Haemorrhoids are swollen veins that can be internal, which means they're inside the rectum, or external, which means they're outside the rectum.
What are the grades of haemorrhoids?
The severity of haemorrhoids is classified by grades as follows:
Grade 1: no prolapse
Grade 2: prolapse that goes away by itself
Grade 3: prolapse that you have to push back in on your own
Grade 4: prolapse that you can't push in on your own and causes you pain
What are the symptoms?
Signs and symptoms of haemorrhoids usually depend on the type of haemorrhoid.
These are under the skin around your anus. Signs and symptoms might include:
- Itching or irritation in your anal region
- Pain or discomfort
- Swelling around your anus
Internal haemorrhoids lie inside the rectum. You usually can't see or feel them, and they rarely cause discomfort. But straining or irritation when passing stool can cause:
- Painless bleeding during bowel movements. You might notice small amounts of bright red blood on your toilet tissue or in the toilet.
- A haemorrhoid to push through the anal opening (prolapsed or protruding haemorrhoid), resulting in pain and irritation.
If blood pools in the external haemorrhoid and forms a clot (thrombus), it can result in:
- Severe pain
- A hard lump near your anus
How is haemorrhoid diagnosed?
- Digital examination Your doctor inserts a gloved, lubricated finger into your rectum. He or she feels for anything unusual, such as growths.
- Visual inspection Because internal haemorrhoids are often too soft to be felt during a rectal exam, your doctor might examine the lower portion of your colon and rectum with an anoscope, proctoscope or sigmoidoscope.
What are the treatment options available for haemorrhoids?
- Medications - If your haemorrhoids produce only mild discomfort, Your doctor might suggest over-the-counter creams, ointments, suppositories or pads. These products contain ingredients such as witch hazel, or hydrocortisone and lidocaine, which can temporarily relieve pain and itching.
- External haemorrhoid thrombectomy - If a painful blood clot (thrombosis) has formed within an external haemorrhoid, your doctor can remove the haemorrhoid, which can provide prompt relief. This procedure, done under local anaesthesia, is most effective if done within 72 hours of developing a clot.
- Rubber band ligation -Your doctor places one or two tiny rubber bands around the base of an internal haemorrhoid to cut off its circulation. The haemorrhoid withers and falls off within a week.
- Sclerotherapy - Your doctor injects a chemical solution into the haemorrhoid tissue to shrink it. While the injection causes little or no pain, it might be less effective than rubber band ligation.
- Coagulation (infrared, laser or bipolar)- Coagulation techniques use laser or infrared light or heat. They cause small, bleeding internal haemorrhoids to harden and shrivel. Coagulation has few side effects and usually causes little discomfort.
- Haemorrhoid removal (hemorrhoidectomy) - Haemorrhoidectomy is the most effective and complete way to treat severe or recurring haemorrhoids. Complications can include temporary difficulty emptying your bladder, which can result in urinary tract infections. This complication occurs mainly after spinal anaesthesia.
- Haemorrhoid stapling - This procedure, called stapled haemorrhoidopexy, blocks blood flow to hemorrhoidal tissue. It is typically used only for internal haemorrhoids. Stapling generally involves less pain than hemorrhoidectomy and allows for earlier return to regular activities. Compared with hemorrhoidectomy, however, stapling has been associated with a greater risk of recurrence and rectal prolapse, in which part of the rectum protrudes from the anus.