Embarrassing Illnesses

Haemorrhoids will usually settle down in a few days without any treatment. However, there are a number of treatments that will reduce itching and discomfort if these symptoms are troublesome. Lifestyle changes can also help.

Dietary changes

If your haemorrhoids are a result of constipation, you should try to keep your stools soft and regular. By making changes to your diet it's likely you will avoid straining while on the toilet. This involves increasing the amount of fibre in your diet and drinking lots of water (see the 'prevention' section).

Self care

Pain from haemorrhoids can be eased by sitting in a bath of warm water. This should reduce the itchiness around your anus.

You could also use cold compresses, such as ice packs, to ease pain and reduce swelling. Hold the ice pack against your anus for no more than 30 minutes at a time to relieve pain.

Also, after passing a stool, try cleaning your anus with moist toilet paper instead of dry toilet paper. Using baby wipes can also help ease any discomfort that occurs after passing a stool.

Creams, ointments and suppositories

Over-the-counter creams and medicines can be used to sooth any inflammation around your anus. A product that contains an anaesthetic may be more effective. However, they should only be used for five to seven days at a time. If used for longer they may irritate the sensitive skin around your anus. Your pharmacist should be able to advise you.

Your GP can also prescribe you with creams to relieve irritation around your anus. These can include:

• bismuth oxide,
• bismuth subgallate,
• peru balsam,
• zinc oxide, and
• witch-hazel.

Creams containing steroids can also be prescribed to reduce inflammation and swelling around your anus. These should not be used for longer than a week.

Always read the patient information leaflet that comes with your medicine before using it. Or, ask your pharmacist for further information.

Banding

Banding involves your GP putting a very tight elastic band around the base of the haemorrhoid inside your anus so that the blood supply is cut off. Within seven days of having the treatment (usually as a day procedure), the haemorrhoids should fall off. This is a common treatment for grade two or three internal haemorrhoids.

You can return to work the following day. However, you might feel some pain or discomfort for a day or so. Normal painkillers are usually effective, but your GP can prescribe something stronger if needed.

You might not notice that the haemorrhoids have fallen off as they should pass out of your body with a bowel movement. Some people notice some mucus discharge within a week of the operation. This usually means the tissue has fallen off.

Directly after the operation it's normal to see some blood on the toilet paper, but you should not bleed a lot. If you start to pass a lot of bright red blood or pass clots, you should go to A&E immediately.

Infections or ulcers can also occur where the banding took place. However, these complications are rare and can be easily treated.

Injections (sclerotherapy)

A chemical solution is injected around the blood vessels in your anus. It relieves pain by numbing the sensory nerve endings at the site of injection. It also hardens the tissue of the haemorrhoid so that a scar is formed. After about four to six weeks, the haemorrhoid should decrease in size or shrivel up. Sclerotherapy is a common treatment for grade two or three internal haemorrhoids and is often used as an alternative to banding.

After the injection, you should avoid strenuous exercise for the rest of the day but can resume your normal activities, including work, the day after. You may also have minor pain for a while and may bleed a little.

Infrared coagulation

Infrared coagulation (also know as infrared light) can be used to treat your haemorrhoids. A special device is used to burn the tissue of the haemorrhoid. One or two bursts of infrared light can cut off the circulation to small internal haemorrhoids, such as grade one or two.

Surgery

Surgery is often used to treat internal haemorrhoids that are either very large or are grade four. See our section on 'surgery' for more information