Haemorrhoids

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Symptoms & Causes Diagnosis & Treatment

What are Haemorrhoids

Haemorrhoids are clusters of swollen blood vessels and connective tissues which arise from normal haemorrhoidal cushions. They may develop internally or externally and vary in severity. Haemorrhoids are classified as internal or external haemorrhoids according to their origin within the anal canal.

What Causes Haemorrhoids?

Haemorrhoids are primarily caused by increased pressure in the lower rectum, which can lead to bulging and inflamed veins. Common triggers include:

  • Straining during bowel movements: Often due to constipation or hard stools.
  • Chronic diarrhoea or constipation: Repeated straining causes engorgement of vessels due to decreased venous return.
  • Sitting for prolonged periods on the toilet affects venous return.
  • Obesity: Excess weight raises pelvic and rectal vein pressure.
  • Pregnancy: The growing uterus presses on pelvic veins; hormonal changes may slow bowel movements.
  • Low-fibre diet and dehydration lead to harder stools and straining.
  • Frequent heavy lifting: Increases abdominal pressure.
  • Anal intercourse: May contribute to irritation or swelling.
  • Sedentary lifestyle: Reduced physical activity slows bowel motility.
  • Chronic liver disease or portal hypertension: Can worsen haemorrhoids.
  • Genetic predisposition: Weak connective tissue may run in families, increasing susceptibility.

Type of Haemorrhoids

Haemorrhoids are classified based on their location:

  • Internal haemorrhoids: Located inside the rectum, usually not visible or painful unless they prolapse or bleed.
  • External haemorrhoids: Found under the skin around the anus, often causing pain, swelling, or irritation.
  • Thrombosed haemorrhoids: Occur when a blood clot forms in an external haemorrhoid, resulting in severe pain and swelling.

Common Symptoms of Haemorrhoids

Symptoms can vary depending on the type of haemorrhoid:

Internal haemorrhoids

  • Painless rectal bleeding during or after bowel movements
  • Bright red blood on toilet paper or in the toilet
  • Prolapsed haemorrhoids (bulging outside the anus), which may cause pain or irritation

External haemorrhoids

  • Itching or burning around the anus
  • Pain or soreness, especially when sitting
  • Swelling or a lump near the anal opening
  • Minor bleeding

Thrombosed haemorrhoids

  • Intense pain
  • Hard, swollen lump near the anus
  • Discolouration (bluish or purplish)
  • Inflammation in the affected area

Who is at Risk of Haemorrhoids?

Haemorrhoids can affect people at any age, but certain factors increase the likelihood of developing them, especially with advancing age.

Ageing

As people age, the connective tissues that support the anal and rectal veins naturally weaken. This makes it easier for veins to swell and bulge, increasing the likelihood of both internal and external haemorrhoids.

Pregnancy

During pregnancy, the growing uterus puts pressure on the pelvic veins, including those in the rectum. Hormonal changes can also contribute to slower bowel movements, raising the risk of straining.

Why Early Recognition Matters

Although complications from haemorrhoids are rare, ongoing symptoms can affect quality of life and may signal more serious conditions. Early assessment at SJMC allows for accurate diagnosis and tailored management, helping to prevent complications such as anaemia, thrombosis, or strangulation of haemorrhoids.

Early recognition also supports better symptom management and provides patients with reassurance through professional medical guidance. At Subang Jaya Medical Centre (SJMC), individuals have access to experienced specialists and advanced diagnostic services, ensuring their condition is carefully evaluated and managed with appropriate care.

FAQs About Haemorrhoids Causes and Symptoms

Haemorrhoids are commonly caused by increased pressure in the lower rectum, often due to risk factors such as chronic straining during bowel movements, prolonged sitting on the toilet, low-fibre diets, or frequent constipation or diarrhoea. Pregnancy, obesity, and ageing also raise the risk.

While haemorrhoids themselves are not directly inherited, a genetic predisposition to weak veins or poor connective tissue support in the rectal area may increase your likelihood of developing them if family members have had the condition.

Indirectly, yes. Stress can disrupt bowel habits, leading to constipation or diarrhoea, both of which increase the risk of haemorrhoids.

External haemorrhoids usually cause pain, swelling, or itching around the anus and may be felt as lumps. Internal haemorrhoids are deeper inside the rectum and often painless, but may cause bright red blood during bowel movements or a feeling of incomplete evacuation.

While bright red bleeding is a common symptom, it’s important to rule out other causes like colorectal cancer or anal fissures, especially if bleeding is persistent, dark in colour, or accompanied by changes in bowel habits.

Low-fibre foods, spicy meals, processed foods, and inadequate water intake can lead to hard stools and constipation, which may worsen haemorrhoids. A fibre-rich diet and proper hydration are key to prevention.

Not necessarily. Internal haemorrhoids are often painless but may cause bleeding or a sensation of fullness. External haemorrhoids are more likely to be painful, especially if a blood clot (thrombosis) forms.

Mild haemorrhoids can resolve with lifestyle changes like a high-fibre diet, better hydration, and avoiding straining. However, recurrent or severe cases may require medical or surgical treatment.

Reference

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