Hemorrhoids

WHAT IS IT?
Hemorrhoids are swollen and inflamed veins in your anus and lower rectum. Hemorrhoids may result for a variety of reasons, including straining during bowel movements or increased pressure on the veins during pregnancy.

Hemorrhoids may be located inside the rectum (internal hemorrhoids), or they may develop under the skin around the anus (external hemorrhoids). The veins around your anus tend to stretch under pressure and may bulge or swell.

Factors that might cause increased pressure include straining during bowel movements, sitting for long periods of time on the toilet, chronic diarrhea or constipation, obesity, pregnancy, anal intercourse, and a low-fiber diet.

Hemorrhoids are common and more likely to occur as you get older because the tissues that support the veins in your rectum and anus can weaken and stretch with aging.

SYMPTOM 

• Painless bleeding during bowel movements — small amounts of bright red blood on your toilet tissue or in the toilet bowl
• Itching or irritation in your anal region
• Pain or discomfort
• Swelling around your anus
• A lump near your anus, which may be sensitive or painful
• Leakage of feces

Signs and symptoms usually depend on the location. You usually can’t see or feel internal hemorrhoids, and they generally don’t cause discomfort. But straining or irritation when passing stool can damage their delicate surfaces and cause bleeding. Occasionally, straining can push internal hemorrhoids through the anal opening, which is known as a protruding or prolapsed hemorrhoid.

When external hemorrhoids around your anus can get irritated, they itch or bleed. Sometimes blood may pool in external hemorrhoids and form a clot, causing severe pain, swelling, and inflammation.

TREATMENT

Most of the time, you can treat hemorrhoids on your own, but sometimes minimally invasive procedures or surgery are necessary.

• Medications

If your hemorrhoids produce only mild discomfort, your doctor may suggest over-the-counter creams, ointments, suppositories, or pads. These products contain ingredients such as witch hazel or hydrocortisone that can relieve pain and itching, at least temporarily.

• Minimally invasive procedures

If a blood clot has formed within external hemorrhoid, your doctor can remove the clot with a simple incision, which may provide prompt relief. For persistent bleeding or painful hemorrhoids, you may need another procedure.

• Rubber band ligation

One or two tiny rubber bands are placed around the base of the internal hemorrhoid to cut off its circulation. The hemorrhoid withers and falls off within a week. This procedure is effective for many people.

• Injection (sclerotherapy). 

A chemical solution is injected into the hemorrhoid tissue to shrink it.

• Coagulation. 

Coagulation techniques use a laser or infrared light or heat. They cause small, bleeding, internal hemorrhoids to harden, and shrivel.

• Surgical procedures

If other procedures haven’t been successful or the hemorrhoids are large, your doctor may recommend more-invasive options.

Hemorrhoid removal. A surgeon removes the excess tissue causing the bleeding. Various techniques may be used. It’s the most effective way to treat severe or recurring hemorrhoids.

Hemorrhoid stapling. This procedure blocks blood flow to hemorrhoidal tissue. Hemorrhoid stapling generally involves less pain, and recovery is quicker than with hemorrhoid removal, but it has a greater risk of recurrence.

      Excerpt From: The Mayo Clinic. “Mayo Clinic A to Z Health Guide”.