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Hemorrhoids or piles refer to a condition wherein the veins around the anus or lower rectum get swollen and inflamed. In simple words hemorrhoids are veins that get swollen in the anal canal. The term hemorrhoids refer to 'cushions of tissue filled with blood vessels at the intersection of the rectum and the anus'. Hemorrhoids are painful but surely not dangerous or life threatening.

Hemorrhoids are common in both men and women. Almost half the population suffers from hemorrhoids when they reach 50. About 89% of Americans suffer from hemorrhoids. Hemorrhoids are very common among pregnant women. The pressure of the fetus on the abdomen and hormonal changes affect the blood vessels and force them to enlarge. These vessels experience severe pressure during childbirth thereby making hemorrhoid a common occurrence in women. In general hemorrhoids induced by pregnancy are a temporary problem in most women.

What causes hemorrhoids?

Too much pressure exerted on the veins in the pelvic and rectal area can cause hemorrhoids. Hemorrhoids can occur either inside the anus (internal) or under the skin around the anus (external). The following conditions can cause strain on the veins thus causing hemorrhoids:

  • Straining too much to pass stools
  • Sitting for too long
  • Chronic constipation
  • Pregnancy
  • Childbirth
  • Obesity
  • Cigarette smoking
  • Excessive coughing
  • Aging
  • Diarrhea
  • Having anal intercourse
  • Hypertension
  • Lifting heavy weight

Types of hemorrhoids

Internal hemorrhoids: Veins that get swollen inside the anal canal are referred to as internal hemorrhoids. Internal hemorrhoids are not very painful as there are no pain receptors in this area. Most people who have internal hemorrhoids are not even aware of having them. Internal hemorrhoids can bleed when they are irritated.

External hemorrhoids: Veins that get swollen near the opening of the anus are termed as external hemorrhoids. These hemorrhoids are at times painful and cause swelling and irritation.

Anal fissure: A thin tear in the anal area is an anal fissure. This hemorrhoid is itchy, painful and bleeds while passing stools.

Prolapsed hemorrhoids: These hemorrhoids are a type of internal hemorrhoid and they stretch down until they protrude outside the anus. This type of hemorrhoid can be painful.

Thrombosed hemorrhoids: A blood clot forms inside the external hemorrhoid thus causing thrombosed hemorrhoid. This type of hemorrhoid is very painful and can be felt as a stiff but tender mass in the anal area.

Symptoms of hemorrhoids

Although many people have hemorrhoids, not all experience symptoms. Symptoms vary based on whether the hemorrhoid is internal or external. Common symptoms for all types of hemorrhoids include:

  • Bleeding during bowel movements
  • Rectal pain
  • Itching

Diagnosis of hemorrhoids

People experiencing bleeding from the rectum or blood in the stool should get a thorough examination done through the doctor. Correct diagnosis of hemorrhoids is very important as bleeding could also be a symptom of other digestive diseases or colorectal cancer. Diagnosis for hemorrhoids includes:

  • Physical examination of the anus and the rectum by the doctor to check for swollen blood vessels that can be a vital sign of hemorrhoids

  • A digital rectal exam to check for abnormalities, if any

  • An anoscope (a hollow, lighted tube is used for viewing internal hemorrhoids) helps to view the rectum closely for hemorrhoids

  • Doctors may also use a proctoscope for a complete examination of the rectum

  • A sigmoidoscopy (use of lighted, flexible tubes inserted through the rectum) is used to view the rectum and lower colon/sigmoid, this helps in ruling out possibilities of other causes of gastrointestinal bleeding.

Treatment for hemorrhoids

  • Tub/sitz baths several times a day in plain/warm water for about 10 minutes

  • Increase intake of fiber and fluids to prevent constipation

  • Ice packs can help reduce swelling.

  • Applying hemorrhoidal cream to the affected area as suggested by the doctor.

  • In few cases when the hemorrhoid is severe, it is removed surgically. Surgery shrinks and destroys the hemorrhoidal tissue.

Common techniques followed in removal of hemorrhoids

Hemorrhoidectomy: At times severe internal or external hemorrhoids may require removal by surgery; this procedure is known as hemorrhoidectomy.

Sclerotherapy: A chemical solution is injected around the blood vessel so as to shrink the hemorrhoid.

Rubber band ligation: A rubber band is positioned inside the rectum around the bottom of the hemorrhoid. The band helps in cutting off blood circulation thereby forcing the hemorrhoid to wither away after a few days.

Infrared coagulation: A special device is used to burn hemorrhoidal tissue.

Laser coagulation: This is a new technique; electric current is applied to remove the hemorrhoids.

Home remedies for hemorrhoids

  • Drinking plenty of fluids to prevent constipation
  • Eating a fiber rich diet to prevent constipation and to ensure soft stools
  • Eat plenty of fresh fruits and vegetables
  • Exercise regularly
  • Wear loose fitting cotton clothes and underwear

Prevention of hemorrhoids

  • Do not sit for too long, take breaks in between

  • Try to keep stools soft so that they can pass easily,this will decrease pressure and straining in the anal area

  • Exercises like walking can prevent hemorrhoids

  • High content fiber diet can prevent constipation thus preventing hemorrhoids

  • Do not lift very heavy objects, if you do so, exhale while lifting the object

  • Do not cough excessively and strain too much while coughing

Interesting facts about hemorrhoids

  • Hemorrhoids are listed as one of the most common ailments.

  • A large percentage of the population develops hemorrhoids, generally after age 30.

  • Most people who suffer from hemorrhoids do not seek immediate medical advice and undergo the suffering quietly.

  • Painless treatment for hemorrhoids is available these days.

Pregnancy and hemorrhoids

Pregnancy makes women more prone to hemorrhoids. The main reason behind hemorrhoids in pregnant women is attributed to:

  • The growing uterus applies pressure on the veins thus causing the veins in the lower limbs to swell.

  • Constipation is common during pregnancy which can also cause or worsen hemorrhoids.

  • An increased level of the hormone progesterone during pregnancy allows the walls of the veins to relax thus causing swelling of the same. Progesterone also causes constipation thus causing hemorrhoids.

Preventing hemorrhoids in pregnant women

  • Eat a fiber-rich diet to avoid constipation.

  • Drink plenty of water.

  • Go in for Kegels exercise; this can strengthen the muscle around the anus and also improve the blood circulation in the area.

  • Get some physical activity.

  • Do not sit for too long.

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