What are haemorrhoids (piles)? Haemorrhoids are an excessive widening of the networks of veins in the anal area, which causes pain and discomfort around the anus and is accompanied by thick mucus discharge and faecal incontinence. Risk factors for developing haemorrhoids: long-term constipation, chronic diarrhoea, straining too hard when opening the bowels, sitting on the toilet for long periods, increasing age, family history, pregnancy, lack of physical activity, and not drinking enough fluids and water.
Signs and symptoms
- Bleeding when passing stool, or dripping after the stool has been passed
- Pain and burning
- Difficulty passing stool
- Protrusion of the lining of the anal area. Ways to prevent haemorrhoids:
- When you feel the urge to open your bowels, go to the toilet and pass stool without rushing, because putting it off makes the stool dry and hard and very difficult to pass.
- Avoid sitting and straining for long periods when opening your bowels.
- Do not sit or stand for long periods. Prolonged sitting and standing put pressure on the veins.
- Exercise: regular light physical activity such as walking reduces the pressure on the veins and lowers the risk of constipation.
Treatment: chronic diarrhoea and chronic constipation, as the most important causes of haemorrhoids, must be treated. Water-absorbing laxatives, sitz baths, ointments and suppositories containing numbing agents, and rest to relieve the widening and congestion of the veins are recommended on your doctor's advice. In the early stages, treatment can be given as an outpatient or by non-surgical methods; otherwise, surgery is performed to remove the haemorrhoids.
Before the operation
- Eat a light diet with plenty of fluids.
- Do not eat or drink for 8 to 10 hours before the operation.
- The night before the operation, to reduce contamination and infection, shave the hair in the operation area and take a bath or shower.
- Before going to the operating theatre, remove jewellery, metal objects, hair clips, contact lenses and dentures.
- Remove your nail polish.
- Empty your bladder.
After the operation
- You must not take anything by mouth; once you are fully awake, and if you do not feel sick, you can start drinking fluids with the doctor's permission. If you tolerate fluids, other foods will gradually be started.
- Lie on your side, change position regularly, and lie on your stomach for a quarter of an hour every hour.
- When you are allowed out of bed, first sit on the edge of the bed with your legs hanging down, and if you do not feel dizzy, get out of bed with the help of a nurse.
- The dressing on the operation area is usually removed before discharge, and you will be given a clean basin of warm water, to help the wound heal, to sit in for 10 to 15 minutes. Using a sitz bath 3–4 times a day, starting 12 hours after the operation, reduces pain and discomfort.
- Pour lukewarm water into a plastic basin, then add enough Betadine (povidone-iodine) to change the colour of the water, and sit in it for 15–20 minutes. Afterwards dry the perineum; avoid rubbing toilet paper on the skin – you can dry yourself with absorbent cotton wool. Continue the sitz baths for one to two weeks after surgery.
Diet and nutrition: it is best to eat a diet rich in protein, vitamins and fibre (vegetables, fruit, etc.). Strictly avoid foods that cause constipation. Next visit: 7–10 days after the operation. See your doctor if a hard lump forms after the operation where the haemorrhoid was, if the haemorrhoids cause severe pain that does not ease with the treatments mentioned, or if there is heavy bleeding.
Prepared by: Zahra Zahiri