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What are haemorrhoids?

Haemorrhoids are often described as “varicose veins” of the anal canal. In fact they consist of various swollen blood vessels covered by the lining of the anal canal. Most haemorrhoids commence as internal haemorrhoids and cannot be seen but as a haemorrhoid enlarges it bulges into the anal canal and eventually it may protrude through the opening of the anus (prolapse). This can sometimes cause an anal skin tag by stretching the skin.

What causes haemorrhoids?

Internal haemorrhoids are due to a weakening of the supportive connective tissues within the anal canal allowing the lower rectal lining to bulge. Contributing factors cause veins within the haemorrhoids to enlarge. Contributing factors might include:

  • ageing
  • chronic constipation or diarrhoea
  • pregnancy
  • faulty bowel habit
  • straining at bowel action
  • long periods on the toilet

What are the symptoms?


This is the most common symptom of haemorrhoids, usually seen on the toilet paper. Often the blood may drip or spray into the toilet bowl. It is unwise to assume that bleeding is always due to haemorrhoids without appropriate investigation.


External lumps from haemmorhoids (prolapse) may occur during a bowel action or at other times. Usually this is reducible. Acute prolapse is less common, painful and requires a surgical opinion.

Discomfort – Pain

Moderate discomfort is common but severe pain may indicate a complication of the haemorrhoids (e.g. perianal thrombosis, acute prolapse) or the presence of an anal fissure (split).


This common symptom is due to mucous discharge.