Hemorrhoids are an anorectal condition affects lots of people whole over the world. They are some of the inflamed and swollen veins in the lowest part of your anus and rectum. They are otherwise called as piles also. Hemorrhoids happen when the surrounding veins of your anus get enlarged because of straining during defecation. When you strain the blood circulation in your rectum becomes fast and put pressure on your veins. As a result, the rectal veins become inflamed and swollen.
Both men and women have hemorrhoids in common and about 50% of people get affected by it after the age of 501.
Table of Contents
Types Of Hemorrhoid
Hemorrhoids are of two types. They are internal and external hemorrhoids. External hemorrhoid can create a Thrombosed hemorrhoid if ruptured. All types of the hemorrhoids need treatment as per their requirement.
Internal hemorrhoids form in the lower rectum and inside of your anus. They are not visible and do not hurt because of the presence of less pain receiving nerves there. But these hemorrhoids can bleed if any of the veins get damaged when straining to move a stool.
External hemorrhoids form under the skin around the anus. You can see a tender and red colour balloon type lump outside the anus. They can bleed or itch in mild when the overline skin gets irritated and eroded. External hemorrhoids can cause severe pain due to the presence of so many pain-receiving nerves there.
When a blood clot forms in external hemorrhoids it is called as a Thrombosed hemorrhoid. You can see a lump around the anus could be blue or purple in colour. When this blood clot dissolves it leaves a skin tag or excess skin which causes more irritation due to severe itching.
Classification Of Hemorrhoids
Hemorrhoids are classified into 4 degrees depending upon their severity as 1st degree, 2nd degree, 3rd degree, and 4th degree.
First Degree Hemorrhoids
The first degree of hemorrhoids do not slip outside of your anal canal but they can bleed sometimes.
Second Degree Hemorrhoids
The second degree of hemorrhoids slips out from your anal canal at the time of discharging stool. But they can retract spontaneously.
Third Degree Hemorrhoids
The third degree of hemorrhoids also slip out of the anus and need a manual push to go inside of your anus.
Fourth Degree Hemorrhoids
The fourth-degree hemorrhoids are the thrombosed ones which cannot be pushed manually. They are the most severe forms of hemorrhoids and extremely painful. They need surgical treatment to be cured.
Causes Of Hemorrhoids
As per the medical practitioners, there are no particular causes of the hemorrhoids. They develop due to the inflamed and swollen veins in your rectum similar to varicose veins. These veins get inflamed when you strain in the time of moving your stool. There are some other associated causes of the development of hemorrhoids are as follows:
- In pregnancy due to the pressure of your enlarged uterus on the rectal veins.
- When you have chronic constipation.
- Ageing is a cause because the supportive tissues which hold the hemorrhoids become weaker and loose.
- Anal Sex
- A prolonged sitting on the toilet
- Low fiber diet
- Regular lifting of heavy objects
Symptoms Of Hemorrhoids
A rectal bleeding is the primary symptom of hemorrhoids always. But the symptoms varied in different types of hemorrhoids.
Symptoms Of Internal Hemorrhoids
The symptoms of internal hemorrhoids include:
- Rectal bleeding
- Dripping of blood in the toilet bowl after a bowel movement.
- You can see blood in the toilet paper and in your stool.
- A prolapsed hemorrhoid from your anal opening.
- The non-prolapsed hemorrhoids generally cause no pain.
- The prolapsed ones are painful and you can feel discomfort.
Symptoms Of External Hemorrhoids
The symptoms of external hemorrhoids include:
- Severe itching inside and outside of your anus.
- You will find more than one tender and hard lumps in the anus.
- Feeling of severe pain and discomfort while sitting.
- Excess rubbing, wiping, and straining around your anus makes worsen the hemorrhoids.
- The symptoms of external hemorrhoids can go away their own within a few days.
You must keep in mind that not all the rectal bleedings are the symptom of hemorrhoids. It may be a symptom of bowel diseases like ulcerative colitis, Crohn’s disease, or colon cancer.
Some of the symptoms of hemorrhoids are quite similar to the symptoms of gastrointestinal tract problems.
Complications Of Hemorrhoids
Hemorrhoids are safely not dangerous and have rare complications.
The possible complications may include:
Strangulated hemorrhoids occur when the blood supply to the internal hemorrhoids cut off. These strangulated hemorrhoids are very painful and uncomfortable as well.
In some cases, you may go through the decreasing of red blood cells due to bleeding in the hemorrhoids. This complication is very rare but in severe cases, chronic blood loss can cause anaemia.
Diagnosis Of Hemorrhoids
Basically, the diagnosis of hemorrhoids depends upon anaemia examination of your anus. Your doctor will diagnose the hemorrhoids with a physical examination and on the basis of your family history.
The doctor will check the area around your anus to diagnose external hemorrhoids. For internal hemorrhoids, your doctor will do a digital rectal exam to see the internal condition of your anus.
1 Case Study Of Your Family History
During the case study of your family history the doctor will ask you:
- to give a thorough description of your symptoms.
- about your eating and toilet habits.
- if you are taking any laxative or enema.
- about your medical conditions.
- about other diseases if you have any.
2 Physical Examination of Hemorrhoids
The doctor will do a physical examination of your rectum for a proper diagnosis and thorough evaluation. She/ he will insert the finger with a lubricated glove inside the anus to check the symptoms like:
- swelling and lumps
- prolapsed veins
- clotting of blood in external hemorrhoids
- if any leakage of stool or mucus
- anal fissures
- if any skin tags
- if any skin irritation.
