Haemorrhoids are one of the most common conditions seen in a proctology clinic, yet they are also among the most under-diagnosed. Many people live with symptoms for months or years without knowing exactly what is wrong, or without daring to seek advice.
What are haemorrhoids?
Haemorrhoids are normal vascular structures of the anal canal. Everyone has them: they are cushions of tissue that help control the passage of stools. The problem arises when they become inflamed, enlarge, or prolapse, producing troublesome symptoms.
There are two types: internal haemorrhoids, inside the anal canal and generally painless, and external haemorrhoids, outside the anus, which can cause pain and irritation.
Most common symptoms
- Rectal bleeding: the most common symptom. Bright red blood on the paper or in the toilet bowl.
- Anal itching or burning: caused by moisture and irritation in the perianal area.
- Sensation of a lump: in more advanced haemorrhoids, tissue may protrude during defecation.
- Pain: internal haemorrhoids rarely cause pain. Intense pain suggests thrombosis or anal fissure.
- Feeling of incomplete evacuation.
Grades of haemorrhoids
- Grade I: they bleed but do not prolapse.
- Grade II: they prolapse during defecation but reduce spontaneously.
- Grade III: they prolapse and require manual reduction.
- Grade IV: they cannot be reduced and remain outside the anal canal.
When should I seek advice?
Consult a proctologist if you have: recurrent rectal bleeding, severe pain, a lump that cannot be reduced, symptoms lasting more than two weeks, or changes in bowel habit alongside bleeding.
Is there treatment without surgery?
In the vast majority of cases, grade I, II and III haemorrhoids are treated without surgery using rubber band ligation or foam sclerotherapy, at the clinic, in the same appointment as the diagnosis, without hospital admission and with immediate recovery.