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Health For Mzansi

Haemorrhoids: Let’s address the big elephant in the room

Given their location in the body, haemorrhoids remain an awkward topic. But these enlarged blood vessels can strike anyone at any given time. To help ease the discomfort, sufferers share their stories and a doctor unpacks symptoms and treatment

by Vateka Halile
20th October 2023
in My Health
Reading Time: 7 mins read
A A
Haemorrhoids: Let's address the big elephant in the room

Haemorrhoids cause discomfort and pain when passing a stool in the toilet. Photo: Myloview.

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.

Haemorrhoids: Let's address the big elephant in the room
Thandeka Magida says lifestyle modifications have eased her piles. Photo: Thandeka Magida.

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

Haemorrhoids: Let's address the big elephant in the room
Zipho Joyi is experiencing a recurrence of piles following childbirth. Photo: Zipho Joyi.

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.

Haemorrhoids: Let's address the big elephant in the room
Haemorrhoids induce pain and a burning sensation when sitting. Photo: Medical News Today.

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.

Haemorrhoids: Let's address the big elephant in the room
Changing one’s lifestyle and getting more exercise, according to Dr Mxolisi Xulu, can lessen haemorrhoids. Photo: Dr Mxolisi Xulu.

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!

ALSO READ: Impepho: A mighty plant with spiritual and healing benefits

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Tags: FibreHelp me understandNutrition
Vateka Halile

Vateka Halile

Vateka Halile grew up in rural areas of Cofimvaba in the Eastern Cape. She was raised in a traditional family setting and found writing to be a source of comfort and escape. Vateka participated in an online citizen journalism course through Food For Mzansi, and her passion for health and medicine-related stories was born. Her dedication to community work and love for social justice and solidarity spaces is evident in her quality time with the community when she isn't working.

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HIV and initiation: Supporting boys through cultural rites Security fails as gangs target Eastern Cape clinics Dr Makanya blends spiritual healing with art therapy Canola oil: A heart-healthy choice for your kitchen No more pain! Tackle the torment of toothaches How smoking causes harmful bacteria in your mouth Discover delicious, healthy dishes that will make your heart sing Rediscover the joy of creamy pap with chicken livers