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By Bjarne Lühr Hansen PhD, MD and Philipp Skafte-Holm MD, Mentor Institute

Haemorrhoids are so common that they can be characterised as a condition not an illness. Haemorrhoids are bulges of the mucous membranes of the intestine that are filled with blood. Bleeding and pains are typical signs. Once you have one haemorrhoid, more will follow – haemorrhoids are a lifelong nasty friend. Hard stool and pressing during visits to the toilet lead to the formation of haemorrhoids. You can treat most haemorrhoids yourself. In the case of heavy pains or repeated bleedings, you doctor can prescribe some crème and/or suppositories. In rare cases, surgery many be necessary.

Haemorrhoids are bulges of the mucous membrane in the rectum that are filled with blood. Constipation, diarrhoea, strong pressing in connection with visits to the toilet, hard physical labour and pregnancy can lead to the formation of haemorrhoids.

Bleeding all over the toilet bowl is a typical sign that a haemorrhoid has burst. It is like a balloon filled with blood that you prick. The blood splatters the entire bowl with blood. It looks violent but the bleeding stops as soon as the bulge is empty of blood.

Pains, slime, itching and irritation can also be signs of haemorrhoids. Sometimes you can feel a ‘bulge’ right next to the rectum. The bulge can be stuffed back into the rectum so that it does not hang around on the outside. If the bulge is big enough, it may become squeezed and this causes heavy pains near the rectum. In this case, the bulge is big and very sore.

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What can you do?

Far most people with haemorrhoids can manage the problem themselves. You should avoid constipation. Eat a diet with extra fibres, exercise on a daily basis and drink plenty of water. Furthermore, you should make sure to have healthy toilet habits, this means no postponement of the need to go, have certain times when you visit the toilet, avoid to much pressing and do not read during visits to the toilet.

If you have a big haemorrhoid that is squeezed near the rectum, you must as fast as possible stuff it back into the rectum again, using a finger. Local cooling with ice or ice water can soothe and make the haemorrhoid decrease in size that makes it easier to stuff back up.

What can your doctor do?

If you discover blood in the toilet and you are certain the blood does not stem from a haemorrhoid.

If you continue bleeding even though you are not constipated and have healthy toilet habits.

If you are in strong pain and are unable to stuff the haemorrhoid back up.

You general practitioner can, with a short rigid tubular instrument called an anoscope, look up into your rectum and determine whether you have haemorrhoids or not. Such an anoscopy is only necessary if the doctor is uncertain whether your nuisances are caused by haemorrhoids or by something else.

The doctor can prescribe some crème and/or some suppositories that will diminish the haemorrhoids and take away the pain. In addition to this, the doctor offers advice on laxatives, if you are constipated.

If you are in strong pains because of a squeezed haemorrhoid the doctor can stuff it back up into the rectum.

What can a specialist doctor do?

In rare cases, in the case of prolonged bleeding and pain in spite of your own and your general practitioner’s treatment, a specialist can help you.

If there is uncertainty whether haemorrhoids are the cause of the nuisances, the specialist can perform an anoscopy and look into the rectum.

The specialist can cut away the haemorrhoids or put a rubber band around the haemorrhoid. The simplest method is to put a rubber band around the haemorrhoid that thereby loses its blood supply and ‘dies’. In the case of surgery, the haemorrhoid and surrounding skin is cut away. The specialist advises you on which method is best for precisely you.