Main
- Haemorrhoids — enlargement and inflammation of the veins of the anus: manifested by pain, itching, bleeding and a feeling of lumps.
- Urgent visit to a doctor: with severe bleeding, unbearable pain or inability to go to the toilet.
- Diagnosis begins with an examination: digital rectal examination, anoscopy, rectoscopy, colonoscopy, blood test.
- The condition is managed by a proctologist, in their absence assistance is provided by a surgeon — examination and selection of management.
- Prevention reduces pressure in the pelvic veins: drinking, fibre, movement, regular stools without straining.
What is haemorrhoids
Haemorrhoids are the enlargement and inflammation of veins in the area of the anus and rectum. They can cause discomfort, pain and bleeding, but in many cases they respond to treatment.
What happens in the body
Haemorrhoids develop when the veins in the area of the anus are under increased pressure. This leads to their stretching and inflammation. The walls of the vessels lose their usual tone and begin to bulge into the lumen of the bowel. Because of this, a feeling of heaviness, burning or pain occurs when going to the toilet. Sometimes the wall of a vessel is damaged, and then traces of blood appear on the paper. Over time, the stretched nodes enlarge and interfere with the person more and more. Therefore, at the first noticeable signs, it is worth seeing a doctor rather than waiting until things get worse.
What causes it to develop
- Chronic constipation or diarrhoea: constant straining or frequent urges create extra load on the veins, and they gradually stretch.
- Sitting on the toilet for a long time: the habit of lingering there with a phone raises the pressure in the vessels of the pelvis and interferes with normal blood outflow.
- A sedentary lifestyle: desk work and little walking slow down the circulation, because of which the venous wall weakens.
- Pregnancy and childbirth: the growing uterus presses on the veins of the pelvis, and the straining during labour sharply raises the pressure in them.
- Hereditary predisposition: a congenital weakness of the vascular wall is passed down in the family and makes a person more vulnerable to strain.
- Heavy physical labour: lifting weights and tensing the abdominal muscles create pressure that the veins do not always withstand.
Who faces this more often
Haemorrhoids occur in people of different ages, but most often they are faced by those who sit a lot and move little. Office workers and drivers spend the whole day in a chair, and the blood in the veins of the pelvis stagnates. In pregnant women, the pressure of the growing uterus adds load to the same vessels. People with chronic constipation strain in the toilet for years and gradually stretch the venous walls. Heredity also plays a role: if close relatives had a similar problem, the risk is higher. Men are more often engaged in heavy physical labour, while women more often go through pregnancy and childbirth. Therefore, it is worth noticing the early signs by everyone, regardless of profession and sex.
What symptoms can there be?
Haemorrhoids manifest differently depending on the location and degree of enlargement of the nodes, and they can be noticed already at an early stage. Many people are embarrassed to see a doctor, although a timely consultation eases the condition and prevents complications.
How it is noticed at the very beginning
At the beginning of its development, haemorrhoids often make themselves known by itching and burning in the anal area, which are easily put down to fatigue or a dietary slip. The discomfort appears after sitting for a long time at a desk or a journey on transport and quickly passes, so it is rarely given any importance. During defecation, pain occurs, which a person explains by hard stools or accidental straining. Traces of blood sometimes remain on toilet paper, and this too is put down to a small fissure. Gradually, a sensation of a foreign body in the anus is added to these signs, intensifying towards the evening. Because of embarrassment or being busy, a person postpones a visit to the doctor and continues to live at the same pace. If such signs recur, it is worth booking an appointment with a proctologist or surgeon without waiting for the pain to worsen.
Signs that occur most often
- Itching and burning: constant irritation in the anal area, which intensifies after visiting the toilet and makes it hard to sit comfortably.
- Pain during defecation: sharp or dragging discomfort during bowel movement, because of which a person begins to postpone going to the toilet.
- Blood on paper or in the stool: scarlet traces after defecation, noticeable on toilet paper, underwear or in the stool itself, and this is a frequent cause for alarm.
- Sensation of a foreign body: a feeling of fullness or prolapse of a node outwards, which intensifies with straining and prolonged sitting.
- Discharge of mucus: moisture and traces of mucus in the anal area, irritating the skin and intensifying the itching.
- Combination of signs: when several symptoms persist together, a visit to the doctor should not be postponed, because the condition may worsen.
When to seek help urgently
Examinations and tests
Examination for haemorrhoids is needed to confirm the cause of the complaints and rule out other bowel diseases. Below is an outline of what happens at the appointment, which investigations are used and what each of them shows.
How the examination begins
Diagnosis of haemorrhoids begins with a conversation and examination by the doctor, and this is not a formality but the basis for all further decisions. The doctor listens to the complaints, clarifies how long they have been present and their connection with defecation, and then proceeds to examine the anal area. This order allows the external nodes to be assessed straight away and changes visible without instruments to be noticed. If the complaints point to internal nodes, the doctor performs a digital rectal examination, assessing the tone of the sphincter and the condition of the bowel wall. Further, to clarify the degree and rule out other diseases, additional investigations may be required. The examination and conversation give direction: they determine whether anoscopy, rectoscopy or a more in-depth examination is needed. If the visit is postponed, the picture changes and it becomes more difficult to work out the cause of the complaints, so book an appointment with a proctologist at the first persistent signs.
What is prescribed and what it shows
What is worth preparing for the appointment
- Discharge summaries: take all previous conclusions from a proctologist or surgeon so that the doctor can see the dynamics and does not prescribe again what has already been done.
- Test results: recent blood data will be useful, especially if low haemoglobin or signs of anaemia have been found before.
