Hemorrhoids (piles) refer to the swollen veins inside of your rectum or outside of your anus, which cause itching and rectal bleeding. Some can maintain the symptoms with a healthy diet and at-home treatments, but sometimes people need medical procedures to treat their hemorrhoids. Hemorrhoids can be shrunk using a laser, but in case the hemorrhoids are large and very painful or bleeding, surgery may be the best choice. But even with surgery, you should eat a high-fiber diet, avoid constipation, and take care of your bottom to help prevent new hemorrhoid flare-ups.
What causes hemorrhoids?
Hemorrhoids are mostly associated with chronic constipation, straining during bowel movements, and prolonged sitting on the toilet with some bleeding. They are also common during pregnancy due to an enlarged uterus pressing on the veins. In most cases, patients with hemorrhoids have a higher resting anal canal tone, with constipation adding to their troubles by causing increased pressure on them. Finally, the connective tissues that support and hold hemorrhoids in place can weaken with age, causing hemorrhoids to bulge and prolapse.
Who might get hemorrhoids?
Hemorrhoids can form in anyone, but since they take a while to develop, they’re uncommon in children, but even teenagers can have them. You may be more at risk if you are:
Overweight/Obese
Pregnant
Eat a low-fiber diet
Chronically constipated or have diarrhea
Regularly lifting heavy objects
Spending a lot of time sitting on the toilet
Straining while having bowel movements
Diagnosing hemorrhoids
Hemorrhoids can usually be diagnosed from a simple medical history and physical exam. If your hemorrhoid is external, it will be apparent especially if a blood clot has formed. You may also be given a digital rectal exam to check for blood in the stool. 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.
Hemorrhoid Home Care
For some patients, their hemorrhoids can be treated and maintained with home care. Some ways to soothe the pain and itching of hemorrhoids include:
Warm Bath: Patients are advised to sit in about 3 inches of warm (not hot) water for 15 minutes, several times a day. Which will help reduce swelling in the area and relax your clenching sphincter muscle.
Ointments: Putting a little petroleum jelly just inside your anus will make pooping hurt less. But you shouldn’t use it for longer than a week unless a doctor instructs you.
Soothing Wipes: After you poop, clean yourself gently with a baby wipe, a wet cloth, or a medicated pad.
Cold Compress: Try putting a simple cold pack on the tender area for a few minutes to numb it and bring down the swelling.
Loose Clothing: Weaning loose clothing in a breathable fabric like cotton may help with discomfort.
High-Fiber Diet: It's the best thing for hemorrhoids. Eat mostly vegetables, fruit, nuts, and whole grains to avoid constipation.
Stool Softeners: For those who aren’t getting enough fiber from food, their doctor may suggest a stool softener.
Keep Hydrated: Drink seven to eight glasses of water each day, at least a half-gallon total. If you're very active or you live in a hot climate, you may need even more.
Medical Procedures for Hemorrhoids
If your symptoms don’t improve after a couple of weeks, your doctor may suggest a procedure to shrink or remove the hemorrhoids. These types of procedures include:
Injection: During this, an internal hemorrhoid will be injected with a solution to create a scar and close off the hemorrhoid.
Rubber band ligation: This procedure is often done on prolapsed hemorrhoids, internal hemorrhoids that can be seen or felt outside. Your doctor will put a tiny rubber band around the hemorrhoid using a special tool. This band will shut off the blood supply and within a week the hemorrhoid will dry up, shrink, and fall off.
Coagulation or cauterization: Using an electric probe, a laser beam, or an infrared light, your doctor will make a tiny burn to remove tissue and painlessly seal the end of the hemorrhoid, causing it to close off and shrink.
Surgery: For large internal hemorrhoids or extremely uncomfortable external hemorrhoids, you may need surgery. Hemorrhoidectomy is the most effective technique to completely remove the hemorrhoids, but it has a painful recovery which can take several weeks. Hemorrhoid stapling is the technique that cuts blood flow to internal hemorrhoids and moves prolapsed tissue back in place. Recovery is easier, but there’s a greater chance of the hemorrhoids coming back.
Complications of hemorrhoid surgery
Although complications from hemorrhoid surgery are rare, some bleeding from the rectum is normal. But if you experience any of the following, you should contact your doctor:
Passing a bowel movement that is mostly or heavily bloody
Experiencing severe pain in anal or abdominal areas
Experiencing diarrhea
Experiencing a fever
Inability to pass urine
Thrombosed external hemorrhoids
Rare, but more serious complications may include:
Abscess, which is a painful collection of pus that typically results from a bacterial infection
Sepsis, which is blood poisoning and is life-threatening
Hemorrhage
Peritonitis, which is inflammation of the tissue that lines your abdomen
Complications that may occur later in the post-operative period include:
Recurrent hemorrhoids
Anal stenosis, which causes the anal canal to narrow and makes it harder to have a bowel movement
Skin tags
Late hemorrhage
Constipation (often due to prolonged use of medications)
Fecal incontinence
Conclusion
Hemorrhoids, also known as piles, are swollen veins in the lower part of the rectum and anus. They can cause discomfort, itching, and bleeding. The condition is often caused by straining during bowel movements, obesity, or pregnancy. Treatment options range from lifestyle changes and medications to surgical procedures. Despite being a common condition, hemorrhoids can significantly impact a person's quality of life. Therefore, early identification and intervention, especially for risk groups, are crucial. It's also important to note that while hemorrhoids are not dangerous, severe complications are rare, and symptoms such as rectal bleeding should not be ignored as they might be signs of more serious conditions.
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