What are Hemorrhoids?
Everyone has ‘normal’ hemorrhoids, which are tissue formations filled with blood vessels. They are found inside the anus, at the end of the rectum. Along with the circular shaped muscle at the opening of the rectum (anal sphincter), they help people control their bowel movements.
The condition commonly known as hemorrhoids, sometimes called piles, is when they become inflamed or swollen. The veins may be enlarged and unpleasant symptoms can be experienced. (1)
This is common in both women and men, affecting about five percent of people in the US. It is more prevalent in people over 50 years old, affecting about 50 percent of this population. (2)
Several factors can cause hemorrhoids to become enlarged. These include straining when passing stools or sitting on the toilet for extended periods of time. Severe diarrhea or constipation also result in enlarged hemorrhoids.
Certain physical factors, like pregnancy, giving birth, aging and obesity can predispose a person to hemorrhoids. These can naturally weaken the rectum and anal tissues.
Many foods which are low in fiber, such as: cheese, fast foods, chips, ice cream, meat and processed foods, should be avoided. They make stools more solid and harder to pass and can lead to hemorrhoids. (3)
Symptoms of hemorrhoids include:
Itchiness and irritation around the area outside the anus or inside the rectum is a common symptom.
Bright red blood might be noticed, either in the toilet bowl or on toilet tissue. This will generally be apparent during or following bowel movements. It is often painless.
Blood might also be seen in the stools. In this instance, a doctor’s advice should be sought, as it could be an indication of a more serious condition.
There are times when mucus may also be discharged and seen on the tissue or surrounding the stool.
Pain and discomfort is sometimes felt in the anal area when sitting down. It might also be noticeable when passing stools. This can sometimes be described as a burning sensation.
The area around the anus might become swollen. There may also be the presence of a swollen, tender lump. This could make a person feel they have not emptied their bowels, even after just passing a stool. (4)
Each type of hemorrhoid can present with its own symptoms, dependent on its location.
Situated inside the rectum, these are generally not felt or seen, and cause little discomfort. Blood is often present when the hemorrhoidal tissue is damaged and irritated by straining to pass a bowel movement.
Sometimes, straining will push an internal hemorrhoid out through the anus (prolapsed hemorrhoid). This can cause irritation and discomfort. (5)
These form under the skin at the entrance to the anus. They can cause pain and discomfort; they might itch and can also bleed. (6)
Thrombosed and Strangulated Hemorrhoids
There are times when a hemorrhoid might fill with blood which creates a clot (thrombosed). This can be painful and result in swelling, inflammation and a lump near the anus, which is hard.
Sometimes an internal hemorrhoid will prolapse and the anal sphincter will cut off the blood supply. This type of hemorrhoid can be painful. (7)
There are other complications associated with hemorrhoids. Skin tags can be left behind following formation of a blood clot in an external hemorrhoid. Excess skin remains once the clot dissolves.
There is also the chance that an external hemorrhoid can become infected. (8)
Hemorrhoids are classified depending on their severity. They fall into the following grades:
Hemorrhoids within this grade are only slightly enlarged. They are not visible outside the anus.
In this grade, hemorrhoids are larger and sometimes fall out of the anus. This can happen when passing a bowel movement or occasionally when taking part in physical activities. The hemorrhoids will return inside the anus of their own accord.
This grade sees the hemorrhoids fall outside the anus when taking part in physical activities or passing a bowel movement. They can be pushed back into the rectum but will not go back of their own accord.
The hemorrhoids are now permanently outside the anus and it is not possible to push them back inside. Some of the anal lining can protrude from the anus. This is also called a rectal prolapse. (9)
Dietary and Lifestyle Changes
The first line of treatment for all grades of hemorrhoids is a dietary and lifestyle change.
Eating foods high in fiber will produce softer stools which pass more easily and help avoid straining.
Fruits, whole grains and vegetables are good sources of fiber. A fiber supplement or stool softener could also help.
Drinking plenty of water, in the region of six to eight glasses a day, will help to keep stools softer. Other fluids will also achieve this, but alcohol should be avoided.
