More Details About Haemorrhoids

Haemorrhoids are vascular structures in the anal canal which help with stool control. They become pathological or piles when swollen or inflamed. The symptoms of pathological haemorrhoids depend on the type present.

Internal haemorrhoids: occur in the rectum. These are varicosities of veins draining the territory of branches of the superior rectal arteries. As this area lacks pain receptors, internal haemorrhoids are usually not painful and most people are not aware that they have them. Internal haemorrhoids, however, may bleed when irritated.

Prolapsed haemorrhoids are internal haemorrhoids that are so distended that they are pushed outside the anus.

Internal hemorrhoids can be further graded by the degree of prolapse.

• Grade I: No prolapse. ("A" on the picture)
• Grade II: Prolapse upon defecation but spontaneously reduce.
• Grade III: Prolapse upon defecation and must be manually reduced.
• Grade IV: Prolapsed and cannot be manually reduced.

External haemorrhoids:These occur outside the anal verge, most often are painful and accompanied by swelling and irritation. Itching, although often thought to be a symptom of external haemorrhoids, is more commonly due to skin irritation. External haemorrhoids are prone to thrombosis: if the vein ruptures and/or a blood clot develops, the haemorrhoid becomes a thrombosed one ("Clot" on the picture). This condition usually treated by an emergency operation, which could be carried out in an NHS hospital or in our clinic.

External skin tags usually cause hygienic problem, and a simple operation (skin tag removal) could improve the symptoms.

You can find further information about the diagnostic process on the next page.

How do we establish the diagnosis?

At first you will have a consultation with our specialist to discuss symptoms being experienced. Following this a thorough examination is performed. This is usually carried out in the left lateral position with the patient facing the wall.  First is an inspection then a gloved rectal examination is carried out unless there is a very painful condition obvious. including a rectal examination, called a rigid sigmoidoscopy. This is a small telescope test which reviews the lower 15-20 cm of the anal mucosa. In has an important role which is to ascertain that there are no other anal conditions possibly causing the symptoms. Then a proctoscopy performed, which enables the direct vision of the anal mucosa, and to establish the proper diagnosis.

Once diagnosed, The Haemorrhoid Clinic will discuss with patients the most appropriate individual management strategy for their condition. You can read about the treatment options on the next page.