Haemorrhoids

Haemorrhoids are swollen blood vessels in and around the anus and lower rectum. They are very common and, while often uncomfortable or distressing, are usually not serious and respond well to simple treatment.

• Bright red blood on toilet paper or in the toilet bowl after a bowel movement
• Itching or irritation around the anus
• Pain or discomfort, particularly with external haemorrhoids
• A lump or swelling near the anus that may be felt or seen
• Internal haemorrhoids may cause bleeding without pain, while external haemorrhoids are more likely to cause pain and itching

• Result from increased pressure on the veins in the lower rectum and anus, often related to straining during bowel movements.
• Risk is increased by chronic constipation or diarrhoea, prolonged sitting on the toilet, pregnancy, obesity, and a diet low in fibre.
• Risk also increases with age, as supporting tissues can weaken over time.

• Often diagnosed based on symptoms and a visual and physical examination of the anal area.
• Since rectal bleeding can also be a sign of other, more serious conditions, further examination — such as looking inside the rectum with a small instrument, or referral for colonoscopy — may be recommended, particularly for new bleeding in older adults or where the diagnosis is not straightforward.

Increasing dietary fibre and fluid intake helps soften stool and reduce straining, which is central to both treating and preventing haemorrhoids.

Over-the-counter creams, ointments, or suppositories can help relieve pain, itching, and swelling for mild to moderate symptoms.

Warm sitz baths (sitting in warm water) several times a day can ease discomfort.

Persistent or more severe haemorrhoids that do not respond to these measures may be treated with an in-office procedure (such as rubber band ligation) or, less commonly, surgery for more significant cases.

Any new rectal bleeding, especially in someone over 50 or with a family history of bowel cancer, should be assessed by a health worker rather than assumed to be haemorrhoids, to rule out other causes.

• Eat a high-fibre diet, including fruits, vegetables, and whole grains, to keep stools soft.
• Drink adequate fluids throughout the day.
• Avoid straining or spending prolonged time on the toilet.
• Respond promptly to the urge to have a bowel movement rather than delaying it.
• Stay physically active, as regular movement supports healthy bowel function.