WHY YOU NEED TO TALK ABOUT YOUR PILES ...
PIleS, or haemorrhoids, are often described as looking similar to a bunch of grapes — they are swollen blood vessels that can hang outside the anus or remain within.
Internal haemorrhoids usually don’t cause any pain as there are no nerve fibres in this area. But if they protrude, they can be itchy and painful and sometimes bleed or ooze mucus.
‘You may notice the piles only when you strain to pass a bowel movement,’ says consultant gastroenterologist Dr Ana Wilson. ‘most cases will be dealt with by GPs and only about 10 per cent of haemorrhoids need surgery.’
It’s important not to be embarrassed about seeking help, says Professor Julian Walters, a consultant gastroenterologist at Imperial College, london.
‘People literally die from embarrassment because they dismiss rectal bleeding or blood in their stools as piles or are reluctant to describe their stools to their doctor. But we deal with these problems every day,’ he says.
‘It’s important to get any new problems checked out, but there may also be effective treatments available for symptoms that have been persistent.’
You’re prone to piles if you are overweight, spend long periods sitting down, suffer a long-term cough or extended vomiting bouts, regularly lift heavy objects or are just getting older.
lifestyle steps to avoid constipation can help by preventing straining, advises Professor Walters.
‘You should also make time for a regular bowel movement so you are not ignoring the urge to pass a stool (the stools are softer then and easier to get out), and your GP may review any drugs that may have constipating effects, such as some antacids, painkillers such as those containing codeine, as well as antidepressants and sedating antihistamines.’
the pain and itching of piles can be relieved by over-the- counter creams containing local anaesthetic and zinc oxide, such as Anusol (£6.29 for 43g), to shrink the haemorrhoid and soothe pain and itching.
PERSISTENT PILES
SOmetImeS piles can become ulcerated or skin tags can develop, making the area difficult to clean. In rare cases, internal haemor- rhoids can become engorged and blood clots develop. ‘In these cases, you will be referred to a specialist,’ says Dr Wilson. there are up to ten procedures available on the nHS, says Amyn Haji, a consultant colorectal surgeon at King’s College Hospital, london. these include attaching an elastic band to the haemorrhoid to cut off the blood supply and cause it to drop off. Or there’s injection sclerotherapy, where painrelieving oil is injected into the rectum lining to harden the haemorrhoid so it forms scar tissue. ‘traditional surgery where the haemorrhoid is cut out is most successful, but patients usually need two weeks off work. ‘Haemorrhoid artery ligation is less painful — it uses ultrasound to locate the blood vessel supplying the haemorrhoid and stitches it to stop blood flow, but it requires a general anaesthetic and a week’s recovery.’ One newer option for internal haemorrhoids is the rafaelo procedure, where a small probe uses radio frequency heat to shrivel the pile. the procedure is painless, says mr Haji.