Hemorrhoids

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Discover why hemorrhoids occur and how they can be treated.

What are hemorrhoids?

Hemorrhoids, also known as piles, occur when veins in the anus or lowest part of rectum become swollen. Some hemorrhoids are asymptomatic, but they can cause bleeding, itching, pain, and discomfort.

Internal hemorrhoids occur within the lower rectum and typically do not cause pain. They appear in the form of a grape-likemass (called a prolapsed hemorrhoid) that can sometimes extend outside of the anus.

External hemorrhoids develop beneath the skin surrounding the anus. These can be uncomfortable and even painful if a blood clot forms in them.

Causes of hemorrhoids

There are a few common contributing factors for hemorrhoids. Extended time sitting on the toilet adds pressure to the rectal and anal veins as does straining during bowel movements. Individuals with chronic constipation or diarrhea also increase risk for hemorrhoids.

During pregnancy, the growing uterus can add pressure on the rectal and anal veins, leading to hemorrhoids. Likewise, obesity can increase pressure on the veins making hemorrhoids more likely.

Symptoms

Symptoms of hemorrhoids can include:

  • Small amounts of bright red blood on toilet paper or in the toilet following the passing of very hard or large stool.
  • Irritation or itching near the anus.
  • Pain, sensitivity, or discomfort.
  • Intermittent swelling around the anus.
  • Mucous discharge from a prolapsed hemorrhoid extending from the anus.

Diagnosis

Talk to your doctor about diagnosis if bleeding during bowel movements occurs frequently or if you have severe pain. One test they might perform is a digital examination; this is when the doctor inserts a gloved finger into the rectum to feel for abnormalities. For internal hemorrhoids, the anoscope, proctoscope, or sigmoidoscopeare procedures that provide additional insight. In some cases, a full colonoscopy may be done if there are possibilities for digestive diseases or high risks for colorectal cancer.

Prevention

There are lifestyle changes that can help regulate bowel movements, soften stool, and prevent constipation. The following suggestions can reduce the occurrence of hemorrhoids:

  • Increase fiber intake.Beans, bran, fresh fruits, and whole grains are examples of high fiber foods that can be added to your diet. Ideal daily intake is 25 to 30 grams of fiber. Other options include over-the-counter fiber powders, such as Citrucel or Metamucil. Small increases in the amount of fiber intake prevents gas and bloating.
  • Regular exercise. Walking approximately 20 minutes each day can improve bowel regularity.
  • Drink plenty of liquids.Drinking 6-8 glasses of water can soften stool.
  • Establish a bowel movement schedule. Consistently sitting on the toilet at the same time each day can help to train your digestive system. However, long periods of sitting are discouraged. Also, it is important to respond quickly to signs you are having a bowel movement.

Treatment

Home remedies are often effective in relieving the inflammation, swelling, and pain associated with hemorrhoids. They include:

  • Topical treatments. Hemorrhoid cream or suppositories are available over-the-counter. Witch hazel pads are recommended to numb the area.
  • Soaking in warm baths. If hemorrhoids are uncomfortable, sitting in a tub of plain warm water for about 15 minutes can help reduce discomfort and inflammation. This can be done 3-4 times each day. It also keeps the rectal area clean, but drying the area is important following each bath.
  • Oral pain relievers. Tylenol, Advil, aspirin, or ibuprofen can offer temporary relief from pain or discomfort.
  • Clean anal area. Showering or bathing daily exposes the skin around the anus to warm water. Using perfume and alcohol-free moist towelettes or wipes also keeps the anal area clean after passing stool.

For more severe cases of internal hemorrhoids, the doctor can use other treatments including:

  • Rubber band ligation. A common office procedure of placing a rubber band around the base of an internal hemorrhoid. This cuts off circulation and shrinks the hemorrhoid.
  • A chemical treatment injected into the hemorrhoid or the surrounding area. The reaction shrinks the hemorrhoids by intervening in the blood flow in the hemorrhoid.
  • Coagulation therapies. Use of infrared light to burninternal hemorrhoids.

Other surgical operations may be necessary. A hemorrhoidectomy is an operation that is effective in treating internal and external hemorrhoids but can be painful. Stapling is a less painful surgical alternative that staples the hemorrhoid, blocks blood flow, and removes the hemorrhoid tissue.

 

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