Expert Answer | Everything About Hemorrhoids | AHM

8 min readNov 28, 2021

Hemorrhoids, aka piles, are veins in your anus and/or lower rectum, they have extremely similar characteristics and cause as that of varicose veins. Piles are seen inside the rectum which is called internal hemorrhoids, or under the skin around the rectal opening called external hemorrhoids.

Three out of four adults are susceptible to hemorrhoids. It is safe to assume that every human being can have hemorrhoids at some point in their life, most of the time they are undetected because of lack of symptoms.

Hemorrhoids are not associated with a certain cause, they are generally a sign of underlying diseases or lifestyle manifestation.

Originally published at https://ahealthminute.com on November 28, 2021.

Some interesting facts about hemorrhoids:
Studies show that women are more likely to get hemorrhoids during pregnancy.
Hemorrhoids occur when the veins around the ano-rectal region bulge out.
Chance of getting hemorrhoids increase as we age.
Surgery or medicines are only needed if the symptoms are difficult to bear.
Around 50% of people will have hemorrhoids by the age of 50 years.
A vast majority of cases go undetected.

What Are The Symptoms of Hemorrhoids?

The symptoms of Hemorrhoids depend on their type and other external factors.

There are mainly 3 types of Hemorrhoids with specific characteristics.

Internal Hemorrhoids: As the name suggests, they are found inside the rectum, they are rarely visible or palpable through examination. They are not known to cause marked symptoms, but it is common to feel irritation during bowel movements.
They are known to cause painless bleeding in stools and on toilet paper. Bright red blood is a common sign. In some individuals, hemorrhoids can get large and during straining, the hemorrhoids can come out of the rectum temporarily. These types of internal hemorrhoids are called protruding/ prolapsed hemorrhoids.
External Hemorrhoids: They are found under the skin of the rectal opening. They are visible and sometimes palpable under self-examination. They are known to cause itching, irritation, discomfort, pain, and soreness in the anal region.
Thrombosed Hemorrhoids: This is a type of external hemorrhoids when the blood pools in the vein and forms a blood clot. They are known to be very painful and are associated with swelling and inflammation. You might be able to feel it as a hard lump near your anal opening.

What Cause The Formation of Hemorrhoids?

As previously mentioned, there is no specific cause or etiology for haemorrhoids. Hemorrhoids can develop due to increased pressure in the lower rectum for a prolonged time, but there are some risk factors associated with haemorrhoids. What are the risk factors associated with hemorrhoids?

Pregnancy
Lifting heavyweights
Obesity
Individuals with chronic constipation or diarrhoea
Excessive straining during bowel movements
Sitting on the toilet for a long time
Age
Unhealthy low fibre diet
Anal intercourse

Why should you pay attention to hemorrhoids?

Complications caused by hemorrhoids are rare, but these are some to watch for.

Anemia: If you have bleeding hemorrhoid for a prolonged duration of time, it can make you anemic. Anemia can cause multiple secondary problems.
Thrombus: aka blood clots. It is possible to have stagnant blood in hemorrhoid and over time the blood can clot and cause Thrombosed hemorrhoids. It can be extremely painful and need medical intervention. On very rare occasions, this clot might be able to travel in your bloodstream and can cause a heart attack or a stroke.
Strangulated hemorrhoid: If the dilated vein gets strangulated or twisted and knot itself, or in any circumstance, if the blood supply is cut off to internal hemorrhoid, it can cause excruciating pain and require immediate medical intervention.

When Should You Treat Hemorrhoids?

Hemorrhoids are not considered a medical emergency, it does not warrant an urgent hospital visit but depends on their type and severity.
Most of the hemorrhoids heal eventually in a few weeks or months without medical intervention. If you have hemorrhoids for a long-standing period and it is causing you difficulty in your day to day life, or if it is causing harm to your standard of living, you can consult a surgeon.
Why should I consult a surgeon for hemorrhoids? More often than not, hemorrhoid patients have undergone surgical treatment, and surgeons are equipped with knowledge of how to treat hemorrhoids.

Visit your health care provider if you have the following symptoms.

Sudden large rectal/anal bleeding.
If hemorrhoids are causing extreme pain or significant discomfort.
No relief in symptoms, even after a few months of waiting.
If over-the-counter medications are not helpful.
If you are unable to get clear your bowels due to pain.
Significant bleeding.
Notice when there is a change in the colour of your bowel movements.

How to Prevent Hemorrhoids?

We can vaguely consider hemorrhoids as a lifestyle manifestation, The best way to prevent hemorrhoids is by lifestyle modification.

So far the best way is to adopt a technique to keep your bowel movement healthy

These are a few tips to prevent hemorrhoids.

