Haemorrhoid Clinic

What are haemorrhoids?

Haemorrhoids are lumps that occur inside and around your anus. They can be likened to varicose veins. They are clumps of vessels that swell and are usually caused by constipation. Constipation causes you to strain when you go to the toilet. This puts pressure on the blood vessels in your anus, making them swell.

Other things that can increase the chance of getting haemorrhoids include:

• ageing – haemorrhoids often occur between the ages of 45 to 65 years
• having diarrhoea
• spending long periods on the toilet
• regularly lifting heavy objects.

Haemorrhoids are particularly common during pregnancy because:

• constipation is quite common in pregnancy
• the baby places pressure on your tummy
• there is more blood flowing through your body.

What are the symptoms of haemorrhoids?

If you have haemorrhoids, you may notice:

• bright red blood on the toilet paper or in the toilet when you have a bowel motion (poo)
• sometimes there can be a lump that protrudes out of your anus (prolapse)
• clotting that becomes very painful
• itchiness, discomfort or pain around your anus.

There is no need to feel embarrassed about seeking medical advice. Haemorrhoids are a common problem; your doctor is used to diagnosing and treating them.

About the Haemorrhoid Clinic

If you have symptoms of haemorrhoids, the Haemorrhoid Clinic provides early or urgent access to a group of doctors, including specialist physicians or surgeons. The clinic’s doctors are experienced in this field and are specialists in the appropriate tests or procedures that may be required.

Appointments are generally made within one week of contacting us. Urgent cases will be prioritised, and appointments will be made as soon as possible.

It is preferable to have a referral from your General Practitioner (GP). We make appointments by phone or email. If you contact us by email, please allow two to three working days for a response. If you do not receive a response, please get in touch with us by phone or fax again.

A Specialist Nurse is in full-time attendance to answer your queries and advise you on the most appropriate way to attend the clinic. If necessary, a doctor will discuss some issues with you over the phone before your appointment.

A Specialist doctor is in attendance every day. The clinic will develop an individual history of your symptoms and conduct all the relevant tests at a reasonable cost to give you peace of mind about your treatment.

How are haemorrhoids diagnosed?

Your doctor will ask you about your symptoms and examine your anal passage to look for any swollen blood vessels.

An abdominal examination is carried out. This is followed by inspecting the haemorrhoid area and then a rectal examination. A rectal examination is where you lie on your side, and your doctor puts on gloves and places a lubricated finger inside your back passage (bottom) to gently feel for any abnormalities.

Sometimes, additional tests are required. These procedures require prior arrangements and usually involve a bowel preparation in our dedicated day surgery centre.

Flexible sigmoidoscopy and colonoscopy examine the bowel higher up or right around the large bowel. After a flexible sigmoidoscopy, you may feel slight abdominal pain or cramping for a few hours after the procedure, or you may notice blood in your first bowel movement. Neither of these symptoms is cause for alarm, and you should be able to return to your daily schedule right after the procedure the next day.

How are haemorrhoids treated?

Your Specialist at the Haemorroid Clinic will grade your condition to guide the preferred treatment method. Internal haemorrhoids are classified into four different types. This is based on their degree of prolapse (how much they protrude outside of your anus):

• Grade I haemorrhoids— stay inside your anus and are not usually very painful.
• Grade II haemorrhoids— protrude out of your anus when you pass a bowel motion. Once the bowel motion is over, they disappear back inside your anus by themselves.
• Grade III haemorrhoids— have to be physically pushed back inside the anus after passing a bowel motion. They may be painful if they are large.
• Grade IV haemorrhoids— are larger lumps that protrude out of the anus permanently and cannot be placed back inside.

Standard procedures for treating haemorrhoids include:

• a high-fibre diet
• use of medicated creams, ointments or suppositories (solid medicines that you put in your anus)
• rubber band ligation (banding) that uses a tight elastic band placed around your haemorrhoid to cut off its blood supply
• an injection into your haemorrhoid
• surgery if the haemorrhoid is large, permanently out or thrombosed.

Considering other causes

Whilst haemorrhoids may be associated with the problem in this area, your Specialist will consider other symptoms, including:

• bleeding
• a lump
• pain, including abdominal pain
• change of bowel habits
• a sense of unsatisfied defecation (feeling like there is still something there)
• weakness or tiredness due to anaemia
• loss of weight
• irritation or discharge from other conditions of the bowel.

Other conditions can only be distinguished by your history and a complete examination. Surveillance, blood testing and colonoscopy are increasingly crucial in early cancer detection. For example, the bleeding of haemorrhoids typically is bright red blood on the toilet paper and found to have spurted into the bowl with a bowel action. The blood is not usually mixed with the bowel action. Bleeding mixed with the bowel action suggests the source is higher in the bowel.