What are hemorrhoids?
In a way, each person has hemorrhoids or the pillow-like clusters of veins. These are located under the mucous membranes, around the lowest parts of the rectum and the anus in humans. On the other hand, the condition most people call hemorrhoids is when these swell and distend, similar to varicose veins in our legs. The blood vessels fight gravity to send the blood back to the heart, so some believe that hemorrhoids are one of the prices of our upward posture.
Two kinds of hemorrhoids exist, internal hemorrhoids are in the lower rectum, while the external hemorrhoids are under the skin around the anus.
The later is the most uncomfortable, as the skin over them gets irritated and erodes. There can be severe and sudden pain if a blood clot appears. There may be lumps around, while the clot usually dissolves. There can be excess skin that itches or irritates after.
Internal hemorrhoids are usually painless, even when they bleed. There can appear some bright red blood on the toilet paper, or dripping of it into the toilet. These might protrude and extend beyond the anus, potentially causing major problems. If they protrude, they collect small traces of mucus and stool particles, causing irritation, or pruritus ani. Wiping to relieve the itching usually worsens this problem.
Chronic constipation, straining during bowel movements, and prolonged toilette sitting are the main causes. All of these interfere with regular blood flow to and from this body region, causing the vessels to pool and enlarge.
Recent studies proved that patients also have a higher resting anal canal tone. Constipation means more troubles, as straining during a bowel movement puts more pressure in the anal canal, which then pushes the hemorrhoids against the sphincter muscle. What is more, connective tissues supporting and holding hemorrhoids in place weakens with age, which causes them to bulge and prolapse.
Hemorrhoids can usually be diagnosed from a simple medical history and physical exam. External hemorrhoids are generally apparent, especially if a blood clot has formed. Your clinician may perform a digital rectal exam to check for blood in the stool. She or he may also examine the anal canal with an anoscope, a short plastic tube inserted into the rectum with illumination. If there’s evidence of rectal bleeding or microscopic blood in the stool, flexible sigmoidoscopy or colonoscopy may be performed to rule out other causes of bleeding, such as colorectal polyps or cancer, especially in people over age 45.
More fiber in your diet alongside adequate fluid will soften the stool and make it easier to pass. This reduces pressure on hemorrhoids. Try broccoli, beans, wheat, whole-grain food, and fresh fruit. In addition, fiber supplements decrease bleeding, inflammation, and enlargement. They may also reduce irritation from small bits of stool that are wrapped around the blood vessels. Start slowly and carefully. Gradually increase the intake to 25–30g per day, and increase fluid intake.
Moderate aerobic exercise like walking for 20–30 helps bowel function.
When you must defecate, go to the bathroom immediately and do not wait. Stool tends to back up, which leads to increased pressure and straining. Try to schedule a time in each day, for example after a meal, and sit on the toilet for several minutes. This may help establish a routine bowel habit.
Sitz baths are warm water baths for the buttocks and hips. This will relieve itching, irritations, and spasms of the sphincter muscle. Ask for small plastic tubs that mount on a toilet seat at pharmacies, or use a regular bathtub. Experts recommend 20 minutes after each bowel movement, and 2-3 times a day.
Many creams with local anesthetics can temporarily soothe the pain, while there are also that are soothing and have no harmful side effects. Small ice packs against the anal area also help with the reduction of pain and swelling. Last but not least, sitting on a cushion instead of hard surfaces helps with the swelling and prevents new one’s hemorrhoids.
When externals hemorrhoids form blood clots, the pain can really be severe. If it is tolerable and is present for more than two days, go with the home treatments. If, on the other hand, the clot is more recent, it can be surgically removed or withdrawn from the vein through a minor office procedure by a surgeon.
Some hemorrhoids can be treated with conservative treatments because symptoms persist, or because internal hemorrhoids prolapsed. Patients are in luck, as the number of minimally invasive treatments are available. They are less painful than traditional hemorrhoid removal and require quicker recovery. The surgeon usually performs them in their offices, or they are in the form of outpatient surgeries in a hospital.