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PILES (HAEMORRHOIDS)

Haemorrhoids are dilated veins, which surround the lower three to five centimetres of the rectum, and its ending, the anus.

They may be external or internal. External haemorrhoids are found below the anal sphincter (the muscle which closes the anus), and internal haemorrhoids may come out through it.

Most haemorrhoids, mainly external, do not cause symptoms. When they do, bright red bleeding, pains after defecation, with itching are the typical symptoms. It is characteristic, mainly with external haemorrhoids, to be unable to keep the anal area clean.

Most haemorrhoids do not require treatment. Occasionally, severe complications develop and do not evolve into malignancy. In all cases it is always necessary to:

• Reassure the patient, showing that the only importance of the condition is the discomfort.
• Hygienic measures. Keep the area as clean as possible, avoiding excessive rubbing with toilet paper and towels, doing regular washings and avoiding long periods of sitting or standing.
• Diet measures. Avoid spicy foods and alcohol; the diet will be high fibre (wholemeal bread, breakfast cereal, vegetables and fruit).
• Bowel regulation. Avoid constipation and diarrhoea.

If haemorrhoids cause symptoms, lukewarm water bathing for fifteen minutes three times a day is recommended. If the pain is severe, bed rest and general anaesthetics, cold pads locally and ointment against haemorrhoids with ruscogenin and trimembutine (DRAWER 2, first aid kits A and B).

If there are internal prolapsed Haemorrhoids (outside the anus) try to replace them after washing the area. If it is not possible, ask for MEDICAL ADVICE VIA RADIO . In any case, a medical consultation is required, for the definitive treatment as well as to exclude any severe bowel disease.