Hemorrhoids also known as “piles” are nothing but inflammation of the veins found in the anus and rectum area. It can be defined as cluster of masses or cushion like tissues that lie within the anal canal. It occurs due to enlargement of veins that gets swollen. The anal canal is the part through which the stool is expelled outside. Anal canal includes rectum and anus and hence any infection or inflammation caused on the anal canal will cause pain and discomfort while passing stool.
They are of two types of hemorrhoids. One is internal hemorrhoids which lie well inside the anal canal (being rectal side) that includes blood vessels and muscles. External hemorrhoids will affect and cause inflammation of the big blood vessels that engulfs the anus. Normally internal hemorrhoids are harmless but in some cases they get enlarged causing bleeding from anus. External hemorrhoids cause chronic pain due to clotting of blood in the blood vessels. Hemorrhoids can be treated well using medications and other methods. Either they are found inside the rectum or below the skin that covers the anus area. Hemorrhoid is a common problem and is found in many adults who have crossed 50 years causing bleeding, discomfort and itching.
How common are hemorrhoids?
Hemorrhoids are quite common in almost every adult above 50-55 years. But they cause problem only when the tissues get enlarged. About 4% of the people with hemorrhoids will have problems and complications. The growth reaches its peak during the age group of 45-65 years in both men and women.
Hemorrhoids are believed to be formed due to repeated strain caused to the rectal muscles while passing stool. Actually the blood vessels and the anal cushions develop inflammation leading to the increased size of the supporting tissues. This tissue accumulates into a bulging mass and protrudes well into the anal canal causing bleeding and pain.
Mostly, hemorrhoids are caused by strained bowel movements during which the veins of the rectum will develop swelling. Chronic diarrhea or constipation can also cause hemorrhoids. If you sit for long time on the toilet pushing the stool it will obviously exert pressure on the veins of the anus making it tear and swollen. Taking low fiber diet, obesity and having anal intercourse can also cause hemorrhoids. Aging is the common reason for developing hemorrhoids since the rectum will get weakened due to old age.
For some people there will be only bleeding while passing stool and not pain. Small volumes of blood are seen in the bowel which is an indication of presence of internal hemorrhoid. For many people it will cause pain, discomfort, itching sensation on the anal region and rectal region. The soft tissue around the anus will develop swelling and becomes enlarged and red. It can also form lump or lesions around the anus which can cause pain while sitting.
Strain while passing stool will affect the delicate tissues of the hemorrhoids causing bleeding. Sometimes repeated strain would push the internal hemorrhoid outside into the anal opening which can be felt by touching. This is called protruding hemorrhoid which can cause irritation and discomfort. This type of prolapsed hemorrhoid can be pushed inside using your finger but it may again push out when you pass stool next time.
In some cases the stool will leak into the anal skin causing itchiness on the anus. For many people hemorrhoid is related to difficulty in passing stools. The range of pain may vary from mild to severe based on the size of hemorrhoid and some causes severe inflammation.
In rare cases, hemorrhoids would protrude from the anus and becomes enlarged so that it cannot be pushed inside again. This condition is described as incarcerated hemorrhoids. These bundles of tissues will not get any blood supply forcing the blood vessels to die inside leading to gangrene (death of tissue). In such situation it is necessary to seek medical care immediately.
Hemorrhoids Grade :
Hemorrhoids can be graded based on the severity of the symptoms as follows :-
- First degree hemorrhoids will cause bleeding but often they would not protrude outside
- Second degree hemorrhoids will protrude outside but retract (pulled inside) without any effort. This may or may not cause bleeding.
- Third degree hemorrhoids are one that are protruding and can be pushed by your finger.
- Fourth degree hemorrhoids are quite serious. Here the cushions will protrude and cannot be pushed inside. It may contain blood clots along with the lining of the rectum. When this happens the stool will automatically leak into the anus skin causing irritation and moisture.
Risk Factors :
Chronic hemorrhoids can cause severe blood loss leading to anemia making you less energetic and weak.
Individuals with hemorrhoids will feel it in one way or the other. It can cause rectal bleeding and they would find drops of blood when they wipe. Protruding or prolapsing hemorrhoid can be felt under the anus after passing stool. It can cause pain, discomfort and irritation.
Your doctor will look for the above symptoms but he has to carefully rule out other complications like anal fissure, fistulae or infections or skin diseases on the anus. It is believed about 20-25% of the people with hemorrhoids can have anal fissures also. For detecting external hemorrhoids your doctor will check for the presence of bump or lesions under the anus. The lump may be tender which indicate that it contains blood clots.
Internal hemorrhoids are easy to diagnose since they protrude from your anus. Having cancerous tumor on the rectal and anal area is a rare phenomenon. He may use a special device called anoscope which is sent into the anus through the anal canal. When the instrument is pulled out the area of the hemorrhoid can be clearly seen. In some cases he may use sigmoidoscopy or colonoscopy procedure for testing the entire colon to rule out other problems like polyps and colon cancer.
Very often hemorrhoids can be managed by making some changes in your lifestyle and by carefully choosing diet. However for some people medications as well as surgery is required. To start with you can use topical creams or ointments to manage pain and itching sensation. There are suppositories or pads available in the drugstore that would control itching temporarily.
Local anesthetics, vasoconstrictors (ephedrine sulfate), protectants (aluminum hydroxide gel, glycerin), and analgesics (menthol) are used widely to manage initial symptoms. It is not advised to use these products for prolonged time since it can make the symptoms worse. Your doctor will make a simple incision for removing blood clots and the tissues for giving relief. Invasive procedures will be done in the doctor’s office.
Rubber band ligation is the process in which your doctor will use few rubber bands and tie the basal area of the internal hemorrhoids. This will eventually cut the blood supply making the tissues to wither off within few days. Sclerotherapy is a procedure in which your doctor will give a shot directly to the hemorrhoid for shrinking it. Laser therapy or Infrared techniques are used for shrinking the hemorrhoid tissues using heat.
If the patient does not respond to other therapy or treatments surgery is to be done for treating hemorrhoids. Removing the hemorrhoid tissue is called hemorrhoidectomy. The surgeon will gently cut down the excess growth of tissues from your anus or rectum using local anesthesia for numbing the area. Sometime epidural or spinal anesthesia is given for this procedure. This is the most effective way of treating severe hemorrhoids. Stapling of hemorrhoids is done in which the tissues are stapled together to block the blood flow.
Lifestyle Changes :
You need to avoid straining bowel movements if you have had hemorrhoids since it can recur. Hence it is necessary to include plenty of fiber foods like fruits and vegetables and whole grains daily. You can also consider taking supplementary fiber with consulting your doctor. Mild swelling can be treated using hydrocortisone creams or other topical ointments.
Soak yourself in warm water bath for 15 minutes daily. You can repeat this procedure several times a day. Now you can get sitz bath in most of the drugstore that can be easily fitted into your toilet. Avoid using perfumed wipe or alcohol containing wipes. Use moist toilet tissue for wiping. Keep the anal area clean by gently washing it with warm water.
Pictures of Hemorrhoid :
Images, Pics, Pictures and Photos of Hemorrhoid
You can prevent hemorrhoids by passing stools easy and quickly.
- Eat fiber rich diet in plenty. In case it is not working, include fiber supplement in your schedule.
- Drink plenty of water/liquids
- Do not strain by pushing the stool which will tear away the veins in your rectum.
- Do not suppress the urge to pass stool which can lead to constipation
- Do not sit for extended time on the toilet which can exert more pressure on the veins of rectum and anus.