Haemorrhoids are also known as piles. They occur when blood vessels around the anus and rectum swell up and enlarge, creating a hanging lump that can protrude from the anus. This lump may need to be pushed back in after going to the toilet. There are several degrees of piles, in most cases the symptoms are mild and relatively painless and often clear up on their own. In cases where piles are causing some discomfort, for example an itch or soreness around the anus, then non-prescription treatments are available to purchase. If these treatments don’t relieve the discomfort, or you experience pain or bleeding after passing a stool then it is recommended you speak to your GP.
What exactly causes piles is still unclear. What we do know is that they are associated with increased pressure in the blood vessels located in and around the anus. The majority of cases are believed to be caused by excessive straining when using the toilet. This is often due to a low fibre diet resulting in constipation. There are other factors that can increase the likelihood of developing haemorrhoids, these include:
- Having a family history of piles
- Being overweight
- Being over 45 years of age
- Regularly lifting heavy weights
- Long periods of sitting down
- Prolonged diarrhoea
- A persistent cough
- Repeated vomiting
There are two main types of piles, these are internal piles and external piles. Internal piles occur above the line inside the anus called the dentate line. External piles will occur below this line. The dentate line is a visible line that marks where the nerves inside the anal canal are able to detect pain. Nerves below the dentate line are capable of detecting pain signals whereas the nerves above it are not.
There are varying degrees of piles, which are classified by their size and severity.
- First degree haemorrhoids cannot be seen outside the anus. They develop on the lining inside of the anus and are small in size.
- Second degree haemorrhoids are larger in size. These swellings may protrude out from the anus when going to the toilet, before retracting back inside.
- Third degree haemorrhoids comprise of one or more soft lumps that hang down from the anus. These can be pushed back inside, known as reducible.
- Forth degree haemorrhoids differ from third degree haemorrhoids by being larger in size. They are also irreducible – they cannot be pushed back inside.