Understanding haemorrhoids: Insights and treatments

In his latest online article, Mr Sebastian Smolarek gives us his insights into haemorrhoids. He talks about the symptoms and how to recognise them, the causes, risk factors, the available treatment options, prevention, and the recovery process.

What are the symptoms of haemorrhoids and how can I recognise them?

Haemorrhoidal disease is a relatively frequent, non-serious condition in the gastrointestinal tract. Haemorrhoids are blood vessel cushions that create a tight seal around the anus, preventing faecal leakage from the rectum. When these cushions enlarge, they can lead to various symptoms such as bleeding during bowel movements, protrusion of tissue from the anus, faecal leakage, itching, anal pain, and mucosal prolapse.

What causes haemorrhoids and what are the risk factors associated with the development?

 The development of haemorrhoids involves multiple factors, and risk factors include obesity, pregnancy, constipation, straining during bowel movements, engaging in heavy weight lifting, prolonged sitting, particularly on the toilet, and a genetic predisposition.

What are the available treatment options for haemorrhoids and how do they vary in effectiveness?

Haemorrhoid treatment is typically categorised into two main approaches: conservative and surgical. Conservative treatment is recommended as supportive care regardless of the disease's stage. It involves measures like taking stool softeners, adopting a high-fibre diet, staying hydrated, avoiding excessive straining during bowel movements, and using medications, suppositories, ointments, or creams to alleviate symptoms. These medications often have anti-inflammatory, analgesic, or local anaesthetic properties.

Surgical treatment options vary based on the severity of symptoms and disease stage. Minimally invasive procedures, such as haemorrhoidal banding and laser haemorrhoidoplasty, can be performed on an outpatient basis. For more advanced cases, more invasive surgical procedures become necessary. These include ligation techniques such as Doppler-guided hemorrhoidal artery ligation (THD) with or without haemorrhoid fixation and excisional procedures like excision haemorrhoidectomy.

How can I prevent haemorrhoids from occurring or recurring?

In general, adjusting risk factors can help prevent the occurrence of haemorrhoids. It is advisable to manage weight, use stool softeners, maintain a high-fibre diet rich in fruits and vegetables, and avoid constipations.. These measures significantly lower the risk of developing haemorrhoids. Caution is advised, particularly in heavy weightlifting situations, where using less weight and focusing on higher exercise intensity is recommended.

What is the recovery process like after haemorrhoid surgery and what can I expect in terms of pain and discomfort?

The recovery process varies slightly between ligation procedures and resection haemorrhoidectomy. Following a ligation procedure, the duration of pain is shorter, and the overall recovery is quicker. However, patients may still experience perianal pain, especially after bowel movements, lasting for two to three weeks on average. This discomfort can be alleviated by taking anti-inflammatory medication, painkillers, and short-term antibiotics like metronidazole. Additionally, bed rest and avoiding strenuous physical activities are necessary for the initial two to three weeks.

Mr Sebastian Smolarek is a respected colorectal surgeon with over 15 years of experience. You can schedule an appointment with Mr Smolarek on his Top Doctors profile.