Haemorrhoids
Although not something people like to talk about, haemorrhoids (also called ‘piles’), are common, affecting around one in two adults at some point in their life. They occur when the tissues and veins around or inside the entrance to your bottom (anus) become swollen and inflamed.
There are a number of different things that can cause haemorrhoids, or make them more likely to 'flare-up' in people who are prone to getting them such as:
Being overweight
Diarrhoea
Getting older
Heavy lifting
Pregnancy or childbirth
Sitting on the toilet for a long time
Sitting or standing for long periods of time
Straining to pass a bowel motion because of hard, dry, stools (as in constipation)
Anal intercourse.
There are two different types of haemorrhoids: external haemorrhoids and internal haemorrhoids.
External haemorrhoids
External haemorrhoids occur around the entrance to your bottom and are visible. They may look like small bunches of grapes and are usually painful and itchy. Occasionally they may bleed, or a blood clot may form inside the haemorrhoid, which can be felt as a firm, tender mass in the area.
Internal haemorrhoids
Internal haemorrhoids occur when the veins inside the rectum become damaged and weak. They are not visible and are usually not painful unless they pop out (prolapse) through your anus. Some pop back in by themselves, but more severe ones need to be pushed back in with your finger. Some cannot be put back in, which can lead to complications.
Bleeding from the rectal area, visible as either bright red blood on toilet tissue, in the toilet bowl, or on the outside of your stool is usually the first sign that you have internal haemorrhoids.
See Your Pharmacist or Medical Professional
If you have other medical conditions, take regular medication for any reason, or if the person with haemorrhoids is a child, always talk to a pharmacist. Also talk to a pharmacist if:
It is the first time you have had haemorrhoids
The blood appears to be mixed in with your stools, not just on the outside
You have sore, hard lumps or severe pain or itching around the rectal area
The haemorrhoids have to be pushed back in after you have been to the toilet
You notice seeping faeces, mucus, pus or any other discharge
You strain when you have a bowel motion and you feel like you cannot completely empty your bowel
You have had symptoms for more than three weeks, if the haemorrhoids do not improve after a week, or if the haemorrhoids return
You have chronic constipation, diarrhoea or your bowel habits have changed
You have other symptoms, such as fever, abdominal pain, vomiting, nausea or if you have no appetite
You have unexplained weight loss or tiredness
Your haemorrhoids seem to be getting worse even though you are treating them
You are pregnant or breastfeeding – some medicines may not be suitable
You have allergies to any medicines or have just started taking a new medicine.
Treatment Tips
Apply a cold compress to the area for relief
A warm salt bath may help painful haemorrhoids
Use baby wipes instead of toilet paper
Avoid scratching the area
Wear cotton underwear to minimise discomfort
Treat any constipation or diarrhoea
Eat a high-fibre diet and drink plenty of fluids
If your diet is not already high in fibre, introduce it gradually
Exercise regularly
Avoid straining when having a bowel motion
Always go to the toilet as soon as you feel the need to go. 'Holding-on' can make haemorrhoids worse.
Treatment Options
Treatment generally relieves symptoms such as itching, pain and swelling
The choice of treatment can depend on how bad your symptoms are
It can take one week for external haemorrhoids to disappear or improve
Some products for haemorrhoids – such as those containing hydrocortisone – are only for short-term use. Check the manufacturer’s directions or ask your pharmacist before using
Always remove foils or plastic wrap from suppositories, and then insert the blunt end first
The dosage may change over days or weeks – always follow product instructions
Haemorrhoid products are well-tolerated by most people but occasionally may cause skin irritation or sensitivity
Local anaesthetics are more effective if applied around the anus and the beginning of the anal canal
Some patients may require surgical therapy to relieve painful or persistent haemorrhoids.
Always discuss treatment options with a pharmacist to ensure the best outcome.
Fibre supplementation
[FOODS]
e.g., Metamucil Fibersure, Benefiber
These products can improve symptoms and also help with constipation
See our topic on constipation for other treatments that are available.
Ointments or suppositories
[GENERAL SALE]
e.g., Anusol ointment and suppositories, Hemoclin Haemorrhoid gel
[PHARMACY ONLY]
e.g., Ego Soov It Haemorrhoidal cream, Proctosedyl ointment and suppositories
[PHARMACIST ONLY]
e.g., Ultraproct ointment and suppositories
Ointments and suppositories include a number of ingredients that relieve symptoms:
-corticosteroids (such as hydrocortisone and fluocortolone): reduce redness, swelling, itching and pain
-local anaesthetics (such as cinchocaine): reduce pain and itching
-protectants (such as aloe vera, zinc oxide, mineral oils): soften and soothe skin
-astringents (such as zinc oxide, witchhazel, aloe, Peru balsam): provide a protective coating over damaged tissue
-antipruritics (such as resorcinol, benzyl benzoate): reduce itching.
Hemoclin gel is an aloe vera gel extract which provides instant cooling relief from haemorrhoids and other anal discomforts
A product containing an astringent and local anaesthetic may be enough if haemorrhoids are not severe
Ointments can be used for internal and external haemorrhoids, especially if they are sore
Suppositories may be more effective for internal haemorrhoids
Most products come with a special applicator
Use ointments or suppositories after bowel motions – follow the manufacturer’s directions
Some haemorrhoid preparations can be used in pregnancy – check with your pharmacist.
Natural/herbal products/supplements
e.g., Weleda haemorrhoid ointment, horse chestnut, calendula, witch hazel
Some natural ingredients can help temporarily relieve the itching, burning and discomfort associated with haemorrhoids.
More Information
Availability of medicines
GENERAL SALE available through pharmacies and possibly other retail outlets.
PHARMACY ONLY available for sale through pharmacies only.
PHARMACIST ONLY may only be sold by a pharmacist.
PRESCRIPTION ONLY available only with a prescription from your doctor or other health professional.
Consumer Medicine Information on some medicines is available at the government website www.medsafe.govt.nz
