Haemorrhoids are a common condition affecting numerous people around the world every year. Also known as ‘piles’, haemorrhoids are thought to impact the lives of up to 75 per cent of people living in the United States alone, for example, with adults aged between 45 and 65 most often affected by it. The condition can be exacerbated by external factors such as obesity, pregnancy and sexual activity, and they can form both internally and externally to the anal area.
According to Dr. Herbert Lerner, a colon-rectal surgeon, “You often can’t see or feel the internal ones, but straining during bowel movements and constipation can cause these haemorrhoids to bleed and occasionally push through the anal opening.”
Anal bleeding can be quite alarming for anyone, and unfortunately, haemorrhoids aren’t the only condition that cause it. In fact, haemorrhoids share symptoms with several other more serious medical problems.
“Common haemorrhoid symptoms in someone who has been diagnosed with haemorrhoids in the past can be treated at home,” explained Jason F. Hall, a colon and rectal surgeon at the Lahey Clinic in Burlington, Mass.
“Any new rectal bleeding or heavy rectal bleeding, especially in someone over age 40, should be evaluated.”
Haemorrhoids can cause significant and uncomfortable itchiness, pressure on the anus, and various degrees of pain, in addition to bleeding. It’s common for patients to feel a lump in the anal region, which can also be alarming.
How might a doctor check for haemorrhoids?
If you experience some of the aforementioned symptoms and fear you may have haemorrhoids, you should visit your doctor as soon as possible for a thorough diagnosis. During the examination, your doctor will need to inspect your anus for a number of potential haemorrhoid red flags, including:
- Lumps and/or swelling
- Stool or mucus leakage
- Anal fissures (small itchy tear in the anus)
- Skin tags (excess skin left behind after an external haemorrhoid blood clot dissolves)
- Irritated skin
- Prolapsed internal haemorrhoids that are visible through the anus
- External haemorrhoids with a blood clot on the inside
In addition, your doctor may also carry out a digital rectal examination in order to determine the tone of the muscles in the anus, or check for any tenderness or lumps/masses in the rectal tissue.
If any examination on the day proves inconclusive, your doctor may refer you for a more extensive diagnosis procedure, such as a:
Rigid Proctosigmoidoscopy. This is a similar procedure to a anoscopy, in which a medical professional uses a proctoscope to examine the lining of your rectal region, as well as your lower colon. During this inspection, the tissue lining your rectum and lower colon will be assessed to find any indications of issues in the lower digestive tract, as well as hints of bowel disease. This procedure, which normally doesn’t require anaesthesia, can be carried out at your doctor’s office during a second visit, or you may be referred to a hospital or clinic elsewhere.
Anoscopy. In the case of an anoscopy, a medical professional will use an anoscope to inspect the lining of your anus and lower rectum, if required, carefully examining the tissue to identify any signs of bowel disease or lower digestive tract issues. As with a rigid proctosigmoidoscopy, this procedure can be performed at the doctor’s office and doesn’t normally require anaesthesia.
Haemorrhoids can also be diagnosed by a doctor during other procedures, such as colonoscopies or flexible sigmoidoscopies.
Which other conditions can cause haemorrhoid symptoms?
If you’ve tried a number of home remedies or over-the-counter medication and your haemorrhoids continue to cause issues, it’s time to seek medical help. Visit your doctor if you experience any of the following haemorrhoid-related symptoms:
- Itchiness, pain, pressure or burning sensations that fail to respond to home treatments
- Rectal bleeding (especially if it’s heavy or doesn’t respond to home treatments)
- Additional symptoms like weight loss, fever, abdominal pain or a change in bowel movements
Jason F. Hall continues: “Haemorrhoids are common, but haemorrhoids symptoms that do not clear up quickly with home care or that keep coming back do need to be evaluated.
“The best place to start is with your primary caregiver. In many cases, a primary caregiver can make the right diagnosis and start you on the best treatment.
“If you need a diagnostic evaluation by a specialist, you may be sent to a gastroenterologist or a colon and rectal surgeon. If you need any surgical treatment, it should be done by a colon and rectal surgeon.”
When you have a good understand of what conditions produce symptoms similar to those of haemorrhoids, you can determine whether or not you can treat the condition at home first.
In the case of rectal or colon cancer, for instance, a patient may experience persistent bleeding, bowel movement changes, inexplicable weight loss or pain in the lower abdomen. “These cancers can occur near the rectum and cause bleeding and discomfort that are similar to haemorrhoid symptoms,” Hall adds. “Rectal and colon cancer are rare before age 40.”
Anal fissures are another condition that impacts on the anus, causing itchiness, pain, bleeding and a burning sensation. Anal fissures are usually caused by constipation but normally clear up with home treatment. Hall describes them a “small tears, like paper cuts, in the anal canal that can act very much like haemorrhoids.”
Inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn’s disease, is also known to cause bleeding and discomfort in the rectum. IDB normally begins to affect people in young adulthood, and may cause a variety of haemorrhoid-like symptoms such as cramps, weight loss, fever and diarrhea.
Finally, pruritis ani. “This condition is frequently mistaken for haemorrhoids because it causes itching and burning in the rectal area,” says Hall. “It is actually a type of localised dermatitis.” The condition causes a seemingly-unrelenting urge to scratch, and often occurs as a result of an excess of moisture or sensitivity to a kind of food.