Hemorrhoids

Hemorrhoids are a prevalent physical feature within the human body, characterized by swollen blood vessels in the rectum and anal canal, the final segment of the intestine. Many adults experience symptoms related to hemorrhoids at some point. This swelling can lead to discomforting symptoms such as bleeding, itching, and pain. Hemorrhoids are classified into two main types. Internal hemorrhoids develop inside the rectum and are generally not visible externally. In contrast, external hemorrhoids occur under the skin around the anus, are visible, and can be felt.

Causes

Several factors can lead to the development of hemorrhoids, explained simply as follows:

• Increased Bowel Movement Frequency: A rise in bowel movements can place excess pressure on the veins in the anus and rectum, causing hemorrhoids.

• Prolonged Toilet Sitting: Extended toilet sitting increases vein pressure, facilitating hemorrhoid formation.

• Straining During Bowel Movements: Straining, often due to constipation or diarrhea, stresses the anal veins, contributing to hemorrhoids.

• Pregnancy: Pregnancy can increase abdominal pressure and cause hormonal changes that weaken vein walls, making hemorrhoids more likely.

• Dietary Factors: Low fiber diets result in harder stools and increased straining risks, which can cause hemorrhoids.

• Heavy Lifting: Regular heavy lifting strains the rectal area veins.

• Prolonged Sitting: General long-term sitting can lead to hemorrhoids.

• Age: Aging weakens support tissues for rectal and anal veins, increasing hemorrhoid risk.

• Hereditary Factors: Genetic predispositions and inherited traits, such as weaker vein walls, may increase susceptibility to hemorrhoids.

Recognizing these causes helps in managing and preventing hemorrhoids by addressing possible contributing factors.

Symptoms

Hemorrhoids can exhibit a variety of symptoms, depending on their location in the rectum or around the anus. Common symptoms include:

• Itching or Irritation: Usually around the anal area, especially with external hemorrhoids, and is aggravated by excessive wiping.

• Lump or Swelling: A noticeable lump around the anus or rectum, typical of external hemorrhoids.

• Bleeding: Bright red blood appearing in the toilet bowl, on stool, or toilet paper after a bowel movement. Internal hemorrhoids often cause painless bleeding.

• Pain: Pain can occur, particularly with a thrombosed hemorrhoid, where a blood clot forms, causing swelling and hard lumps near the anus.

Consult a healthcare professional if you experience substantial bleeding or persistent symptoms despite a week of home treatment.

Diagnosis

Hemorrhoids diagnosis involves evaluating symptoms, reviewing medical history, and performing physical exams or diagnostic procedures. For external hemorrhoids, a visual inspection often suffices. For internal hemorrhoids, a digital rectal exam, where a gloved finger is used to check for irregularities, is typical. Diagnostic tools like an anoscope or sigmoidoscope allow for examination of the anal canal and lower rectum. If necessary, a colonoscopy may be performed to explore other digestive issues. These procedures are generally straightforward and rarely need anesthesia.

Treatments

Treatment for hemorrhoids, or piles, usually depends on symptom severity. Initial management often starts at home. Increasing Fiber (to 20-30 grams daily) and water intake (six to eight glasses a day) can help soften stools. Sitz baths, where one sits in warm water up to the hips, can alleviate discomfort. Over-the-counter remedies, like witch hazel pads or ice packs, offer topical relief, while Hydrocortisone suppositories or creams and stool softeners, such as docusate, are also beneficial.

Severe or persistent symptoms, especially with significant pain or bleeding, warrant medical consultation. Office procedures might be necessary, such as rubber band ligation, sclerotherapy, or infrared coagulation. Surgical options like hemorrhoidectomy or stapling are considered for severe cases. Seek medical advice if symptoms don't improve with home treatments or if there's excessive bleeding.

Medications

Several medications can help relieve hemorrhoid discomfort:

• Over-the-counter Creams and Ointments: These, containing Hydrocortisone, reduce itching and pain but should be used cautiously due to potential skin thinning. Consult healthcare professionals for guidance.

• Suppositories: Hydrocortisone or other soothing ingredients provide internal hemorrhoid relief.

• Witch Hazel Products: Known for reducing swelling and discomfort.

• Lidocaine: A local anesthetic that numbs affected areas, offering quick pain relief.

If these medications aren't effective, medical procedures like rubber band ligation or sclerotherapy might be recommended. Consult with healthcare professionals for the best treatment approach.

Prevention

Consider these lifestyle adjustments to prevent hemorrhoids and support healthy digestion:

• Increase Fiber Intake: Aim for 20–30 grams daily by incorporating more fruits, vegetables, and whole grains to maintain soft stools and regular bowel movements.

• Stay Hydrated: Drink six to eight glasses of water daily to aid digestion.

• Use Constipation Medications: Over-the-counter options like Miralax or docusate can be helpful.

• Don't Delay Bathroom Visits: Go promptly when you feel the urge.

• Limit Toilet Time: Avoid prolonged sitting, such as browsing your phone while on the toilet.

• Stay Active: Regular physical activity promotes bowel function and reduces rectal vein pressure.

• Fiber Supplements: Consider these if your dietary intake falls short.

Implementing these changes can significantly decrease the risk of hemorrhoid development.