Haemorrhoids

Straining to go to the toilet can cause the blood vessels around the rectum and anus to become swollen. This is haemorrhoids, often referred to as piles. 

Sufferers may notice spots of bright red blood or anal discharge, experience pain when defaecating, and not feel they have emptied their bowels completely. They may also complain of itching around their anus. Causes include poor toilet or eating habits, being overweight, pregnancy and childbirth.

Much of the advice provided for constipation is relevant for haemorrhoids as well, but there are also products available that may ease symptoms, including astringents to relieve irritation, anti-inflammatories such as hydrocortisone to reduce swelling and local anaesthetics to reduce pain and itching. However, if symptoms continue for more than a week or so, patients should be advised to seek medical help for further investigation.

IBS and IBD

Irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) may seem similar from their initials, and both can feature abdominal pain, diarrhoea and constipation, but in fact they are very different long-term conditions.

IBS can be very distressing for sufferers but is not serious in itself. IBD, on the other hand, causes progressive damage to the gastrointestinal tract due to ulcerative colitis or Crohn’s disease.

IBS and IBD are also treated very differently:

• IBS management is centred on relieving symptoms, for example by identifying and avoiding triggers and/or using antispasmodics such as mebeverine, antidiarrhoeals and laxatives. Dietary modification is effective for some people
• IBD management focuses on reducing the inflammatory response through use of aminosalicylates such as sulfasalazine and mesalazine, corticosteroids, calcineurin inhibitors such as tacrolimus and ciclosporin, immunosuppressants such as azathioprine and methotrexate, and immunomodulators such as infliximab and adalimumab.