Haemorrhoids: Causes, Symptoms, Complications, & First Aid Management

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Haemorrhoids are painful, swollen and inflamed veins in the lower rectum or the anus, specifically inside the anus or under the skin around the anus. This is a common problem, especially during pregnancy, after childbirth and at old age, but most commonly occurs from straining too much to have a bowel movement. By the age of 50, an estimated half of the total population will have haemorrhoids, equally affecting both men and women. Because of the pressure on the veins, there is pain in normal activities, such as sitting.

Haemorrhoids are either classified as internal or external. Internal haemorrhoids pertain to haemorrhoids that appear inside the anus, at the beginning of the rectum. On the other hand, external haemorrhoids pertain to haemorrhoids that appear at the anal opening and may hang outside the anus. It is possible to have both internal and external haemorrhoids at the same time. Haemorrhoids are also called piles.

Causes of Haemorrhoids                   

Tissues inside the anus are filled with blood to help control bowel movements. The following may lead to causing the tissue to swell and stretch leading to haemorrhoids:

• Straining during bowel movement (most common cause)
• Excessive pressure on the pelvic and rectal veins
• Chronic constipation or diarrhoea
• Sitting for extended periods of time on the toilet
• Pregnancy and/ or straining to push during labor
• Obesity
• Anal infections
• Anal intercourse
• Low-fibre diet
• Certain diseases

Symptoms of Haemorrhoids

Symptoms for internal and external haemorrhoids may slightly vary but they have similar symptoms:

• Painless bleeding during bowel movements
• Streaks of bright red blood on the toilet paper or in the toilet bowl after defecating
• Itching or irritation
• Rectal pain or discomfort after bowel movement
• Fecal incontinence
• Internal haemorrhoids: blood on the stool surface but haemorrhoids cannot be seen or felt
• External haemorrhoids: clotting under the skin causing a painful lump

Complications from Haemorrhoids

Complications rarely arise from haemorrhoids, however, the common complications include:

• Anaemia
• Strangulated haemorrhoid

First Aid Management for Haemorrhoids

In most cases of haemorrhoids, medical treatment is not necessary and can be managed with home treatment. With sufficient treatment, haemorrhoids usually disappear within a week. The following steps are recommended:

• To reduce discomfort from pain and itching produced by haemorrhoids, apply over-the-counter (OTC) ointments, creams, suppositories or pads that contain hydrocortisone or with hazels. Do not use for more than one week unless recommended by the doctor.
• Take a sitz bath for 10-15 minutes twice or thrice daily. In a sitz bath, the anal area is soaked in plain warm water.
• Bathe or shower daily to keep the anal area clean. Use only warm water and avoid using soap as it may exacerbate the haemorrhoids. Gently dry the area.
• Avoid using dry toilet paper after passing stool, instead, use small, moist towels or wet toilet paper.
• Apply cold compresses or ice packs on the anus to minimize swelling. Do not apply ice directly over the skin.
• To reduce pain, paracetamol, ibuprofen and aspirin may be taken orally.

Disclaimer: The article should not substitute for medical advice or treatment. Enrol in First Aid Courses to learn more about haemorrhoids and other rectal and anal injuries, such as haemorrhoids.