procedures

Haemorrhoids may be inside or outside the body.

• Internal haemorrhoids occur just inside the anus, at the beginning of the rectum. When they are large, they may fall outside (prolapse). The most common problem with internal haemorrhoids is bleeding during bowel movements.

• External haemorrhoids occur outside the anus. They can result in difficulty cleaning the area after a bowel movement. If a blood clot forms in an external hemorrhoid, it can be very painful (thrombosed external hemorrhoid).

Symptoms
Haemorrhoids are most often not painful, but if a blood clot forms, they can be very painful.
Common symptoms include:

• Painless bright red blood from the rectum
• Anal itching
• Anal ache or pain, especially while sitting
• Pain during bowel movements
• One or more hard tender lumps near the anus

Exams and Tests
Most of the time, a health care provider can diagnose haemorrhoids by simply looking at the rectal area. External haemorrhoids can often be detected this way.
Tests that may help diagnose the problem include:

• Rectal exam
• Sigmoidoscopy
• Anoscopy

Treatment

Treatments for haemorrhoids include:

• Over-the-counter corticosteroid (for example, cortisone) creams to help reduce pain and swelling
• Hemorrhoid creams with lidocaine to help reduce pain
• Stool softeners to help reduce straining and constipation

Things you can do to reduce itching include:

• Apply witch hazel to the area with a cotton swab.
• Wear cotton underwear.
• Avoid toilet tissue with perfumes or colors. Use baby wipes instead.
• Try not to scratch the area.
• Sitz baths can help you to feel better. Sit in warm water for 10 to 15 minutes.

If your haemorrhoids do not get better with home treatments, you may need rubber band ligation treatment to shrink the haemorrhoids.
If the previous treatments is not enough, some type of surgery may be necessary, such as Transanal haemorrhoidal dearterialisation (THD) is a minimally invasive surgical procedure or removal of the haemorrhoids (hemorrhoidectomy). These procedures are generally used for people with severe bleeding or prolapse who have not responded to other therapy.

Possible Complications
The blood in the hemorrhoid may form clots. This can cause tissue around it to die. Surgery is sometimes needed to remove haemorrhoids with clots.
Rarely, severe bleeding may also occur. Iron deficiency anemia can result from long-term blood loss.

Prevention
Constipation, straining during bowel movements, and sitting on the toilet too long raise your risk for haemorrhoids. To prevent constipation and haemorrhoids, you should:

• Drink plenty of fluids.
• Eat a high-fiber diet of fruits, vegetables, and whole grains.
• Consider using fiber supplements.
• Use stool softeners to prevent straining.