Hemorrhoids
Also known as: Piles
What is it?
Hemorrhoids are masses of dilated veins on the
wall of the rectum and in the tissues at the
opening of the anus. The rectum is the end of the
large intestine, where stool is held until it is
released during a bowel movement. The anus is the
opening through which stool is released.
Who gets it?
While anyone can get hemorrhoids, they are more
common during middle age, in pregnant women, in
those who are obese, in people who have frequent
diarrhea, and in people who are often constipated.
People with liver disease are also more likely to
develop hemorrhoids.
What causes it?
Hemorrhoids are caused by pressure on the veins
in the rectum and anus. Pressure can be caused by
pregnancy and childbirth, straining during bowel
movements, being overweight, and sitting on the
toilet for long periods of time. Frequent diarrhea
can be caused by illness, diet, disease, and the
misuse of laxatives. Constipation is often caused
by diet, but can also be a consequence of aging,
illness, or disease.
What are the symptoms?
Hemorrhoids can be internal, which means they
are located inside the rectum. People with
internal hemorrhoids may notice bright red blood
after a bowel movement. External hemorrhoids are
located around the anus, and are the source of
itching, burning, pain, and swelling. These
hemorrhoids may bleed if you scratch them or if
you strain during a bowel movement. Blood clots
can form in hemorrhoids, causing inflammation and
painful lumps. Hemorrhoids may also drop down and
protrude from the anus.
How is it diagnosed?
Hemorrhoids are diagnosed through a visual and
internal examination of the rectal area. The
doctor will perform a rectal examination by
feeling inside the rectum with a lubricated,
gloved finger. Your doctor may look inside your
rectum with a lighted tool called an anoscope or
proctoscope. In some cases, your doctor may
recommend a procedure called a sigmoidoscopy or
colonoscopy to check the colon for tumors that can
also cause bleeding.
What is the treatment?
If you are frequently constipated, your doctor
will recommend a high fiber diet and plenty of
fluids. The fiber will help keep your bowel
movements regular and the fluid will keep them
softer so they are easier to pass without
straining. High fiber foods include bran cereals,
fresh fruits, and vegetables, such as broccoli,
carrots, and leafy greens. Some people need
additional fiber provided by over-the-counter
bulking agents, such as methylcelloulose or
psyllium. Any healthy diet should also include six
to eight 8-ounce glasses of fluid per day. While
water is the best fluid, this can also include
fruit juices. You can relieve pain, itching, and
swelling by using over-the-counter ointments,
creams, and suppositories. You can also relieve
pain and swelling with ice packs or warm water
soaks. Larger internal hemorrhoids are treated
with a variety of non-surgical and surgical
techniques. Banding, or rubber band ligation,
involves placing a tight band around the
hemorrhoid. If there is a blood clot in the
hemorrhoid, the doctor may cut the hemorrhoid open
and remove the clot. Because the band cuts off the
hemorrhoid’s blood supply, the vein withers and
falls off within a few days. This procedure is
usually painless. Internal hemorrhoids can also be
injected with a chemical that will cause them to
shrink, or destroyed with infrared light, a laser,
an electrical current, or freezing with liquid
nitrogen (cryosurgery). A hemorrhoidectomy is
performed when hemorrhoids are severe and other
treatments are not effective. Patients having a
hemorrhoidectomy are given either spinal or
general anesthesia. Then, the doctor inserts a
lighted viewing tube, such as an anoscope, into
the rectum and removes the hemorrhoids and any
extra tissue around them. Hemorrhoids caused by
pregnancy usually shrink with time.
Self-care tips
You can prevent hemorrhoids by eating a diet
high in fiber, drinking plenty of fluids, and
maintaining an active lifestyle. Use laxatives
only when absolutely necessary. If you have
hemorrhoids, use a soft toilet tissue or
premoistened wipe to wipe gently, then pat dry.
Avoid straining during bowel movements. See your
doctor if hemorrhoids are extremely uncomfortable
and bleed frequently. While hemorrhoids are not a
serious or life-threatening condition, it is
important to see a doctor for any type of rectal
bleeding, which can be a sign of other, more
serious, conditions such as colon cancer.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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