Description

Hemorrhoids (HEM-uh-roids), also called piles, are swollen veins in the anus and lower rectum. Hemorrhoids are similar to varicose veins. Hemorrhoids can develop inside the rectum are called internal hemorrhoids. You can also develop under the skin around the anus, it is called external hemorrhoids.

There are several options available for the treatment of hemorrhoids. Many people get relief with home treatments and lifestyle changes.

Symptoms

Hemorrhoid symptoms usually depend on the type of hemorrhoids.

Internal hemorrhoids

Internal hemorrhoids are inside the rectum. Usually you can't see or feel, and they rarely cause discomfort. But straining or irritation when passing stool can cause:

  • Painless bleeding during bowel movements. You might notice small amounts of bright red blood on toilet paper or in the toilet.
  • A hemorrhoid to push through the anal opening, called a prolapsed or protruding hemorrhoids. This can result in pain and irritation.

External hemorrhoids

These are under the skin around the anus. Symptoms may include:

  • Itching or irritation in the anal region.
  • Pain or discomfort.
  • Swelling around the anus.
  • The bleeding.

Hemorrhoids thrombosed

The blood may pool in an external hemorrhoid and form a clot, called a thrombus. Thrombosed hemorrhoids can result in:

  • The severe pain.
  • The swelling.
  • Inflammation.
  • A hard, discolored lump near the anus.

When to see a doctor

If you have a bleeding during the bowel movement or you suffer from hemorrhoids that do not improve after a week of home care, talk to your health care provider.

Do not assume that the rectal bleeding is due to hemorrhoids, especially if you have changes in bowel habits or if the stool, change in the color or consistency. Rectal bleeding can occur with other diseases, including colorectal cancer and anal cancer.

Seek emergency medical attention if you have large amounts of rectal bleeding, lightheadedness, dizziness or fainting.

Causes

The veins around your anus tend to stretch under pressure and may bulge or swell. Hemorrhoids can develop from increased pressure in the lower rectum due to:

  • Straining during bowel movements.
  • Sitting for long periods of time, especially in the toilet.
  • Having chronic diarrhea or constipation.
  • Being obese.
  • The fact of being pregnant.
  • Have anal sex.
  • Eating a diet low in fiber.
  • Regularly lifting heavy objects.

Risk factors

As people age, the risk of hemorrhoids increases. That is because the tissues that support the veins in the rectum and anus can weaken and stretch. This can also occur during pregnancy due to the weight of the baby puts pressure on the anal region.

Complications

Complications of hemorrhoids are rare, but may include:

  • Anemia. Rarely, the continuous loss of blood from hemorrhoids may cause anemia. Anemia is when there are not enough red blood cells to carry oxygen to the cells of the body.
  • Strangulated hemorrhoids. When the blood supply to an internal hemorrhoid is cut off, the hemorrhoid is called a strangulated. Strangulated hemorrhoids can cause extreme pain.
  • Blood clot. Sometimes a clot can form in a hemorrhoid. This is called a thrombosed hemorrhoid. Although it is not dangerous, it can be extremely painful and sometimes need to be drained.

Prevention

The best way to prevent hemorrhoids is to keep stools soft so they pass easily. To prevent hemorrhoids and reduce the symptoms of hemorrhoids, follow these tips:

  • Eating high-fiber foods. Eat more fruits, vegetables and whole grains. Doing so softens the stool and increases its volume. This will help you avoid the straining that can cause hemorrhoids. Add fiber to your diet slowly to avoid problems with gas.
  • Drink plenty of fluids. Drink 6 to 8 glasses of water and other fluids each day to help keep the stools soft. Avoid the consumption of alcohol may also help.
  • Consider fiber supplements.Most people do not consume enough fiber in their diets. Studies have shown that the over-the-counter fiber supplements, such as psyllium (Metamucil, Konsyl, others) or methylcellulose (Citrucel), can decrease the symptoms and bleeding of hemorrhoids. If you use fiber supplements, be sure to drink at least eight glasses of water or other fluids each day. Otherwise, the supplements can cause constipation or make things worse.
  • Don't strain. The effort and holding your breath when trying to pass stools create a greater pressure in the veins in the lower rectum.
  • Exercise. Staying active helps prevent constipation and reduce the pressure on the veins. The exercise can also help you lose the excess weight that could be the cause of hemorrhoids or worsen.
  • Avoid long periods of sitting. Sitting for too long, especially on the toilet, you can increase the pressure on the veins in the anus.

