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What are haemorrhoids?

Haemorrhoids (also called piles) are enlarged veins around the anus. They are caused by an increases in pressure around the anus, which results in a swelling of the veins and tissue.

Types of haemorrhoids

Haemorrhoids have different names depending on where they are. Internal haemorrhoids can't be seen unless they come out when the person is passing a bowel motion. External haemorrhoids are on the outside of the anus. A person can have internal and external haemorrhoids at the same time.

Internal haemorrhoids:

• are inside the rectum so you can't usually see them
• can squeeze out of the anus when the person passes a bowel motion, but then usually go back in again when they are finished
• usually don't cause pain
• can bleed, especially when the person is on the toilet.

External haemorrhoids:

• feel like hard lumps under the skin around the anus
• are caused by a stretching of the veins under the skin
• can make it hard to clean properly after passing a bowel motion.

What causes haemorrhoids?

Haemorrhoids can be the result of:

• constipation and straining (pushing) to pass a bowel motion. This is the most common cause.
• pregnancy
• heavy manual work or lifting
• a hereditary (passed on through the family) condition
• sitting on hard surfaces for a long time
• not using the right, or enough, lubricant when inserting enemas and suppositories.

What are the symptoms of haemorrhoids?

Symptoms of haemorrhoids can include:

• bright red blood when passing bowel motions, which can be seen on the toilet paper, in the toilet bowl or in the bowel motion
• itching around the anus
• pain or aching in the anus, especially when sitting down
• autonomic dysreflexia for those with spinal cord injury. For more information go to Autonomic dysreflexia.
• pain when passing bowel motions, if the haemorrhoids are large
• hard lumps around the anus, which might feel sore when touched.

How can haemorrhoids be prevented?

Haemorrhoids can be prevented or stopped from getting worse by some simple lifestyle changes. They include:

• drinking plenty of fluids and eating a high-fibre diet with plenty of cereals, fruit and vegetables. This keeps the bowel motions soft and easier to pass.
• sitting in the right position on the toilet to help pass bowel motions. For more information go to Correct toileting position.
• using lubricant if inserting enemas or suppositories (usually done by a nurse)
• not sitting on the toilet or on hard surfaces for a long time. This can increase the pressure on the anus and can make the veins and tissues swell into haemorrhoids.

Need more help? Call the National Continence Helpline on 18OO 33 OO 66 and talk to a continence nurse advisor.