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Piles / Haemorrhoids – Anal Itchiness or Pain

What Are Piles or Haemorrhoids?

Haemorrhoids are also known as piles, are engorged/swollen veins (varicose veins) inside and around the anus. When the veins engorge with blood they can be felt and seen as either a hard or soft lump in the rectum and around the anus. They range in size from a small pea up to a large grape – sometimes the walls of the veins are so stretched they bulge out & get irritated especially when passing a bowel movement.  Haemorrhoids can be itchy or painful and are the most common causes of rectal bleeding.

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Internal Haemorrhoids - Ones Higher Up In The Rectum

Generally the internal haemorrhoids are not that uncomfortable as they are higher up in the rectum and there are not as many pain sensing nerves there. However they can be the cause of blood on toilet paper after you wipe.  They can sometimes prolapse out as well.

External Haemorrhoids - Ones You Can See And Feel On the Outside

The external haemorrhoids are the ones that are most frustrating and painful.  They are quite common in the third trimester of pregnancy. This is due to the increase in progesterone hormone as well as increased pressure on the anus from the growing uterus as well as any issues with constipation. The straining during constipation or giving birth can increase the likelihood of developing them.

What are Anal Fissures or Tears?

Anal Fissures are small tears in the delicate lining of your anus again often due to straining.  The tear can expose the muscle around the anus called the anal sphincter.  The damage from the tear can cause that anal sphincter muscle to spasm pulling the edges of tear apart even more.  Hence they tend to be very painful when they happen.

They like haemorrhoids often present with itchiness, pain and blood appearing with the stool.

Treatments

Avoid Constipation And Straining

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Ensuring sufficient fibre & fluid intake and adhering to the advice in our ‘Constipation’ section will help to not irritate the haemorrhoids.

Keep The Area Clean And Dry

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Using a squirt bottle or sitz bath or wet toilet wipes both after using the toilet and for symptomatic relief.  Keep the wipes next to your toilet ready to use.

When bathing or showering try using a gentle medicated body wash and make sure pat with a towel or use a hair dryer on cool heat over the area until completely dry.

Position

Normal Sitting Position

When using the toilet ensure to use a stool or potty squatty to help optimise relaxation of the pelvic floor.  Where possible relieve pressure by lying down to offload the pelvic floor and anal region. Or sitting on a ring cushion or a wedge cushion.

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Ice and Cold Baths

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Cool baths or showers and cold compresses applied to the itchy and inflamed area can provide temporary relief.    It’s not an easy area to apply ice to but you can try putting a small cylindrical tube in the freezer until icy cold then wrapping in a small cloth and placing between your bottom cheeks and sitting on it.  It is very important to wrap in something and not apply directly to prevent ice burn.

Clean Properly and Promote Healing with Sitz Baths

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You can try the following to relieve discomfort, promote faster healing and ensure the area is as clean as possible.  Fill a bath tub or basin with 3-4 inches of clean warm water and sit in it for about 15-20 mins.  You can also add a little bit of epsom salt or baking soda to the water which can help with soothing.  In addition to cleaning the warm water increases blood flow to the perineal area which can promote faster healing as well as reduce itching, irritation and mild pain.

Stool Softeners & Suppositories

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Each time you strain due to constipation and your faeces being hard and difficult to pass it can worsen your symptoms and prevent healing. Stool softeners (taken orally) and suppositories (inserted into the anal canal) can help by encouraging your faeces to absorb fluid so that they become easier to pass.  It is strongly recommended however to discuss with your Medical Provider before using them as some can be contraindicated in pregnancy especially in the first trimester.

Medicated Treatments

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There are some simple topical treatments which can be applied from the pharmacy but the most effective creams with a small amount of steroid in are available on prescription so worth seeing your Doctor if symptoms are quite debilitating.

Always make sure you wash the area and ensure is completely dry by patting with towel or using hairdryer on cool heat over the area.  Creams are not effective when they are applied to areas that are not completely dry.  Bacteria also grows much more readily in moist conditions.

Exercise

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Avoid strenuous exercises such as weight lifting or impact exercise until your symptoms have resolved as can lead to them become aggravated and worsening.

Once healed it may be worth trying to learn some pelvic floor relaxation to help with reducing the need to strain.  Take a look at our ‘Constipation’ Section to view more details on how to do this.

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