Hemorrhoids

What are hemorrhoids (piles)?

Hemorrhoids, commonly known as “piles” or “kookoo” in some African communities, are swollen veins in the lower rectum or around the anus. They are similar to varicose veins that appear on the legs but occur in a more sensitive area.

Hemorrhoids can be internal (inside the rectum) or external (around the anus). The external ones are usually more painful and uncomfortable.

Many people experience hemorrhoids, especially as they grow older. In fact, about 50% of adults over 50 years old will have hemorrhoids at some point in their lives. However, younger people, including pregnant women, can also develop them.

How common are hemorrhoids in Africa?

In many African countries, hemorrhoids are becoming more common due to lifestyle changes such as consuming low-fiber diets, prolonged sitting, and lack of exercise. Although exact figures vary, some studies suggest that 1 in 3 adults in urban areas experience symptoms of hemorrhoids at some point. However, because of cultural stigma, many people do not talk about it or seek medical attention until the condition worsens.

Symptoms of hemorrhoids?

Hemorrhoids can cause discomfort and irritation. Here are some signs to look out for:

  • Internal hemorrhoids:
  • Blood on toilet paper or in the stool after using the toilet
  • Feeling like something is sticking out of your anus after a bowel movement
  • External hemorrhoids:
  • Itching around the anus
  • Swelling or painful lumps near the anus
  • Pain while sitting
  • Severe hemorrhoids:
  • Blood clots forming in external hemorrhoids (thrombosed hemorrhoids), causing intense pain
  • Prolapsed hemorrhoids (internal ones that bulge out and do not go back in)

Although hemorrhoids are not life-threatening, they can be very uncomfortable. If you experience severe pain, continuous bleeding, or black stool, you should see a doctor immediately.

What causes hemorrhoids?

Hemorrhoids happen when there is too much pressure on the veins around the anus. Some common causes include:

  • Straining during bowel movements: This often happens due to constipation, a common issue when people eat low-fiber diets.
  • Sitting for long periods, especially on the toilet: Many people in Africa spend extra time in the toilet, especially when using mobile phones. This can worsen the condition.
  • Chronic constipation or diarrhoea: Both conditions increase pressure on the rectal veins.
  • Pregnancy: Pregnant women are at high risk due to increased pressure from the growing baby.
  • Obesity: Excess body weight increases strain on the rectal veins.
  • Heavy lifting: Jobs or exercises that involve lifting heavy objects can contribute to hemorrhoids.
  • Family history: If your parents or grandparents had hemorrhoids, you are more likely to develop them.

Myths about hemorrhoids?

There are many misconceptions about hemorrhoids, including:

   •“Hemorrhoids are caused by eating too much starchy food.”
  • Not true! Hemorrhoids are caused by pressure on the veins, not by eating foods like yam, rice, or maize. However, eating too little fiber can contribute to constipation, which can increase the risk.
  • “Hemorrhoids mean there is dirt stuck in your bowels.”
  • Also, false! Hemorrhoids have nothing to do with how clean your stomach is.
   •“Traditional herbal mixtures can cure hemorrhoids completely.”
  • Some herbal treatments may help with pain and swelling, but they do not always cure hemorrhoids. Be cautious of unverified local remedies.

How to treat hemorrhoids?

Treatment depends on how severe the hemorrhoids are. Here are some ways to manage them:

Home remedies

If you have mild hemorrhoids, try these simple home treatments:

  • Soak in warm water: Sitting in warm water (a sitz bath) for 10–15 minutes daily can reduce swelling and pain.
  • Eat high-fiber foods: Foods like whole grains, fruits, and vegetables help soften stool and reduce constipation.
  • Drink plenty of water: At least 8 glasses per day help prevent hard stools.
  • Use pain relievers: Paracetamol or ibuprofen can help with pain.
  • Avoid straining when using the toilet: If you feel the urge to go, do not delay.
  • Wear loose clothing: Tight underwear and trousers can make symptoms worse.

Medical treatment?

If home remedies do not work, a doctor may suggest:

  • Rubber band ligation: A small rubber band is placed around the hemorrhoid to cut off its blood supply, causing it to shrink.
  • Injection therapy (sclerotherapy): A chemical solution is injected into the hemorrhoid to shrink it.
  • Surgery: In extreme cases, doctors may remove large or very painful hemorrhoids.

How to prevent hemorrhoids?

Prevention is always better than treatment! Follow these steps to avoid hemorrhoids:

  • Eat a fiber-rich diet: Include more fruits, vegetables, and whole grains in your meals.
  • Drink enough water: This helps soften stools and makes bowel movements easier.
  • Exercise regularly: Physical activity helps keep your bowels active and prevents constipation.
  • Do not sit for too long: If you have a desk job, take short breaks to move around.
  • Use the toilet when needed: Do not force yourself to go, and do not hold it in for too long.

Complications of hemorrhoids?

Although rare, untreated hemorrhoids can lead to:

  • Blood clots in the swollen vein
  • Severe bleeding, leading to anemia (low blood count)
  • Infection of an external hemorrhoid
  • Painful skin tags (extra skin) left after healing

Final advice? Hemorrhoids are common and treatable. Many people feel embarrassed to talk about them, but there is no shame in seeking help. If you have constant pain, bleeding, or discomfort, visit a