It can be painful, itchy and uncomfortable. It is also not something people discuss openly or admit they suffering from for fear of embarrassment. Haemorrhoids (piles) can feel like a big, uncomfortable elephant in the room, but it’s a topic that needs to be addressed.
For Thandeka Magida from Khayelitsha, in Cape Town, haemorrhoids have been a constant source of discomfort, embarrassment, and anxiety.
She first noticed symptoms in her twenties, and they would often flare up after taking laxatives or having a stomach bug. Magida described the symptoms as “a nightmare” that impacted her everyday life. She tells Health for Mzansi that it’s “not easy to talk about, but knowing you’re not alone can make a big difference”.
‘Living with piles is annoying’
“I’ve realised over time that if I consume too much bread in a week, I get a burning sensation in my anus and find it difficult to sit.”
Magida used her fingers to examine her anus and found that it was swollen and covered in small growths that felt like warts. She says that these growths made it uncomfortable to have a bowel movement and that they became especially irritated and itchy during her menstrual period.
“I have tried over-the-counter medications, and treatments at clinics, and occasionally I would steam using warm water in a bucket with eucalyptus oils and sit for a few minutes. I always use this method, even if they return.”
Thandeka Magida
Magida says she followed social media advice on how to deal with haemorrhoids, limited her bread consumption, and practised drinking more water. Haemorrhoids no longer visit her as frequently as they previously did after she adjusted her lifestyle.
Haemorrhoids after birth
Zipho Joyi of East London in the Eastern Cape noticed that she was having problems after giving birth in 2021. She experienced swelling, pain, and discomfort. Her mother recognised the symptoms as haemorrhoids and helped her find treatment by drinking Chinese tea. Eventually, the piles went away and Zipho Joyi was able to return to her normal life.
However, she gave birth to her second child in August of this year, just a few days after becoming constipated and turning to the special tea, which isn’t working this time.
“Social media advised me to opt for a higher fibre diet, and I have attempted it, but nothing has changed. I no longer have constipation and my poop is not hard, but I have itchy, extremely painful, inflamed haemorrhoids.”
Zipho Joyi
Joyi says she has tried steaming and other home remedies, but her haemorrhoids continue to make her life wretched; she can recline comfortably, but going to the toilet is a challenge. She explains to Health for Mzansi that pushing a stool is comparable to pushing a hard object, and the resulting agony is intolerable.
Causes and symptoms
Dr Mxolisi Xulu from the Nelson Mandela Academic Hospital in Mthatha in the Eastern Cape explains that haemorrhoids can be classified into two main types: external and internal haemorrhoids. He further explains that internal haemorrhoids form within the rectum, whereas external haemorrhoids develop in the vicinity of the anus.
The primary distinction in presentation between the two types lies in the visibility or palpability of external haemorrhoids, as opposed to internal haemorrhoids which cannot be seen or felt externally. Internal ones may only become noticeable if they begin to bleed or cause additional symptoms such as itching or discomfort.
He says, there are various causes of haemorrhoids. People over the age of 50 are at risk due to age, because many people over 50 have a slower metabolism, as well as those who are obese, pregnant or have recently given birth, Xulu explains.
Other factors include straining during bowel movements, following a low-fibre diet, experiencing chronic diarrhoea, or having a family history of haemorrhoids.
However, Xulu emphasises that while these causes may contribute to the development of piles, many of them can be managed or controlled.
“Certain risk factors can be managed, such as diet and exercise, while others, such as family history, are beyond our control.”
Treatment options
According to Xulu, there are various phases of haemorrhoids, and each stage is characterised by distinct symptoms.
Stage 1: Haemorrhoids are the mildest form, and symptoms may not even be present.
Stage 2: Haemorrhoids may protrude, or ‘prolapse,’ outside the anus, but they will typically return to the interior on their own. After a bowel movement.
Stage 3: Haemorrhoids must be manually forced back into the anus.
Stage 4: Haemorrhoids are so enlarged that they cannot be shoved back inside the anus. As the stage progresses, the severity of the symptoms increases.
Depending on the severity of the condition, there are a variety of treatment options for haemorrhoids. Procedures such as rubber band ligation or coagulation therapy may be effective if these treatments fail or if the haemorrhoids are more severe.
Xulu states that in some instances, surgery may be required.
“It is important to be physically active, consume more fibre, and avoid reading and sitting in the bathroom.”
Dr Mxolisi Xulu
Although complications from surgery are possible, Xulu says they are very rare to occur.
He explains that haemorrhoid surgery is typically intended when other treatments have failed or when the haemorrhoids are severe and causing significant suffering and anguish. In addition, surgery is frequently recommended for patients whose bleeding persists despite other treatments, or who have other complications such as anaemia or infections.
“In some cases, surgery may also be recommended for people who have a family history or other risk factors for complications.”
It all starts with good nutrition
What you eat has a big impact on your digestive system and eating the wrong kinds of food can cause or exacerbate haemorrhoids. There is also a link between stress and haemorrhoids. Although stress does not directly cause it, it is a factor so when you are going through a stressful time, it is important to eat well.
According to WebMD, wrong foods that can cause constipation are:
- White bread and bagels
- Milk, cheese, and other dairy
- Meat
- Processed foods such as frozen meals and fast food
Good foods that can aid in good bowel movement are legumes such as beans and lentils; whole-grain food; and fruit and vegetables, especially with the skin on. Leafy greans and brightly coloured produce packs a nutritional punch and will get your digestive system going. And remember to drink a lot of water!
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