Hemorrhoids, or sometimes called piles, are swollen veins that can be found in the lower rectum or around the anus.
Approximately half of the adults who have had hemorrhoids experienced the symptoms at the age of 50 or above. It is, although, very possible to have cases where the patient is younger than 50 years old.
What causes them?
To date, no exact causes of hemorrhoids have been determined. However, some experts believe that there are risk factors, some of them include:
- A family history of hemorrhoids
- Sitting or standing for long periods
- Obesity
- Straining during bowel movements
- Constant strain on the body (e.g. lifting heavy weights)
- Diarrhea or chronic constipation
- Pregnancy
- Coughing, vomiting or sneezing
- Maintaining a low-fiber diet
Since it is possible to genetically pass on hemorrhoids, you are at risk of getting hemorrhoids if your parents had them.
Constantly standing without taking breaks may also lead to hemorrhoids. Pregnancy is another possible cause of hemorrhoids.
This is because, during pregnancy, the uterus enlarges and pushes against the colon, causing the vein to protrude.
Diarrhea and repeated anal penetration can also lead to hemorrhoids. A fibrous diet, or lack thereof, plays a vital role in preventing or causing hemorrhoids.
Those who sustain a daily diet that is rich in fiber are less at risk of experiencing hemorrhoids.
On the other hand, individuals who have a low-fiber diet and consume processed foods regularly are more at risk of hemorrhoids.
Constipation is a common effect of a low-fiber diet that can lead to hemorrhoids through:
- producing stiff stools, which can aggravate the swollen veins and make the hemorrhoids worse; or
- cause prolonged straining during bowel movements
What are the symptoms?
Some of the symptoms of hemorrhoids are:
- pain or soreness in the anal area
- irritable bowel movement
- severe itchiness around the anus
- fecal leakage
- blood in your stool
- swelling or lump in the anus
Fortunately, hemorrhoids do not pose any serious risks to a person. In fact, although they are painful, they can eventually disappear on their own, even without being treated.
In some rare cases, those who get hemorrhoids often may end up becoming anemic due to blood loss.
What are the different types?
Internal hemorrhoids
Internal hemorrhoids are usually found in the inner lining of the rectum. This kind of hemorrhoid is not evident unless it swells to a significant size and is felt.
While hemorrhoids of this type are normally painless, they can cause some bleeding during bowel movements. On other occasions, the hemorrhoids bulge to the outside of the anus.
In this case, bulging hemorrhoids may cause some discomfort, given that the anus is full of pain-sensitive nerves.
Treatment for bulging hemorrhoids is usually not needed, as they often regress into the inside of the rectum on their own.
Otherwise, one can simply push them back into the rectum.
External hemorrhoids
External hemorrhoids are lower compared to internal hemorrhoids. It can be found under the skin surrounding the anus.
Once it swells, it becomes more evident and can cause pain, itchiness or bleeding. External hemorrhoids may protrude during bowel movements.
In some cases, the bulging external hemorrhoid may form blood clots and lead to thrombosis. This condition, although not serious, can be exceedingly painful and uncomfortable.
A thrombosed external hemorrhoid turns blue or purple in color and may start bleeding. Thrombosis may get better on its own over time.
However, the blood clot may be removed by a doctor in case the pain becomes intolerable.
How are they diagnosed?
A quick look at the anus is usually sufficient to diagnose hemorrhoids. For those who would like further confirmation, the doctor may conduct a digital rectal exam.
In this procedure, the doctor inserts a finger (gloved) inside the rectum and feel around for any abnormalities.
For further analysis, the doctor may conduct a sigmoidoscopy, wherein a small camera is inserted into the rectum via a tube.
This allows the doctor to see the inside of the rectum and inspect any abnormality at close range.
How are they treated?
Hemorrhoid treatment may be done either at a doctor’s clinic or at home.
Pain relief
A good way to relieve the pain brought by hemorrhoids is to soak in a tub full of warm water for 10 minutes or longer daily.
For those with external hemorrhoids, sitting on a warm water bottle can help alleviate pain.
Those who cannot tolerate the pain may choose to use cream, ointment or medicated suppository to lessen the pain and itch.
Fiber supplements
Constipated individuals will benefit from fiber supplements. These over-the-counter supplements, such as methylcellulose and psyllium, will aid in softening the stool.
Home remedies
There are also a number of home remedies available for hemorrhoids. Applying cold compress on the anus will help lessen the swelling of hemorrhoids.
Cleaning the anal area using warm water every day during a bath or shower will help keep it clean. However, avoid using soap as it can further irritate hemorrhoids.
For the discomfort, there are some topical treatments available over the counter, such as hydrocortisone. Oral medication such as aspirin or ibuprofen can also be taken to relieve any pain.
Medical procedures
In case the home remedies do little to treat the hemorrhoids, medical help must be taken. A common medical treatment for hemorrhoids is through sclerotherapy.
This involves the doctor directly injecting a chemical into the affected blood vessel, which will cause hemorrhoids to shrink.
Another possible medical treatment is a rubber band ligation. In this procedure, the doctor will place a rubber band around hemorrhoids.
This effectively cuts off circulation to it, thereby causing it to reduce in size. Although this seems like a simple method, it should only be conducted by a doctor or medical professional.
How can they be prevented?
Preventing the onset of hemorrhoids can be done through a number of simple ways. For one, not straining during bowel movements is a good way to prevent hemorrhoids.
Another good prevention method is to not hold bowels in. Incorporating exercise into your daily routine will also help battle constipation and, in turn, hemorrhoids.
A change in diet can also go a long way in preventing hemorrhoids.
Consuming fiber-rich food (e.g. whole wheat, oatmeal) and drinking lots of water will help with digestion, allowing stool to pass easily.
We actually use the squat stool here at the nursing homes. It helps much better than the prune juice. Demographics in certain countries have also shown that squatting while passing motion will help reduce the incidence of constipation and hemorrhoid issues.
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