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Haemorrhoids

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What are haemorrhoids?

Haemorrhoids (piles) are swollen blood vessels in the anal canal (back passage). This creates swellings, similar to varicose veins that some people have on their legs. They are very common. One in three people experience haemorrhoids at some time in their life.

The most usual cause is constipation: this is because straining to open the bowels causes congestion of and eventually enlargement of the veins in the anal canal. Haemorrhoids also seem to occur more frequently in some families and are more common during or after pregnancy. They can cause bleeding and discomfort and many protrude outside the anal canal. There are a number of different treatment options the most commonly used at Milton Keynes University Hospital are:

  • Injecting
  • Banding

What is injecting of piles and how will it help me?

The doctor who examined you felt that injecting your piles would be the best treatment option for you. This involves injecting a small amount of a chemical called phenol (usually 5% phenol in arachis oil) near the haemorrhoid causing the haemorrhoid to shrivel up. This treatment will usually take 4-6 weeks to be effective, so you should not expect immediate relief. Many people require more than one injection.

What should I do when I get home?

You may experience some discomfort or a feeling of fullness in the anus for a day or so after the injection. You should take your regular household painkillers such as Paracetamol if you need to.

After your treatment you may feel that you want to open your bowels. Do not worry if you have to, but try to avoid straining.

You may see some minor spots of blood on your stools when you open your bowels or on the tissue when you wipe yourself. You may also have a minor discharge or spots of blood from the anus for a couple of days.

Avoid strenuous exercise for the rest of the day. For example, avoid sport, jogging or riding a bike.

You can bath or shower as you wish.

You should be able to get back to your normal life the next day.

Complications following injection of haemorrhoids are very rare. In the exceptional circumstance that you develop problems with the bladder or genital area shortly after injection, particularly if you have a high temperature, you should attend your local Casualty Department with this leaflet. You may be seen again in 6-12 weeks.

What is ‘banding’ and how will it help me?

The doctor who examined you felt that banding your piles would be the best treatment option for you. This involves using a small instrument to put a very tight elastic band over the haemorrhoid. This band cuts off the blood supply so that the haemorrhoid should drop off, usually within 3-7 days after the banding. The principle of this procedure is same as for docking lambs tails.

What should I do when I get home?

  • You may experience some pain or discomfort for a day or so after the banding. You should take your regular household painkillers (such as paracetamol) if you need to. Very occasionally these do not work effectively and you may need to ask your pharmacist or contact your GP for something stronger.
  • After your treatment you may feel that you want to open your bowels. Usually this feeling wears off after a time. If you find it necessary to open your bowels do not worry, but try to avoid straining.
  • Avoid using any applicators or creams directly into the anus.
  • Avoid strenuous exercise for the rest of the day. For example, avoid playing sport, jogging or riding a bike.
  • You can bath or shower as you wish.
  • You should be able to get back to your normal life the next day.

What should I do if I bleed after I go home?

  • A small amount of bleeding on your stool or on the toilet paper when you wipe yourself is normal. You may notice bleeding when the haemorrhoids fall off, leaving a small raw area inside the anus, (usually about 1 week after banding). You will probably not see the haemorrhoids or bands as they will pass down the toilet with a bowel motion.
  • Very rarely there can be more major bleeding. If you see a lot of fresh bright red blood or pass clots, you should seek urgent medical attention.
  • You may be seen again in 6-12 weeks to check that the banding has been successful.

Sometimes the banding needs to be repeated.

Can I prevent the haemorrhoids coming back?

Unfortunately, having your haemorrhoids injected/banded does not guarantee that they will never come back. You now know that you have a tendency to develop haemorrhoids, so it makes sense to try to avoid this happening in the future.

Some doctors feel that the best way of preventing haemorrhoids is to avoid straining to open your bowels and to go when you feel the urge rather than putting it off because you are busy. Try to increase the amount of fibre and water in your diet. Fibre forms the structure of cereals, fruit and vegetables. It is not completely digested and absorbed by the body, so it provides bulk to the stools. This helps the movement of waste through the bowel resulting in soft stools which are easy to pass.

Further Information – Colorectal Nurse Specialist – 01908 243305.

This leaflet is based on one designed by the Association of Coloproctology of Great Britain and Ireland, but has been modified (with permission) by us to reflect local policies. The Association of Coloproctology web site (www.acpgbi.org.uk) has further information on all aspects of colon and rectal disease.

People are unique and the alternatives, risks and benefits will of course vary from person to person. We hope this leaflet will support the information you have already received from your doctor in enabling you to make an informed decision about your treatment.