The
term hemorrhoids refers to a condition in which the veins around the anus or
lower rectum are swollen and inflamed.
Hemorrhoids
may result from straining to move stool. Other contributing factors include
pregnancy, aging, chronic constipation or diarrhea, and anal intercourse.
Hemorrhoids
are either inside the anus—internal—or under the skin around the anus—external.
the symptoms of hemorrhoids
Many
anorectal problems, including fissures, fistulae, abscesses, or irritation and
itching, also called pruritus ani, have similar symptoms and are incorrectly
referred to as hemorrhoids.
Hemorrhoids
usually are not dangerous or life threatening. In most cases, hemorrhoidal
symptoms will go away within a few days.
Although
many people have hemorrhoids, not all experience symptoms. The most common
symptom of internal hemorrhoids is bright red blood covering the stool, on
toilet paper, or in the toilet bowl. However, an internal hemorrhoid may
protrude through the anus outside the body, becoming irritated and painful.
This is known as a protruding hemorrhoid.
Symptoms
of external hemorrhoids may include painful swelling or a hard lump around the
anus that results when a blood clot forms. This condition is known as a
thrombosed external hemorrhoid.
In
addition, excessive straining, rubbing, or cleaning around the anus may cause
irritation with bleeding and/or itching, which may produce a vicious cycle of
symptoms. Draining mucus may also cause itching.
diagnosed of hemorrhoids
A
thorough evaluation and proper diagnosis by the doctor is important any time
bleeding from the rectum or blood in the stool occurs. Bleeding may also be a
symptom of other digestive diseases, including colorectal cancer.
The
doctor will examine the anus and rectum to look for swollen blood vessels that
indicate hemorrhoids and will also perform a digital rectal exam with a gloved,
lubricated finger to feel for abnormalities.
Closer
evaluation of the rectum for hemorrhoids requires an exam with an anoscope, a
hollow, lighted tube useful for viewing internal hemorrhoids, or a proctoscope,
useful for more completely examining the entire rectum.
To
rule out other causes of gastrointestinal bleeding, the doctor may examine the
rectum and lower colon, or sigmoid, with sigmoidoscopy or the entire colon with
colonoscopy. Sigmoidoscopy and colonoscopy are diagnostic procedures that also
involve the use of lighted, flexible tubes inserted through the rectum.
treatment hemorrhoids
Medical
treatment of hemorrhoids is aimed initially at relieving symptoms. Measures to
reduce symptoms include:
- tub baths several times a day in plain, warm water for
about 10 minutes.
- application of a hemorrhoidal cream or suppository to
the affected area for a limited time.
Preventing
the recurrence of hemorrhoids will require relieving the pressure and straining
of constipation. Doctors will often recommend increasing fiber and fluids in
the diet. Eating the right amount of fiber and drinking six to eight glasses of
fluid—not alcohol—result in softer, bulkier stools. A softer stool makes
emptying the bowels easier and lessens the pressure on hemorrhoids caused by
straining. Eliminating straining also helps prevent the hemorrhoids from
protruding.
Good
sources of fiber are fruits, vegetables, and whole grains. In addition, doctors
may suggest a bulk stool softener or a fiber supplement such as psyllium
(Metamucil) or methylcellulose (Citrucel).
In
some cases, hemorrhoids must be treated endoscopically or surgically. These
methods are used to shrink and destroy the hemorrhoidal tissue. The doctor will
perform the procedure during an office or hospital visit.
A
number of methods may be used to remove or reduce the size of internal
hemorrhoids. These techniques include:
Rubber band ligation. A rubber band is placed around the base of the
hemorrhoid inside the rectum. The band cuts off circulation, and the hemorrhoid
withers away within a few days
Sclerotherapy. A
chemical solution is injected around the blood vessel to shrink the hemorrhoid.
Infrared coagulation. A special device is used to burn hemorrhoidal tissue
Hemorrhoidectomy. Occasionally, extensive or severe internal or
external hemorrhoids may require removal by surgery known as hemorrhoidectomy.
prevented
hemorrhoids
The best way to
prevent hemorrhoids is to keep stools soft so they pass easily, thus decreasing
pressure and straining, and to empty bowels as soon as possible after the urge
occurs. Exercise, including walking, and increased fiber in the diet help
reduce constipation and straining by producing stools that are softer and
easier to pass.