Hemorrhoids (HEM-uh-roids) are also known as piles. Hemorrhoids are swollen veins in the lower part of anus and rectum. Hemorrhoids can either be internal or external where external hemorrhoids are the most common. Internal hemorrhoids usually develop inside the anus or rectum. External hemorrhoids usually develop under the skin around the anus.
When the walls of these blood vessels stretch, the veins bulge and get irritated. Hemorrhoids may cause rectal bleeding, severe itching, pain and difficulty in sitting. Fortunately, hemorrhoids can be treated with many effective medical treatments, home remedies and lifestyle related changes. Hemorrhoids often get better on their own.
Everyone has hemorrhoids but they don’t develop any symptoms until they become swollen and enlarged. They affect people of all ages, genders, races and ethnicities. But they’re more common over the age of 50.
Types of hemorrhoids are defined by where the swollen veins are developed and symptoms they show. These types are as below:
Internal hemorrhoids: In this type, swollen veins develop inside the anus or rectum and thus they are not visible from the outside. Rectum connects the large intestine to the anus.
Usual symptoms of this type are as below:
Internal hemorrhoids are usually painless
Small amounts of bright red blood on toilet tissue
External hemorrhoids: In this type, swollen veins develop underneath the skin around the anus.
Usual symptoms of this type are as below:
Itching or irritation in anal region
Swelling around anus
Prolapsed hemorrhoids: In this type, internal and external hemorrhoids may stretch and bulge outside of the anus.
Usual symptoms of this type are as below:
Itching or irritation in anal region
A hard lump near anus
Anyone can develop symptoms of hemorrhoids including teenagers but mostly it is uncommon in children. Usually Hemorrhoids occur when veins around anus feel too much pressure. The most common causes and factors regarding this condition are listed below.
Straining / Pushing hard during a bowel movement (poop) because of constipation.
Sitting for a longer period of time and especially on the toilet.
Having chronic diarrhea or constipation.
Straining to lift heavy objects or weightlifting regularly.
Having obesity or being overweight.
Having anal intercourse regularly.
Being pregnant where the growing uterus presses veins.
Eating a low-fiber diet.
Being over the age of 50.
Having a family history of hemorrhoids.
Doctors may diagnose by gathering more information about a person's medical condition by examining and knowing the following things:
By knowing about the person's symptoms & possible triggers.
By knowing about the medical history of the person.
By knowing about the family history of the person.
A doctor might be able to see and diagnose external hemorrhoids. There are various tests to diagnose internal hemorrhoids. These tests may be uncomfortable but they are not painful. These tests are as below:
Digital rectal examination: Doctor inserts a gloved and lubricated finger into anus and rectum to feel swollen veins and to check lumps and any unusual growth.
Anoscopy: Doctor uses a plastic lighted tube called an anoscope to view the lining of the anus and rectum.
Sigmoidoscopy: Doctor uses a flexible lighted tube with a camera called a sigmoidoscope to look into the lower (sigmoid) part of the colon and rectum. A doctor can also take a bit of tissue for tests using this tube.
Colonoscopy: Doctor uses a long and flexible tube called a colonoscope to examine the entire large intestine. This test is performed usually when a doctor may think that there is another digestive system disease or there are risk factors for colorectal cancer. A doctor can also take a bit of tissue for tests using this tube.
There are a number of options available for treating and managing the disease after diagnosis. Medications, medical treatments and surgical treatments as well as diet and lifestyle management help to manage symptoms and to treat disease.
Over-The-Counter (OTC) medications to use at home: Apply these Over-The-Counter (OTC) medications at the affected area to reduce symptoms such as pain, itching and inflammation. These creams can be applied once / twice a day on the affected area.
Oral medicines for pain relief: These oral pain relievers are helpful to relieve pain and discomfort temporarily.
Medical Treatments: These medical treatments can be used when symptoms don’t improve after doing medication at home for at least a week or having a persistent bleeding or pain. Doctors may treat hemorrhoids with following non-surgical medical treatments: For persistent bleeding or painful hemorrhoids, your doctor might recommend one of the other minimally invasive procedures available. These treatments can be done in your doctor's office or other outpatient setting and don't usually require anesthesia.
Rubber band ligation: Doctors place an elastic band around the base of the internal hemorrhoid to block its blood supply. The hemorrhoid will either shrink or fall off within a week. Internal hemorrhoid banding may be uncomfortable and bleeding but it is not severely painful.
Electrocoagulation: Medical experts send a low electric current into a hemorrhoid to cut off the blood flow into a hemorrhoid. This will result in hemorrhoids to shrink.
Infrared coagulation: Medical experts insert a small amount of laser or infrared light or heat into the rectum. This will harden the scar tissues and block the hemorrhoid’s blood supply to reduce its size.
Sclerotherapy: Doctors inject a chemical solution into internal hemorrhoids. This procedure shrinks or destroys hemorrhoids.
Surgical Treatments: Very small percentage of people with hemorrhoids require surgery. However, these surgical treatments can be performed when a person has large external hemorrhoids or forming a painful blood clot within an external hemorrhoid or all other medications and medical treatments are not helpful. In that case, doctors may suggest any of the surgeries listed below:
Hemorrhoidectomy: Surgery removes large external hemorrhoids or prolapsed internal hemorrhoids. The surgery can be done with local anesthesia. This is the most successful way to treat severe or recurring hemorrhoids. Most people have some pain after the procedure but that can be reduced by medications.
Hemorrhoids stapling: A stapling instrument removes an internal hemorrhoid or pulls back prolapsed internal hemorrhoids inside the anus and holds it there. This procedure is less painful than hemorrhoidectomy. However, there is a risk of recurrence in stapling procedures.
Diet: Diet: Diet also plays a crucial role in managing symptoms.
Take fiber-rich food such as fruits, vegetables and whole grains.
Avoid or reduce Caffeine
Avoid or reduce spicy and oily foods
Lifestyle management: Hemorrhoids often go away on their own without treatment. Person should take the following steps to reduce symptoms like pain and irritation:
Take prescribed medications regularly.
Take laxatives whenever needed to soften stool.
Drink more water to overcome constipation issues.
Take more fruits, vegetables and whole grains as well as supplements to increase fiber intake to overcome constipation issues.
Soak anal area in plain warm water for 10 to 20 minutes a day.
Applying ice packs and cold compresses to the affected area to ease pain.
Use toilet paper with lotion or flushable wet wipes to gently clean your bottom.
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