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Haemorrhoids, also known as piles, are swollen veins in the lower rectum and anus that can cause discomfort, itching, and bleeding. While often manageable with conservative treatments, some cases may require surgical intervention, especially if symptoms are severe or persistent. This article explores what haemorrhoids are, what causes them, when surgery might be necessary, and how to prevent their recurrence.
What are Haemorrhoids?
Haemorrhoids are swollen and inflamed veins in the lower rectum or anus. Internal haemorrhoids are usually painless but can cause bright red bleeding during bowel movements. In contrast, external haemorrhoids tend to be more painful, often resulting in swelling, irritation, and sometimes a hard lump near the anal opening. Common symptoms include discomfort during bowel movements, anal itching, and a sensation of incomplete emptying.
These symptoms are usually triggered by chronic straining, constipation, prolonged sitting, obesity, pregnancy, or ageing. Fortunately, most haemorrhoids resolve with increased fibre intake, hydration, and over-the-counter medications. However, when conservative measures do not improve symptoms, surgery may be required.
Do I Need Surgery for Haemorrhoids?
Surgical intervention is typically considered a last resort for treating haemorrhoids and is reserved for cases where conservative therapies are unsuccessful or when complications arise. Surgery becomes a more likely option if haemorrhoids are large, prolapsed, severely painful, or cause frequent bleeding.
Patients who have tried dietary changes, topical creams, and minimally invasive procedures like rubber band ligation without success may be candidates for surgery. Surgery is also indicated in more advanced stages involving significant prolapse and persistent symptoms.
Two of the most common surgical options are haemorrhoidectomy, which involves the complete removal of haemorrhoidal tissue, and stapled haemorrhoidopexy, which repositions the haemorrhoid and cuts off its blood supply. Recovery may include mild pain, bleeding, and limited activity for a few weeks.
What Causes Haemorrhoids?
Haemorrhoids result from increased pressure on the veins in the rectum and anus. This pressure causes blood to pool and the veins to swell, often leading to inflammation and discomfort. There are multiple reasons why this pressure might develop.
Straining during bowel movements is one of the most common causes. It typically occurs due to chronic constipation, which makes stools hard and difficult to pass. Similarly, prolonged sitting on the toilet increases pressure on rectal veins.
Pregnancy is another major contributor due to hormonal changes, increased blood volume, and pressure from the growing uterus. Obesity has a similar effect, with extra abdominal weight placing additional pressure on the pelvic region (Kepley et al., 2023).
Other factors include heavy lifting, which strains abdominal muscles and pelvic veins, and ageing, as tissues supporting the rectal veins may weaken over time. Awareness of these risk factors can help in prevention and early management.
How Can Haemorrhoids Be Prevented?
Preventing haemorrhoids primarily involves lifestyle and dietary changes that promote healthy bowel habits and reduce pressure in the lower rectum. One of the most effective strategies is eating a high-fibre diet. Fibre softens the stool and promotes regular bowel movements, reducing the need to strain. Aim for a daily intake of 25–35 grams through fruits, vegetables, legumes, and whole grains.
Equally important is proper hydration. Drinking plenty of water helps maintain soft stool consistency, further reducing the risk of constipation and straining. Establishing regular bowel habits, responding promptly to the urge to defecate and not sitting on the toilet for extended periods also plays a key role.
Physical activity can stimulate bowel function and improve overall circulation. A sedentary lifestyle or prolonged sitting should be avoided, especially for people with desk jobs. If increasing fibre through food proves difficult, fibre supplements like psyllium husk may be helpful.
Other preventive measures include avoiding constipation-inducing medications where possible, performing pelvic floor exercises, maintaining a healthy weight and avoiding heavy lifting.
Frequently Asked Questions (FAQ)
1. How do I know if my haemorrhoids need surgery?
If you have tried diet, hydration, creams, and outpatient treatments without improvement, or if you have large, bleeding, or recurring haemorrhoids surgery may be necessary. Speak with your doctor to evaluate your condition.
2. Can haemorrhoids go away on their own?
Yes, mild haemorrhoids often improve with lifestyle changes, such as increasing fibre and water intake, and using over-the-counter treatments.
3. Is haemorrhoid surgery painful?
Discomfort is common after surgery but manageable with pain relief and proper care. Recovery time varies but usually lasts one to two weeks for most patients.
4. Are haemorrhoids dangerous?
Haemorrhoids are not typically dangerous, but severe cases can lead to complications like anaemia or blood clots. It is best to seek treatment early.
Book an Appointment at Pantai Hospitals
While haemorrhoids are often not life-threatening, they can be painful, and affect your quality of life. Fortunately, with early intervention and appropriate treatment, the majority of cases can be resolved without surgery. Simple changes like increasing dietary fibre, staying hydrated, avoiding straining, and getting regular exercise can prevent many flare-ups and promote healing.
At Pantai Hospitals, we offer holistic care tailored to each patient’s condition. Do not wait—book your appointment today and start your journey toward better health. Our team is here to support you every step of the way. You may also book an appointment via our website or download our My Health 360 applicationfrom the Google Play Store or Apple App Store.
Pantai Hospitals have been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.
