Haemorrhoids

Haemorrhoids can cause bleeding, itching or a lump around your anus. While they’re common, these symptoms can be uncomfortable and sometimes worrying, particularly if you haven’t experienced them before.

Getting the right diagnosis matters because rectal bleeding can have other causes. Our gastroenterology team can find out what’s causing your symptoms and talk you through the treatment that may help.

What are haemorrhoids?

Haemorrhoids, also known as piles, are swollen blood vessels and tissue in or around the anus, the opening where bowel motions leave your body.

They may form inside the anal canal, which is the short passage at the end of your bowel, or around the outside of the anus. Internal haemorrhoids can sometimes push out through the anus. This is known as a prolapse.

An external haemorrhoid may feel like a small lump. Occasionally, a blood clot can form inside one, making it suddenly swollen and painful.

Haemorrhoids aren’t cancerous. However, because bleeding from the anus can have several causes, new or ongoing bleeding should be assessed rather than assumed to be haemorrhoids.

Haemorrhoid symptoms

The symptoms you notice can vary depending on where the haemorrhoids are and how swollen they’ve become.

You may experience:

• Bright red blood after a bowel motion
• Blood on toilet paper or in the toilet bowl
• Itching or soreness around your anus
• Swelling or a lump near the opening
• A haemorrhoid that pushes out when you open your bowels
• Mucus or moisture around the anus

Internal haemorrhoids don’t always hurt. Pain is more likely if a haemorrhoid becomes trapped outside the anus or a blood clot forms in an external haemorrhoid.

See a doctor if you notice bleeding from your anus, particularly if it continues, comes with a change in your usual bowel habits or you’re losing weight without trying.

Seek urgent medical help if the bleeding is heavy or won’t stop, your stools are black or you feel faint or dizzy.

What causes haemorrhoids?

Haemorrhoids are linked to increased pressure on the blood vessels around the anus and lower bowel.

One of the most common triggers is constipation. Repeatedly straining to pass hard bowel motions puts extra pressure on this area.

Haemorrhoids may also be more likely during pregnancy or as you get older, when the tissues supporting the blood vessels can become weaker.

Other factors can include:

• Sitting on the toilet for long periods
• Frequent diarrhoea
• Regularly lifting heavy loads
• Carrying excess body weight

Sometimes there isn’t one obvious cause. 

Diagnosing haemorrhoids

A diagnosis usually starts with a conversation about your symptoms. Your doctor may ask when the bleeding happens, what your bowel motions are like and if you’ve noticed any recent changes.

They may then examine the skin around your anus. A digital rectal examination may also be needed. This involves your doctor gently inserting a gloved, lubricated finger into your rectum, the final part of your large bowel, to feel for anything unusual.

Another possible test is a proctoscopy. This uses a short tube to look inside your anus and lower rectum.

If the cause of bleeding isn’t clear, or there are symptoms that need further investigation, you may be advised to have a colonoscopy. During this test, a thin, flexible tube with a camera is used to look inside your large bowel.

Haemorrhoid treatment

Not everyone with haemorrhoids needs a procedure. If symptoms are mild, treatment often begins by making bowel motions easier to pass.

This may mean adding more fibre to your diet, drinking enough fluids and treating constipation if it’s contributing to the problem. Trying not to strain or spend too long on the toilet can also help.

Short-term creams, ointments or suppositories may ease irritation or discomfort. A suppository is a solid medicine placed inside the anus.

If haemorrhoids continue to bleed or push out through the anus, further treatment may be recommended.

Haemorrhoid banding

Rubber band ligation, often simply called banding, is used for some internal haemorrhoids.

A small rubber band is placed around the base of the haemorrhoid. This stops its blood supply, causing the tissue to shrink and eventually fall away. The area then heals naturally.

Banding doesn’t involve cutting the haemorrhoid out and is commonly performed without a general anaesthetic, which is medicine that makes you unconscious during a procedure. Some people need more than one treatment.

Other treatments can include sclerotherapy, where medicine is injected into the haemorrhoid to make it shrink, or treatment with infrared light.

Surgery may be considered for larger haemorrhoids, haemorrhoids that regularly push out through the anus or symptoms that haven’t improved with other treatments. A haemorrhoidectomy is surgery to remove haemorrhoids.

Explore personalised gastroenterology care with Complete Health Australia

Our gastroenterologists have extensive experience investigating bowel symptoms, including rectal bleeding and changes in bowel habits. They’re experienced in recognising haemorrhoids as well as other bowel conditions that can cause similar symptoms, helping you get a clear diagnosis and suitable treatment.

If you need further tests, our specialists also have expertise in procedures such as colonoscopy.

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