These are varicosities of the haemorrhoidal plexus often complicated by inflammation, thrombosis, and bleeding. Haemorrhoids are not commonly associated with pregnancy.

Clinical Features

  • There is painless rectal bleeding
  • Prolapse or sensation of a mass in the anal area (especially during defecation)
  • Mucous anal discharge.

Appropriate assessment is digital examination and proctoscopy (use good lght).

Haemorrhoids may be complicated

  • Thrombosis
  • Infection
  • Profuse bleeding


  • Advise a high residue diet or bulk laxative to prevent constipation
  • Specific treatment includes:
    • Rubber-band ligation for 2°–3° haemorrhoids
    • Manual anal dilatations
    • Injection sclerotherapy.
    • Haemorrhoidectomy (for 2°–3° piles) where other methods have failed.
    • Management of associated compilations.