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 defaecation:

• 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