High Fiber Diet: High fibre diet physiologically softens your stool and increase their bulk, which reduces straining, which is a risk factor for hemorrhoids. Adding high fibre content also reduces stomach discomfort and gas buildup in the stomach.
High Fluid Intake: High amount of fluid will soften the stools and aid in easy bowel movements.
Natural Fiber Supplements: There is no argument that high fibre food is an excellent choice, but let’s be real, we do not find high fibre vegetables and fruits sexy enough to consume. If you are a person who belongs to this category, then you should consider natural fibre supplements 20 to 30 grams a day in your diet would be a great start for your bowel movements.
Relax Yourselves: Don’t strain excessively in your toilet, this is one of the primary risk factors for hemorrhoids. Holding your breath and creating pressure in your abdomen to pass the stools is a big NO.
Go When You Want To Go: If you want to make a bowel movement, don’t wait, find a restroom nearby and GO! The longer you wait, the stools can dry and make the bowel movement very hard.
Be Active: Being physically active can reduce constipation and increase blood circulation reducing the pressure on veins. It also helps move the stagnant blood as well, hence reducing your chance of getting thrombosed hemorrhoids.
No Phone in Toilet: Studies show that people who use the mobile phone in the toilet take longer, and that extra time in a sitting position can increase the pressure and is a risk factor for hemorrhoids.

What can you expect from your Doctor?

Your doctor might take a thorough medical history, and a physical examination might be required.

Digital Rectal Examination: Your doctor will wear a glove and insert a finger inside your anal region with the help of lubrication gel, to examine for any anomalies or swellings.

Visual inspection: Small internal hemorrhoids can be difficult to examine by a DRE, so a visual exam of your rectum might be conducted by a medical device called a sigmoidoscope or proctoscope.

What Are The Treatment For Hemorrohoids?

Treatment for hemorrhoids can be arbitrary and symptomatic.

Before a hospital visit, go through these Home Remedies:

Eat a high fibre diet. Encourage yourself to eat a lot of fruits, vegetables, and whole-grain food that soften the stools and increase their bulk.
Use Topical Treatment: Find an effective over-the-counter hemorrhoid cream or suppository, which contains hydrocortisone, or use pads containing witch hazel or a numbing agent.
Sitz Bath: Sitzs bath is a warm, shallow bath that cleans your anal region. A sitz bath generally fits over the toilet rim.

Most of the home remedies are enough to get relief from symptoms of hemorrhoids in a few weeks.

What is the Medication for Hemorrhoids?

Your doctor might prescribe you a local anaesthetic like lignocaine pads, ointments, or suppositories, to relieve you from pain. Your doctor might also advise you not to use the local anaesthetics if you have any other medical conditions or for more than a week at a time.

Invasive Procedures: For chronic hemorrhoids, a high bleeding hemorrhoid, or painful hemorrhoids you may have to undergo a minimally invasive surgical procedure. Your surgeon will advise you on a specific treatment protocol depending on your medical situation.

Here are a few options your doctor might suggest.

Rubber Band Ligation: It’s a procedure where your doctor places one or more tiny rubber bands around the base of your internal hemorrhoid to cut their circulation. The hemorrhoid withers and falls off within a week’s time. Rubber band ligation is a safe procedure, but common side effects can include being uncomfortable and minimal bleeding.
Sclerotherapy: This is a procedure where your doctor injects chemical agents into a hemorrhoid to shrink it. Even though this is a relatively painless procedure, it is less effective than rubber band ligation.
Coagulation: It is a technique that uses laser or infrared heat to remove the hemorrhoids. It is common to find minimal bleeding.

What Are The Surgical Options For Hemorrhoids?

Hemorrhoidectomy: [Removal of Hemorrhoid] It’s a common surgical procedure to remove the excess tissue that is causing you discomfort and bleeding. It is not considered major surgery, some Hemorrhoidectomies can be done under local anaesthesia. This is the most effective way to treat hemorrhoids. It is common to have some pain after the procedure, but medication and sitz baths can help you recover faster.
Hemorrhoid Stapling: It’s also called stapled hemorrhoidopexy. It blocks the blood flow to the hemorrhoidal tissue [the principle behind this procedure is the same as rubber band ligation]. Stapling is a painless procedure compared to hemorrhoidectomy, but this procedure has a greater risk of recurrence and rectal prolapse.
Side effects include bleeding, urinary retention, pain, and rarely infections caused by the procedure.

Only a small population undergo surgical procedures. If your surgeon suggests you undergo surgical procedures, that means it is the most effective way to treat the hemorrhoids.

Hemorrhoids can be extremely difficult and painful in nature. Learning the cause and risk factors can be very helpful in their managment and prevention.
We hope to write about articles that are highly relevant to your everyday medical questions.

Stay Healthy! Stay Happy!

Originally published at https://ahealthminute.com on November 28, 2021.