Haemorrhoids (Piles)

Haemorrhoids is also known as piles. Haemorrhoids or piles are swollen vascular cushions (blood vessels) around or just inside the anal canal (back passage). There are two kinds of haemorrhoid: internal and external.

Different Types of Haemorrhoids

What Is The Difference Between Interval vs External Haemorrhoids?

Internal haemorrhoids are covered by the mucosal lining of the rectum, and often remain on the inside (Grade 1). Although usually not painful, internal haemorrhoids may descend and prolapse out of the anus, usually during defecation (passage of stool). Internal haemorrhoids that prolapse and reduce back inside by themselves are classified as Grade 2, while those that only reduce with
gentle pushing are Grade 3.

External haemorrhoids (Grade 4) are permanently on the outside of the anus, and are covered by skin. If a blood clot forms within a haemorrhoid, it will cause it to harden, can be very painful and is referred to as a ‘thrombosed’ pile.

  • The 4 Grades of Haemorrhoids
  • There are 4 grades of haemorrhoids or piles, depending on how severe the symptoms.

  • Grade 1:

    Internal haemorrhoids inside the rectum

  • Grade 2:

    Internal, prolapsed haemorrhoids with an external element, which will go back inside naturally

  • Grade 3:

    More advanced internal haemorrhoids, with an external element, which will go back inside by gentle pushing

  • Grade 4:

    External haemorrhoids, which remain permanently outside of the anus

Clinical Grades of Haemorrhoids or Piles

What Causes Haemorrhoids?

What are the Causes of Haemorrhoids?

Haemorrhoids are caused by naturally occurring haemorrhoidal cushions, which are normal anatomical structures. They are associated with increased pressure in the blood vessels in and around the anus. This can cause the blood vessels to become swollen and inflamed. Other causes of haemorrhoids or piles are obesity, pregnancy and childbirth, constipation and straining or heavy lifting can all contribute to the enlargement of these cushions.

80% of people will experience the pain and discomfort of haemorrhoids or piles at some point in our lives. Approximations suggest that 100,000s of patients are suffering in the UK at any one time. Half of us will experience an issue with haemorrhoids at some point in our lives.

Multiple causes of haemorrhoids exist:

  • Constipation, resulting in excessive straining on the toilet
  • Being overweight or obese, increasing pressure on the vascular system in general
  • Age where the body’s supporting tissues weaken, increasing haemorrhoid risk
  • Pregnancy creating increased pressure on the pelvic blood vessels
  • Poor diet through insufficient fibre
  • Regularly lifting heavy objects
  • A persistent cough or repeated vomiting
  • Sitting down for long periods of time
  • Family history

What are the Symptoms of Haemorrhoids?

Enlargement or inflammation of Haemorrhoids can cause symptoms such as: bleeding, itching, soreness, discomfort, discharge and prolapse.

  • Bleeding

    There is usually light bleeding or spotting when passing stools. The presence of blood in stools or when wiping following its passing should always be referred to the doctor for investigation to eliminate other causes.

  • Itching

    Itchiness is a common symptom of haemorrhoids and is more annoying than concerning. This can often be reduced or eliminated through over the counter or prescription remedies.

  • Soreness and discomfort

    Soreness and discomfort is generally caused when wiping regularly, straining whilst defecating, or when the haemorrhoid becomes thrombosed. Often using soft tissue for wiping can help. If you feel discomfort when sitting on a hard service, a haemorrhoid air cushions can assist your comfort.

  • Mucous discharge

    Discharge is more inconvenient and unpleasant symptom, but is a typical symptom of haemorrhoids. Your doctor can recommend suitable remedies.

  • Prolapse

    Haemorrhoids become prolapsed as they enlarge and form a mass which can appear through the anus. Some prolapse can be tucked back in manually, others may not and a doctor can provide guidance on this.

Do Haemorrhoids go away on their own?

Haemorrhoids can go away on their own without medical intervention, usually by a change of diet in order to avoid undue straining when passing stools. They can often reappear intermittently though. In some cases, one can suffer from an external element without any symptoms of pain, itchiness or bleeding, but this tends to be a nuisance and makes hygiene difficult to maintain.

When haemorrhoids become regularly symptomatic, they will usually require some medical intervention.