot be pushed back inside.
Internal
External
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Do haemorrhoids lead to cancer?
Treatment for haemorrhoids
No. There is no relationship between haemorrhoids and cancer.
However, the symptoms of haemorrhoids , particularly bleeding are similar
to colorectal cancer and other diseases of the digestive system. Therefore,
it is important that all symptoms are thoroughly
investigated by a specialist in diseases of the colon and rectum.
Ligation - rubber band treatment
Do not rely on over the counter medications or other self-treatments. See
your doctor first so your symptoms can be properly evaluated and effective treatment prescribed.
How are haemorrhoids treated?
Works effectively on internal haemorrhoids that protrude with bowel
movements (image A).
A small rubber band is placed over the haemorrhoid, cutting off its blood
supply (image B).
The haemorrhoid and the band fall off in a few days and the wound usually heals in a week or two. This procedure sometimes causes mild
discomfort and bleeding.
 Mild symptoms can be often be relieved by increasing the amount of
fibre (e.g. fruit, vegetables, pulses and cereals) and fluids in your diet
 Eliminating excessive straining reduces the pressure on
Ligator
haemorrhoids and helps prevent them from protruding
Forceps
 Sitting in a bath of plain warm water for about 10 minutes after
using the toilet may provide some relief
Rubber bands
 Appropriately prescribed medication, e.g. ‘Anusol’ to reduce
discomfort and swelling
Rectum
With these measures, the pain and swelling of most symptomatic haemorrhoids will decrease in two to seven days, and the firm lump should recede within four to six weeks.
If these measures do not relieve symptoms and you are still in severe, persistent pain, your doctor may refer you to a Colorectal Surgeon and you
can receive treatment as a day case patient.
The surgeon may decide to remove the haemorrhoid containing the clot
with a small incision, performed under local anaesthesia as an outpatient,
this procedure generally provides relief.
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Haemorrhoid
Often there is anal pain in the 24-48 hours following the banding. Occasionally there can be bleeding when the band separates.
Injection
We do not offer this at Yeovil District Hospital, but the doctor you
see will be able to discuss this with you.
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