Hemorrhoids, also called as piles are the enlarged or swollen blood vessels around the rectum and anus. It is a common condition; almost 50% of adults experience the symptoms of hemorrhoids. Initially, there will be no symptoms but as the condition gets severe, the patient experience discomfort, itching, and bleeding. However, there are various treatment options for hemorrhoids.
Types of hemorrhoids
These are 2 types-
- Internal hemorrhoids- these are located inside the rectum, they do not usually hurt because of the presence of very few pain-sensing nerves. Bleeding is the only sign of this condition.
- External hemorrhoids- these develop under the skin around the anus which has more pain-sensing nerves. Therefore, patients with this condition experience pain as well as bleeding.
- Prolapsed hemorrhoids- in severe conditions, hemorrhoids become bigger and bulge outside the anal sphincter that hurt very severely, especially during bowel movements. These hemorrhoids usually go back inside on their own, if not, can be placed in their place.
Signs and symptoms
Although the symptoms of hemorrhoids are painful, they are not life-threatening and can be managed with treatment. The signs and symptoms of hemorrhoids include:
- Itching or pain in anal region
- Painless bleeding during bowel movements
- Fecal leakage
- Pain or discomfort
- Swelling around the anus
- Sensitive or painful lumps near the anus
If the patients experience the above symptoms for a longer duration, they may develop complications like anemia, weakness, and pale skin during blood loss.
Hemorrhoids are mainly caused by stretching and bulging of veins due to building up of pressure caused by:
- Sitting for longer periods, especially in toilet
- Straining during bowel movements
- Lifting something heavy
- Participating in anal sex
- Low-fiber diet
- Chronic diarrhea or constipation
Hemorrhoids are believed to be a genetic condition. People are more likely to get hemorrhoids if the patients have the disease. Frequently lifting heavy weight, obesity, and straining the body consistently increase the risk of hemorrhoids.
Hemorrhoids, especially external hemorrhoids can be easily diagnosed by looking. However, other tests are performed to confirm the diagnosis:
- Digital examination- in this test, the doctor inserts a gloved finger inside the rectum, if the unusual growth in the rectum is felt, hemorrhoids are suspected and the doctor suggests for sigmoidoscopy.
- Sigmoidoscopy- the doctor inserts a sigmoidoscope (a thin, small tube with an optic camera) into the rectum.
- Visual inspection- Internal hemorrhoids are too soft to be felt during a rectal examination and hence the lower part of the colon and rectum are examined using anoscope, proctoscope.
- Colonoscopy- the doctor suggests this test if signs and symptoms of other digestive disease are suspected and if the patient is at risk of developing colon cancer.
There are various treatment options for hemorrhoids
- Pain, swelling, and inflammation of the hemorrhoids can be managed by home remedies.
- Eating fiber-rich foods like fruits, vegetables, and whole grains. This increases the bulk of the stool, softens it, and prevents the straining of hemorrhoids.
- Using topical agents such as suppository containing hydrocortisone
- To relieve the pain, soak the anal region in warm water for 10 to 15 minutes two to three times a day.
- Keep the anal area clean by gently cleaning with warm water. Alcohol based or perfumed wipes should be avoided.
- Use ice packs or cold compresses on the anus to relieve pain.
The doctor prescribes medications such as creams, ointments, suppositories to relieve mild discomfort, pain, itching.
Surgery is recommended only when hemorrhoids are not managed with other treatment options. If blood clots are formed within external hemorrhoid, the doctor removes the clot with simple incision and drainage. This surgical technique gives immediate relief. The other surgical techniques include:
- Hemorrhoid removal- excess tissue that causes bleeding is removed
- Hemorrhoid stapling- this technique involves blockage of blood flow to the hemorrhoidal tissue; this technique is typically used for internal hemorrhoids.
- Eat fiber-rich food such as vegetables, fruits, whole grains, nuts, seeds, beans, and legumes
- Drink lots of water to avoid constipation
- Exercise regularly, for at least half an hour to keep blood and bowels moving
- Use the toilet as soon as there is an urge to go