Haemorrhoids, also called piles, are swollen veins inside or around the anus and lower rectum. They may be internal (inside the anus) or external (visible outside). Anal fissures, on the other hand, are small tears or cracks in the lining of the anus that cause sharp pain during or after passing stool.
These conditions are common in Uganda, especially among people who are constipated, sit for long hours, or eat low-fibre diets. Although often not life-threatening, they can cause discomfort, pain, or bleeding and can greatly affect quality of life if not managed properly.
If you have persistent rectal pain, bleeding, or swelling, Hope Plus can connect you to a licensed healthcare provider in minutes. You can get medical advice, prescriptions, or referrals for examination and treatment. Learn more at Hope Plus.
Key Takeaways
- Haemorrhoids are swollen veins in or around the anus; anal fissures are small tears in the anal lining.
- The main causes include constipation, straining, pregnancy, and sitting for long periods.
- Common symptoms include rectal bleeding, pain, swelling, and irritation.
- Treatment involves dietary changes, sitz baths, creams or suppositories, and sometimes antibiotics or surgery.
- Prevention focuses on a fibre-rich diet, adequate fluids, and avoiding straining when passing stool.
Causes of Haemorrhoids and Anal Fissures
- Constipation and straining when passing stool.
- Pregnancy or conditions that increase pressure on the pelvic veins.
- Portal hypertension, which increases pressure in the anal veins.
- Abdominal tumours compressing veins.
- Sedentary lifestyle or sitting for long periods.
Symptoms
Haemorrhoids (Piles)
- Painless rectal bleeding during bowel movements.
- A visible swelling or lump at the anus that may protrude during defecation.
- Mucous discharge and irritation around the anus.
- Blood coating the stool or appearing on toilet paper, not mixed within the stool.
Anal Fissures
- Sharp pain when passing stool.
- Bright red bleeding seen on toilet paper or stool surface.
Diagnosis
Healthcare providers may perform:
- Visual inspection and digital rectal examination.
- Proctoscopy, sigmoidoscopy, or colonoscopy to check for other causes such as polyps, rectal cancer, or infections.
Treatment and Management
Step 1: Home and Medical Care
- Increase fibre and fluid intake to soften stool.
- Correct constipation using fibre-rich foods (vegetables, fruits, whole grains) or mild laxatives if prescribed.
- Sitz bath: Sit for 10–15 minutes in lukewarm water with a spoon of salt, 2–3 times a day to ease pain and swelling.
- Apply a haemorrhoid cream or suppository such as Anusol or Sediproct, inserted every 12 hours for 5 days.
Step 2: If Infection is Present
- Metronidazole 400 mg every 8 hours for 5 days may be given.
- Pain relievers can be used as prescribed by a healthcare provider.
Step 3: If No Improvement
- Refer to hospital for surgical treatment, especially if bleeding, prolapse, or severe pain persists.
Prevention Tips
- Eat a high-fibre diet: include vegetables, fruits, and whole grains.
- Drink plenty of water daily.
- Exercise regularly to improve bowel movement.
- Avoid straining and spending long periods on the toilet.
- Avoid reading or using your phone in the toilet, which delays bowel emptying.
Frequently Asked Questions
1. What are haemorrhoids?
They are swollen veins around the anus that can cause bleeding, itching, or swelling, especially after straining during bowel movements.
2. What causes anal fissures?
They are caused by passing hard stool or frequent straining that tears the lining of the anus.
3. Can haemorrhoids and fissures heal without surgery?
Yes. Most mild cases improve with diet, sitz baths, and topical treatment. Surgery is only needed if symptoms persist or become severe.
4. What does the bleeding look like?
Usually bright red blood that coats the stool or appears on toilet paper after wiping.
5. Is it safe to use haemorrhoid creams without seeing a doctor?
It is better to consult a healthcare provider first to confirm the cause of bleeding and get proper treatment.
6. Can constipation cause piles?
Yes. Straining and passing hard stool are major causes of haemorrhoids and fissures.
7. How can Hope Plus help?
Through Hope Plus, you can speak with a licensed healthcare provider who can assess your symptoms, prescribe safe treatments, and guide you on diet and lifestyle changes.
