Warning: Contains sensitive and possibly triggering imagery.
What are Hemorrhoids?
Hemorrhoids, otherwise known as piles, are a condition where the veins near the opening of the anus swell up. These veins are similar to those of the varicose veins in the legs. Also, there are two types of hemorrhoids: external and internal. Internal hemorrhoid is the swelling of veins around and inside the anus. On the other hand, external hemorrhoids is the swelling of veins under the skin around the anus. External hemorrhoids can be extremely irritating and troublesome, because the skin can become irritated and scrape away. This pain can worsen if a blood clot forms in an external hemorrhoid. Additionally, the pain can come unexpected and can be excruciating. When the blood clot recedes, excess skin remains and causes irritation and itching. Internal hemorrhoids, on the other hand, are less painful, often painless in many cases. However, there is still bleeding. The internal hemorrhoid can develop into a prolapse, which means that part of the anus will protrude outside. When it protrudes, it can collect some particles from stool and irritates. Moreover, wiping will only worsen the itching. According to drugs.com (and medically reviewed by Leigh Ann Anderson, PharmD), the disorder, “Hemorrhoids, also called piles, have been reported to occur in roughly 1 in 20 people in the U.S. Approximately 50% of people over the age of 50 have hemorrhoids.”
Causes and Risk Factors
As one ages, they are more likely to develop hemorrhoids, because the supporting tissues in the anus weakens. Pregnancy is also another risk factor. Here, because the baby’s weight puts pressure on the anal region. Frequent anal intercourse can also contribute to hemorrhoids.
Nonetheless, the most common cause of hemorrhoids is straining during bowel movements and sitting on the toilet for a long period of time. Other symptoms include:
- Chronic constipation or diarrhea
- Prolonged daily sitting
- Low fiber diet
- Regular heavy lifting
- Family history of hemorrhoids
- The supporting tissues in your anus and rectum are weakening due to aging.
All of these can cause the veins of the anus to swell and manifest as hemorrhoids.
Symptoms and Diagnosis
Before reading on, please keep in mind that this article is not meant for medical advice or diagnosis. Please consult your physician if you suspect you have cancer or any other medical issues.
The symptoms of hemorrhoids vary if it is an external hemorrhoid or internal hemorrhoid. Consult your physician if you suspect you have hemorrhoids.
Common symptoms that shows up in both types of hemorrhoids are:
- Rectal bleeding
- Anal itching and iritation around the anal region
- Leakage of feces and can’t completely clean after bowel movement.
- Swelling of tissues in the anus region.
Symptoms that are unique to internal hemorrhoid include:
- Painless bleeding during bowel movement
- The swelling tissue pushes pass the anus and can form a prolapse, causing irritation.
Symptoms that are unique to external hemorrhoid include:
- Uncomfortable and pain in the anal region
- Lumps near or around the anus
When the blood in hemorrhoids pool and forms a clot, it becomes thrombosed hemorrhoids. Symptoms include:
- Severe pain
- A hard lump near your anus
When you visit your doctor, they may examine the skin around your anus. They may also do a digital examination. This entails inserting a lubricated, gloved finger into the anus to check the anal canal with a probe called an anoscope.
Treatment and Prevention
There are lifestyle considerations to prevent them, which includes:
- Eating high fiber food
- Taking stool softener or fiber pill
- Drinking more water and nonalcoholic liquids,
- Refrain from straining during bowel activity
- Reduce the time spend sitting on the toilet
- Taking over-the-counter pain relievers
- Sitting in a sitz, a tub of warm water, or a bath
Most hemorrhoids will go away even without at home treatment. However, bleeding internal hemorrhoids and severe cases of prolapse may need professional attention. This is where the doctor operates on the hemorrhoids. There are operations that can be done in the doctor’s office and there are some that require surgeons to operate.
Operations that can be done in a doctor’s office includes:
- Rubber band ligation: an operation where the doctor puts a rubber band on the hemorrhoids that cuts its blood supply and will fall out within a week.
- Sclerotherapy: The doctor injects a solution into the hemorrhoids which forms a scar tissue that cuts the hemorrhoid’s blood supply off. This is similar to rubber band ligation, but instead of using a rubber band to cut off the blood supply, the physician uses a chemical.
- Infrared photocoagulation: This is where the physician directs infrared light towards the hemorrhoid to cut its blood supply so it will fall out.
- Electrocoagulation: The physician sends an electric current to your hemorrhoids which creates scar tissue and cuts of the hemorrhoid’s blood supply.
Operations that need to be done in a hospital includes:
- Hemorrhoidectomy: This is when the hemorrhoid doesn’t terminate with the treatment above. The doctor will surgically remove the hemorrhoid with anesthesia.
- Hemorrhoid stapling: The doctor may use a special stapling tool to remove an internal hemorrhoid and push a prolapse back in the anus.
Check with your physician for the most fitting treatment for you.
Ways to prevent hemorrhoids are don’t delay bowel activity, drink plenty of water, eat fibrous food, exercise often, and so on.
In summary, hemorrhoids are a condition where the veins inside and around the anus swells up. Hemorrhoids can be internal or external, with external being the more painful one. Common causes of hemorrhoids include pregnancy, chronic constipation and diarrhea, spending too long on the toilet, low fiber diet, age, and so on. Symptoms of hemorrhoids include blood in stool, leakage, anal itch, swelling, inflammation, pain and discomfort in the anal region, etc. The physician may observe the outside of the anus or use digital examination. At-home treatment remedies include sitz bath, consuming high fiber food, refrain from straining in bowel activity and minimized time spent on the toilet and so on. Treatment methods that the physician can perform include rubber band ligation, sclerotherapy, infrared photocoagulation, and electrocoagulation. Surgical treatment methods include hemorrhoidectomy and hemorrhoid stapling.
Andrew Pham, Youth Medical Journal 2020
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