Consider fiber supplements. Most people do not consume enough fiber in their diets. Studies have shown that the over-the-counter fiber supplements, such as psyllium (Metamucil, Konsyl, others) or methylcellulose (Citrucel), can decrease the symptoms and bleeding of hemorrhoids.

If you use fiber supplements, be sure to drink at least eight glasses of water or other fluids each day. Otherwise, the supplements can cause constipation or make things worse.

Diagnosis

Your health care provider might be able to see external hemorrhoids. Diagnosing internal hemorrhoids might include examination of your anal canal and rectum.

  • The Digital examination. The doctor inserts a lubricated, gloved finger into the rectum. This allows your provider to check for anything unusual, such as tumors.
  • Visual inspection. Internal hemorrhoids are often too soft to be felt during a rectal exam. Your health care provider can look at the lower part of the colon and rectum with a tool such as an anoscope, a proctoscope or sigmoidoscope.

Your health care provider may want to look at the entire colon with colonoscopy if:

  • The symptoms suggest that he might have another digestive system disease.
  • You have risk factors for colorectal cancer.
  • Who are middle aged and have not had a recent colonoscopy.

Treatment

Home remedies

You can often relieve the mild pain, swelling and inflammation of hemorrhoids with home remedies.

  • Eating high-fiber foods. Eat more foods that are high in fiber. This helps to soften the stool and increases its size, which will help you to avoid constipation. Add fiber to your diet slowly to avoid problems with gas.
  • The use of topical treatments. Apply a hemorrhoid cream or suppository containing hydrocortisone, that can be purchased without a prescription. You can also use pads containing witch hazel or a numbing medicine.
  • Soak regularly in a warm bath or sitz bath. Soak your anal area in plain warm water for 10 to 15 minutes two or three times a day. A sitz bath fits over the toilet.
  • Take pain medicine by mouth. You can temporarily use acetaminophen (Tylenol, others), aspirin or ibuprofen (Advil, Motrin IB, others) to help relieve your discomfort.

With these treatments, hemorrhoid symptoms often go away within a week. Consult your health care provider within a week if you don't get relief. Contact your provider before if you have pain or bleeding.

Medications

Hemorrhoids, can only produce a mild upset. In this case, your doctor may suggest creams, ointments, suppositories or pads that you can buy without a prescription. These products contain ingredients, such as witch hazel or hydrocortisone lidocaine, which can temporarily relieve pain and itching.

Hydrocortisone is a steroid that can thin the skin when used for more than a week. Ask your doctor how long you should use.

External hemorrhoid thrombectomy

If a painful blood clot that has formed within an external hemorrhoid, your health care provider can eliminate hemorrhoids. The removal can provide immediate relief. This procedure, carried out with a drug that numbs a body part, is also called a local anesthetic, which works best when it is done within 72 hours of receipt of the formation of a clot.

Minimally invasive procedures

For the bleeding that does not stop or painful hemorrhoids, your health care provider may recommend one of the other minimally invasive procedures available. These treatments can be done in your provider's office or other outpatient setting. In general do not require anesthesia.

  • Rubber band ligation.The doctor places one or two tiny rubber bands around the base of an internal hemorrhoid to cut off its blood flow. The hemorrhoid withers and falls off within a week. Hemorrhoid banding can be uncomfortable and cause bleeding. The bleeding may begin 2 to 4 days after the procedure, but is rarely serious. Sometimes, more serious complications can occur.
  • Sclerotherapy. With sclerotherapy, the doctor injects a chemical solution into the hemorrhoid tissue to reduce it. While the injection causes little or no pain, it might be less effective than rubber band ligation.
  • The coagulation. The coagulation of the techniques use laser or infrared light, or heat. They cause small, bleeding, internal hemorrhoids to harden and crack. Coagulation has few side effects, and usually causes a bit of discomfort.

Rubber band ligation. The doctor places one or two tiny rubber bands around the base of an internal hemorrhoid to cut off its blood flow. The hemorrhoid withers and falls off within a week.

Hemorrhoid banding can be uncomfortable and cause bleeding. The bleeding may begin 2 to 4 days after the procedure, but is rarely serious. Sometimes, more serious complications can occur.