- List of complaints: write down in advance when the discharge, pain or itching appeared and how often it recurs.
- Description of the stool: note the regularity, consistency and presence of blood, because these details influence the choice of examination.
- List of medications taken: indicate everything you take regularly, including blood thinners, this is important for assessing the risk of bleeding.
- Questions for the doctor: formulate in advance exactly what you want to find out, so that the appointment gives you a clear picture of what is happening.
Which doctor should I see?
The choice of a doctor for haemorrhoids usually comes down to one specialist in the field, but it is important to understand what exactly they do at an appointment. Below is information about who manages the condition, what the care consists of, and which part of the result depends on the patient themselves.
Which specialist manages this condition
Haemorrhoids are managed by a proctologist, and if one is not available at the clinic, care is provided by a surgeon. A proctologist deals with diseases of the rectum and the anal area, so it is they who understand complaints of this kind. A surgeon has the same methods of examination and intervention at their disposal, if we are talking about a small town or a district hospital. At the first appointment, the doctor clarifies the complaints, the history of their onset and the circumstances under which they worsen. Then they conduct an examination to assess the condition of the tissues and see the full picture, rather than relying on a description. Based on the results of the examination, the specialist determines the stage and selects a suitable option of care for the specific case. If there is no specialist nearby, it is reasonable to start with a surgeon rather than postponing the visit until a trip to another city.
What the treatment consists of
- Selection of therapy by the doctor: the specialist chooses the direction of care taking into account the symptoms and the stage, because no two cases are alike.
- Monitoring and lifestyle correction: the doctor gives recommendations on diet and daily routine, and then monitors how they affect the condition.
- Physiotherapy procedures: they are used as part of a comprehensive approach when the main direction of care needs to be supplemented.
- Minimally invasive interventions: low-trauma techniques are used at certain stages, when the conservative path is no longer sufficient.
- Surgery when indicated: surgical intervention is considered if other options do not give the required effect.
What depends on the patient themselves
The regularity of follow-up with the doctor noticeably affects how care for haemorrhoids turns out. If a person comes for an examination at the appointed time, the specialist sees changes in time and adjusts the approach. Missed visits lead to the condition being assessed late, and the selected recommendations losing their meaning. Following the advice on diet and lifestyle works only with consistency, and not from time to time. Notes on when and what was troubling help the doctor understand more precisely what changes between appointments. Refusing follow-up after improvement often brings the complaints back, because the cause has not been eliminated completely. The patient should keep in touch with the doctor and report any changes, rather than waiting for the next exacerbation.
What helps prevent an exacerbation?
Prevention of haemorrhoids aims to reduce pressure in the veins of the pelvis. Regular bowel movements and sufficient activity help avoid flare-ups, so everyday habits and monitoring how you feel matter.
What to change in your habits
Drinking enough fluids is worth doing so that stools stay soft and regular. Eating more fibre makes stools bulkier and easier to pass. Not straining during a bowel movement is important because straining raises pressure in the veins of the pelvis. Moving more is useful: activity improves blood flow and bowel function. Treating constipation promptly is necessary so that it does not become persistent and does not lead to flare-ups. If stools are infrequent or hard, a person notices this by discomfort when going to the toilet and by heaviness in the pelvic area. The practical conclusion is simple: organise your day so that drinking, fibre and movement are regular, not occasional.
What to keep under control
- Regularity of bowel movements: keep track of how often you have a bowel movement, because infrequent stools lead to straining and pressure in the veins.
- Consistency: pay attention to the density of stools, since hard stools require more effort when emptying the bowel.
- Amount of fluid: note how much you drink per day, as not drinking enough makes stools drier and harder.
- Fibre in the diet: keep an eye on how many vegetables, fruits and grains you eat, since this affects stool softness.
- Physical activity: watch how much you move during the day, because a sedentary position slows blood flow in the pelvis.
- How you feel: note any changes so that you can discuss them with a doctor in time and not let the condition progress to a flare-up.
How often to see a doctor
Regular check-ups with a doctor are needed even when you feel well and nothing bothers you. The specialist assesses the course of the condition over time and notices changes earlier than they become noticeable to the person. When the condition is stable, routine visits are enough, and their frequency is determined by the doctor taking into account the features of each case. If new signs appear or your usual sensations change, the visit should not be put off for long. The doctor looks at how the measures taken are working and, if necessary, adjusts lifestyle recommendations. Such monitoring does not replace everyday habits but complements them and helps keep the situation under observation. The practical conclusion: arrange routine visits in advance and attend them even if there is no flare-up.
What is worth remembering
A conversation about haemorrhoids ends not with a list of symptoms, but with an understanding of how to structure one's behaviour so that flare-ups occur less often. Below are the conclusions that help make a decision without haste and unnecessary mistakes.
Main conclusions
Haemorrhoids are a condition in which it is important not to postpone a visit to the doctor at the first noticeable changes. Many endure the discomfort for months, attributing it to fatigue or a sedentary job, and come when the complaints already interfere with life. Meanwhile, seeking help early noticeably simplifies both the examination and the selection of treatment. Haemorrhoids do not require heroism: an honest account to the doctor of one's sensations speeds up the assessment of the situation. A mistake is to try to endure it or to treat oneself on the advice of acquaintances, because the causes of discomfort can vary. Another mistake is to abruptly change one's lifestyle for a week and give up as soon as it gets easier. With haemorrhoids, a lasting result comes not from a one-off effort, but from calm, consistent habits. The foundation for a solution is regular follow-up with a specialist and attention to one's own condition.
