Haemorrhoids are vascular cushions which usually create the water and air tight seal at the junction of the rectum and anal canal. When the haemorrhoids become enlarged and swollen they can slip downwards through the anal canal and cause bleeding, irritation and lumps that can be felt when wiping. Typically, people notice painless bleeding from the rectum.

The “slippage” of haemorrhoids occurs more so in patients with chronic constipation when straining to open bowels leads to congestion of the vascular cushions and then their descent towards the anus. Maintaining a diet high in fibre and fluid so that bowels open with minimal straining can be effective at reducing bleeding and symptoms of haemorrhoids.

Internal haemorrhoids remain within the anal canal and present with painless rectal bleeding.