Surgical procedures

Only a small percentage of people with hemorrhoids need surgery to remove them. However, if other procedures have not worked or you have large hemorrhoids, your health care provider may recommend one of the following:

  • Hemorrhoids removal, also called a hemorrhoidectomy.The surgeon removes excess tissue that causes bleeding through the use of one of the various techniques. The surgery can be performed with local anesthesia, combined with a medication to help you feel calm or less anxious, also called a sedative. Spinal anesthesia or general anesthesia may also be used. Hemorrhoidectomy is the most effective and complete for the treatment of severe or recurrent hemorrhoids. Complications may include temporarily having a hard time urinating, which can lead to urinary tract infections. This complication occurs mainly after spinal anesthesia. The majority of people have a little bit of pain after the procedure, medications can relieve. Soaking in a warm bath can also help.
  • Hemorrhoid stapling.This procedure, called stapled hemorrhoidopexy, it blocks the blood flow to hemorrhoidal tissue. It is typically used only for internal hemorrhoids. Stapling generally involves less pain than the hemorrhoidectomy and allowed to return to their regular activities sooner. Compared with hemorrhoidectomy, however, the stapling has been associated with an increased risk of hemorrhoids come back and rectal prolapse. Rectal prolapse is when part of the rectum pushes through the anus. Complications may include bleeding, problems emptying the bladder, and pain. A rare complication is a serious blood infection called sepsis. Talk with your health care provider about the best option for you.

Hemorrhoids removal, also called a hemorrhoidectomy. The surgeon removes excess tissue that causes bleeding through the use of one of the various techniques. The surgery can be performed with local anesthesia, combined with a medication to help you feel calm or less anxious, also called a sedative. Spinal anesthesia or general anesthesia may also be used.

Hemorrhoidectomy is the most effective and complete for the treatment of severe or recurrent hemorrhoids. Complications may include temporarily having a hard time urinating, which can lead to urinary tract infections. This complication occurs mainly after spinal anesthesia.

The majority of people have a little bit of pain after the procedure, medications can relieve. Soaking in a warm bath can also help.

Hemorrhoid stapling. This procedure, called stapled hemorrhoidopexy, it blocks the blood flow to hemorrhoidal tissue. It is typically used only for internal hemorrhoids.

Stapling generally involves less pain than the hemorrhoidectomy and allowed to return to their regular activities sooner. Compared with hemorrhoidectomy, however, the stapling has been associated with an increased risk of hemorrhoids come back and rectal prolapse. Rectal prolapse is when part of the rectum pushes through the anus.

Complications may include bleeding, problems emptying the bladder, and pain. A rare complication is a serious blood infection called sepsis.

Talk with your health care provider about the best option for you.

Preparing for your appointment

If you have hemorrhoids symptoms, make an appointment with your primary care provider. If necessary, your doctor may refer you to one or more specialists for evaluation and treatment. These may include a physician with experience in the digestive system, called a gastroenterologist, or a colon and rectal surgeon.

Here are some suggestions to help you prepare for your appointment.

What you can do

Be aware of any pre-appointment restrictions. When you make the appointment, ask if there is something that you need to do beforehand.

Make a list of:

  • Your symptoms and how long you have realized them.
  • Key personal information, including the typical bowel habits and diet, and especially consumption of fiber.
  • All medications, vitamins or supplements that you take, including over-dose.
  • Questions to ask your health care provider.

For hemorrhoids, some questions to ask your provider include:

  • What is the likely cause of my symptoms?
  • Is my condition likely temporary or permanent?
  • Am I at risk of complications related to this disease?
  • What treatment approach do you recommend?
  • If the treatments we first try does not work, what would you recommend then?
  • Am I a candidate for surgery? Why or why not?
  • There are additional self-care measures that could help?
  • I have other medical problems. How can I manage along with hemorrhoids?

Do not hesitate to ask other questions.

What to expect from your doctor

Your health care provider is likely to ask questions such as:

  • How uncomfortable are the symptoms?
  • What are the typical bowel habits?
  • How much fiber does your diet contain?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • Have someone in your family has had hemorrhoids or cancer of the colon, the rectum or the anus?
  • Has had a change in your bowel habits?
  • During bowel movements, have you noticed blood on the toilet paper, which drips into the toilet bowl or mixed in with the stool?

What you can do in the meantime

Before your appointment, to take measures to soften the stool. Eat more foods rich in fiber, such as fruits, vegetables and whole grains. Consider over-the-counter fiber supplement, such as Metamucil or Citrucel. Drink 6 to 8 glasses of water a day can also help relieve your symptoms.

The symptoms and treatment of Hemorrhoids