Hemorrhoids, also known as piles, are swollen and inflamed veins in the rectum and anus that cause discomfort, itching, pain, and sometimes bleeding. They are a common condition and can occur inside the rectum (internal hemorrhoids) or under the skin around the anus (external hemorrhoids).
Causes:
Hemorrhoids are caused by increased pressure in the lower rectum, which may result from:
- Straining during bowel movements.
- Chronic constipation or diarrhea.
- Sitting for long periods, especially on the toilet.
- Obesity.
- Pregnancy (due to increased pressure on the pelvic veins).
- Low-fiber diet.
- Aging, as the tissues that support the rectal veins may weaken.
Types of Hemorrhoids:
- Internal Hemorrhoids:
- Located inside the rectum and usually painless.
- May cause bleeding during bowel movements.
- In severe cases, they may prolapse (protrude outside the anus).
- External Hemorrhoids:
- Found under the skin around the anus.
- Can cause itching, pain, and swelling.
- If a blood clot forms inside an external hemorrhoid (thrombosed hemorrhoid), it can be very painful and appear as a hard lump.
- Prolapsed Hemorrhoids:
- Internal hemorrhoids that have extended outside the anus.
- May cause discomfort and difficulty during bowel movements.
- Thrombosed Hemorrhoids:
- A clot forms in a hemorrhoid, causing severe pain and swelling.
- Often requires prompt medical treatment.
Symptoms:
- Bleeding during bowel movements, often painless.
- Itching or irritation around the anus.
- Pain or discomfort, especially with external or thrombosed hemorrhoids.
- Swelling around the anus.
- A lump near the anus that may be sensitive or painful (in the case of external hemorrhoids).
- Protrusion of internal hemorrhoids during bowel movements.
Diagnosis:
- Visual inspection: For external hemorrhoids.
- Digital rectal exam: A doctor may feel for abnormalities.
- Anoscopy or sigmoidoscopy: To inspect the rectum and lower colon for internal hemorrhoids or other causes of symptoms.
Treatment:
Home Remedies:
- Increase fiber intake: Eat more fruits, vegetables, and whole grains.
- Stay hydrated: Drink plenty of water to soften stools.
- Warm sitz baths: Soak the anal area in warm water for 10-15 minutes several times a day.
- Over-the-counter creams and ointments: Products containing hydrocortisone or witch hazel can reduce swelling and irritation.
- Cold compresses: Apply ice packs to reduce swelling.
- Avoid straining during bowel movements.
Medical Treatments:
- Minimally Invasive Procedures:
- Rubber band ligation: A rubber band is placed around the base of an internal hemorrhoid to cut off its blood supply, causing it to shrink.
- Sclerotherapy: A chemical solution is injected into the hemorrhoid to shrink it.
- Coagulation therapy: Heat, laser, or infrared light is used to harden and shrink the hemorrhoid.
- Surgical Procedures:
- Hemorrhoidectomy: Complete removal of large or severe hemorrhoids.
- Stapled hemorrhoidopexy: A procedure to remove part of the prolapsed hemorrhoidal tissue and reposition the rest.
Prevention:
- Eat a high-fiber diet to avoid constipation.
- Drink plenty of fluids to keep stools soft.
- Exercise regularly to prevent pressure on the rectal veins.
- Avoid prolonged sitting or standing to reduce pressure on the anal veins.
- Practice good bowel habits, such as going to the bathroom when the urge arises and not straining during bowel movements.
When to See a Doctor:
- Persistent bleeding during bowel movements.
- Severe pain or swelling.
- Protruding hemorrhoids that cannot be pushed back in.
- Symptoms that do not improve with home remedies or over-the-counter treatments.
Outlook:
Hemorrhoids can often be managed with lifestyle changes and home remedies. For more severe cases, medical or surgical treatments are effective. Early treatment can help prevent complications and improve quality of life.