Whenever you feel the need to pass a stool, it’s better not to wait. This can cause the stool to become dry and it will be harder to pass. Straining to pass a bowel movement can lead to hemorrhoids.
Long periods of sitting can also contribute to the formation of hemorrhoids, so daily exercise is a good idea. Staying active will help prevent constipation and also reduce excess weight.
Sitting in a warm bath several times a day can help relieve pain, as can non-prescription medications.
Hemorrhoid creams and suppositories can be obtained over the counter from a pharmacist. They can assist in relieving the swelling, itching and mild pain associated with external hemorrhoids.
However, should these medications not help within a week of using them, or you have a rash or dry skin around the anus, you should see a doctor. (10)
Often, dietary and lifestyle changes and over the counter medications will successfully treat this condition. When hemorrhoids are very painful, bleeding or not healed by self-medication and treatment, medical assistance should be sought.
There are several treatments which a doctor can recommend to treat hemorrhoids. These include:
Rubber Band Ligation
This procedure is used by doctors for the treatment of prolapsing internal hemorrhoids or ones which are bleeding.
A special rubber band is tied at the base of the hemorrhoid. This stops the blood supply, causing the hemorrhoid to shrivel up and fall off. It usually takes up to a week for this to happen.
The hemorrhoid which remains forms scar tissue and often shrinks as a result. This is a specialized treatment, performed by a doctor, and should not be tried at home.
During this procedure a solution is injected into the hemorrhoid which causes scar tissue to form. Once scar tissue is present, it stops the blood supply to the hemorrhoid which usually has the effect of shrinking it. This procedure is used for internal hemorrhoids.
A special tool is used to direct an infrared light at a hemorrhoid found inside the rectum. The heat generated by the infrared light can cause scar tissue to form, again stopping the blood supply. This induces scarring and shrinks the hemorrhoid.
This procedure also uses a special tool, this time one which sends an electric current into a hemorrhoid located in the rectum. Once again, it stops the blood supply and induces scarring. This leads to shrinkage of the hemorrhoid. (11)
If hemorrhoids don’t respond to other treatments, or when they are large external hemorrhoids or prolapsed internal hemorrhoids, surgery might be considered. Surgery is also the treatment of choice for strangulated hemorrhoids.
A hemorrhoidectomy involves the surgical removal of a hemorrhoid. This procedure is carried out in a hospital, and either a general or local anesthetic is administered.
Another surgical procedure which could be used is hemorrhoid stapling. A special stapling tool is used to either pull a prolapsed hemorrhoid back into the rectum, or to remove internal hemorrhoid tissue.
This surgery will again be performed in a hospital and a local or general anesthesia administered. (12)
What are hemorrhoids? Hemorrhoids, sometimes called piles, are swollen or inflamed veins, either found outside or inside the anus.
What are the signs of hemorrhoids? The signs of this condition include pain, itching and swelling in the anal area. Bleeding can accompany bowel movements.
How do you develop hemorrhoids? Straining when passing a stool or sitting on the toilet too long can contribute to the formulation of hemorrhoids. Other contributing factors are a low fiber diet, obesity, pregnancy and lifting heavy objects.
How are you diagnosed for hemorrhoids? A doctor can diagnose this condition from a physical examination. An internal imaging device might be used.
What is the best treatment for hemorrhoids? Treatments for this condition include dietary and lifestyle changes, procedures to remove the blood supply to hemorrhoids or surgery. (13)
What are the long term complications of hemorrhoids? In most cases, this condition can be successfully treated However hemorrhoids can recur.
Are hemorrhoids considered a disability? This condition is not considered a disability. (14)
Is there a cure for hemorrhoids? This condition is treated successfully in most cases.
Are hemorrhoids life threatening? This condition is not considered to be life threatening.
Hemorrhoids, sometimes called piles, are swollen or inflamed veins, either found outside or inside the anus.
While this common condition can be embarrassing and painful, various treatments are available which are often successful.