3 Digital Rectal Examination
Your doctor may do a digital rectal exam if he will find any abnormalities in your anus during the physical exam. The doctor will attempt some procedures to check the following conditions such as:
- the tone of the muscles in your rectum
- the blood in the internal hemorrhoids
- tenderness of lumps or masses
The procedures of the digital rectal exam may be one of the following such as:
- Anoscopy through a hollow tube with a light to view the internal hemorrhoids.
- Proctosigmoidoscopy through an instrument to view the lining of your colon and lower rectum.
What Are The Treatment Options Of Hemorrhoids
You can treat the hemorrhoids at home by following some regular healthy habits. Actually, home remedies for hemorrhoids give the spectacular results within a short time.
In the medical treatment, your doctor also refers you to get relief from the symptoms of hemorrhoids initially at home. You may be recommended to follow some conservative remedies at your home.
Conservative Remedies At Home
Your doctor will tell you to follow some basic habits at your home such as:
- eating foods rich in fiber or taking a bulk stool softener.
- drinking a lot of water for a smoother bowel movement.
- no straining at the time of passing the stool.
- to take pain relievers.
- Not to sit on the toilet bowl for a long time.
- a sitz bath or sitting in a tub filled with warm water several times in a day.
- to apply a hemorrhoidal cream in the affected areas.
- a medicine to insert in your rectum.
The doctor will recommend you to follow all these over-the-counter remedies for one week. If you will not get any relief or feel dryness or rashes inside and outside skin of your anus, it is the time to follow up with your doctor.
Painless Non-Surgical Techniques
Definitely, the doctor will prescribe you to follow some further medical treatments. Because some prolapsed hemorrhoids do not go away with following only the conservative remedies. They need some painless non-surgical treatments for permanent relief. Let’s know about these techniques in brief.
i. Ligation With A Rubber Band
Rubber band ligation process uses to treat the prolapsed and bleeding internal hemorrhoids. It is the most widely used procedure to treat the lesser degree prolapsed hemorrhoids.
In this process, the doctor will cut off the blood circulation with a special rubberband by placing it around the base of the hemorrhoids. As a result, the banded part of hemorrhoid will shrink and falls off within a week.
Sclerotherapy is an injection therapy your doctor will use if the rubber band ligation is not a suitable recovery in your case. In this process, your doctor will inject a solution into the mucous membrane near internal hemorrhoid which will form a scar tissue. The scar tissue cuts off the blood supply to hemorrhoid. As a result, the injected hemorrhoid will shrink off.
Photocoagulation is a laser therapy uses to treat the internal hemorrhoids. Your doctor will use a device known as photocoagulator for this process. He will insert the device into your rectum and create heat with the infrared light to form the scar tissue. This scar tissue will cut off the blood supply to hemorrhoids and shrink them.
In this process, the doctor uses a device which sends an electric current into internal hemorrhoid. The current creates scar tissue to cut off the blood supply into the hemorrhoids and shrink them afterward.
v. Super Freezing
In this process, the doctor uses a cryogenic device which inserts liquid nitrogen to freeze the hemorrhoids. As a result, the new tissues will grow up by sloughing off the affected tissues in their space. It is one of the most effective techniques to treat external hemorrhoids.
Surgical Treatment Of Hemorrhoids
Your doctor will refer you to consult a surgeon when all the above-mentioned treatments become failed in your case. The surgeon will recommend a surgery to provide you with a satisfactory long-term cure for hemorrhoids.
Hemorrhoidectomy is a traditional surgery you need to remove the prolapsing internal hemorrhoids and large external hemorrhoids. In this process, the surgeon makes a narrow incision around the tissue of both internal and external hemorrhoids and problematic blood vessels.
You are given anesthesia for this procedure but you can go home on the same day. The surgery takes about 20 minutes to perform. You can go back to work within a week after the surgery. About 95% of people get beneficial results from Hemorrhoidectomy.
ii. Stapled Hemorrhoidopexy
Stapled hemorrhoidopexy is otherwise known as PPH (Procedure for Prolapse & Hemorrhoids) procedure.
In this process, the doctor uses a circular stapling device to remove the excess tissue in the external hemorrhoids. He/she staples the remaining prolapsed tissue of hemorrhoids. This procedure restores the prolapsed hemorrhoid back to its original position in the rectum.
Complications Of Hemorrhoid Surgery
In a hemorrhoid surgery, you may face some complications just after the surgery or in late. Let’s know about them in a brief.
- You can experience severe post-operative pain due to the ligation and incision.
- Swollen skin in the rectum and surrounding skin.
- Post-operative bleeding.
- Difficulty in urination and bowel movement.
- Pain while sitting.
- Formation of skin tags and anal stenosis.
How Can You Prevent Hemorrhoids
Any type of hemorrhoids is always painful and uncomfortable to manage your daily life. Hemorrhoids are not at all dangerous but it is somehow difficult to bear the pain. Thus, it is recommended to follow some healthy habits to prevent hemorrhoids.
Actually, the best way to prevent hemorrhoids is a strainless bowel movement. Thus, you must follow some basic habits to get rid of constipation or to pass stool without straining.
- Eat foods rich in high fiber.
- Drink at least 8-10 glasses of water in a day for a strainless bowel movement.
- Empty your bowel as soon as an urge occurs.
- Do regular exercise and a half an hour of walking every day.
Hemorrhoids need prevention. If you get affected by them it is recommended to seek an immediate appointment with your doctor. Hemorrhoids are curable with proper treatment as per the need of the condition. Sometimes the hemorrhoids can come back again after treatment also. You can prevent the hemorrhoids from coming back by following some healthy habits. Remember, it is always better to cure a disease before getting worse.
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