Haemorrhoids

What are haemorrhoids?

Haemorrhoids (piles) are swellings in the rectum and the anus that fill up with blood. They are caused by weakened blood vessels and they can be compared to varicose veins. They develop in the anus (internal haemorrhoids), but sometimes they swell outside (external haemorrhoids). Blood clots may develop in haemorrhoids. The main cause is constipation, which results in excessive straining. This raises the pressure in the arteries and makes them weaker and wider locally.

What are the complaints associated with haemorrhoids?

Haemorrhoids can remain quite small and unnoticed. Their presence is usually indicated by bright-red blood in stools, on the toilet paper or in the toilet. External haemorrhoids are painful swellings or hard bumps around the anus. Hard haemorrhoids may be caused by a blood clot. Excessive straining, rubbing or cleaning around the anus can cause irritation with bleeding and itching. 
Haemorrhoids are the main reason for rectal blood loss (in about 16-35% of people who see their GP for rectal blood loss, the cause is haemorrhoids). ^245x

People with intellectual disabilities sometimes find it impossible to communicate pain. The people around them may then notice only a change in behaviour.

How common are haemorrhoids in the general population?

Research ²⁴⁵ , ²⁴⁶  indicates that the prevalence of haemorrhoids is 5% to 10%. It is known that only a small proportion of people with haemorrhoids go to the GP. Approximately half of the population may suffer from haemorrhoids. ²⁴⁷

How common are haemorrhoids in people with intellectual disabilities?

Only limited research has been found about the prevalence of haemorrhoids in people with intellectual disabilities. A Dutch study of 318 people with intellectual disabilities found haemorrhoids 2.2 times more frequently than in the control group without intellectual disabilities. ²⁴⁸

It can be expected that this problem occurs frequently because constipation, as the major cause of haemorrhoids, is more than fifteen times more prevalent in people with intellectual disabilities than in the general population (see constipation).