Clinical features

Haemorrhoids often only produce intermittent symptoms. Symptomatic episodes are often precipitated by constipation. These episodes usually last from a few days to a few weeks. Often they are completely asymptomatic between episodes.

• Clinical features of haemorrhoids (piles) include:
  bright red bleeding after defecation:
  • may just stain the toilet paper or streak the faeces (it is not mixed in)
  • if copious, it may splash around the lavatory pan
• faecal soiling due to impaired continence
• mucus discharge
• pruritus ani, caused by a persistent discharge irritating the perianal skin
• a feeling of incomplete evacuation after a bowel movement if prolapse occurs
• occasionally pain:
  • thrombosis may cause acute severe anal pain occasionally necessitating hospital admission
• grades 2-4 may be felt as a rectal mass