Piles

Question 1

Symptoms?

Answer 1

Bright red, painless rectal bleeding - Typically occurs with defecation and can be seen as streaks on toilet paper, in the toilet bowl and outside of the stool.

Anal itching or irritation

Incomplete evacuation of bowel movements, a feeling of discomfort or rectal fullness.

Soiling

Pain - only in prolapse and becomes strangulated. Not usually reported in internal or external haemorrhoids unless thrombosis occurs in external haemorrhoids.

Question 2

Red flag?

Answer 2

Bleeding during bowel movements

Noticeable bulge at the anus that seems to retract following bowel movement

Sensation you’re not emptying stool completely

Discomfort, itching and irritation in the anal region

unexplained appetite loss

deep vein thrombosis

unexplained weight loss

unexplained anal mass or anal ulceration

anaemia (age 60 and over) and anaemia in adults under 50 with rectal bleeding

unexplained abdominal pain without rectal bleeding,

change in bowel habit with bleeding in adults ages under 50 and change in bowel habit in adults ages over 60

occult blood in faeces

rectal mass

unexplained rectal bleeding aged 50 years and older

Question 3

Questions?

Answer 3

Any unexplained weight loss?

Any change in bowel habit?

Is there any bleeding?

Any blood in faeces?

Any conditions that raise intra-abdominal pressure (pregnancy, childbirth, ascites or a pelvic mass)?

Are there any reliving factors? Anything that makes the symptoms worse or better?

Question 4

Treatment?

Answer 4

Ispaghula Husk

Child 6-11 years:
2.5-5ml twice daily, dose to be given as half or whole level spoonful in water, preferably after meals, morning and evening.

Child 12-17 years and adults:
1 sachet twice daily, dose to be given in water preferably after meals, morning and evening.