What Are Hemorrhoids?
Hemorrhoids involve the blood vessels that line the anus. Pressure on the walls of the rectum weakens the muscles that support the hemorrhoidal vessels. They then become enlarged and lose their support and result in a sac-like protrusion inside the rectal canal (called internal hemorrhoids) or under the skin around the anus (called external hemorrhoids).
Who Gets Hemorrhoids?
- People over the age of 50
- Chronically constipated persons
- Pregnant women
- Chronic laxative users who strain during bowel movements
- Spending long periods of time on the toilet bowl reading
What are the Symptoms of Hemorrhoids?
- small amount of blood in the stool or on the toilet paper after wiping**
- protrusion during bowl movements
- incomplete bowel movements
- rectal itching
- soft lump felt at the anal opening
** Note: Bleeding from the rectum should be reported to the doctor. Bleeding could be a symptom of other medical conditions, such as inflammation of the intestines, anal fissures (crack in the lining of the anal canal), rectal polyps and/or colorectal cancer.
Diagnosis of Hemorrhoids
To diagnose hemorrhoids, the doctor will do a rectal examination. The doctor places a gloved and lubricated finger into the rectum to feel for abnormalities. External hemorrhoids can be diagnosed by a visual and/or rectal examination.
To diagnose internal hemorrhoids, the doctor will insert a thin tube-like instrument (called an anoscope) into the lower few inches of the rectum. The anoscope has a light at the end and an eyepiece at the front for viewing into the anal canal.
To look for other sources of bleeding, the doctor may perform a colonoscopy (an examination of the inside of the colon) or a sigmoidoscopy (an examination of the rectum and the last part of the colon - the sigmoid colon).
Treatment of Hemorrhoids
Medical treatment of hemorrhoids is initially aimed at relieving symptoms. Measures to reduce symptoms include:
- warm tub or sitz baths several times a day in plain, warm water for about 10 minutes
- ice packs to help reduce swelling
- application of petroleum jelly, cortisone creams, hemorrhoidal cream (such as Preparation-H) or suppositories to the affected area
- wearing cotton underwear and loose clothing
- cleaning the anus after each bowel movement by patting gently with moist toilet paper or moistened pads
- taking acetaminophen or aspirin
For hemorrhoids that don't respond to self-care measures, there are some other techniques to alleviate the hemorrhoids:
For treatment of internal hemorrhoids, one of three methods is usually used:
- Rubber Band Ligation - This procedure involves placing a small rubber band at the base of the internal hemorrhoid. The band cuts off blood supply to the hemorrhoid, causing it to shrivel up and fall off in about four to seven days.
- Infrared Photocoagulation - This procedure involves directing an infrared light to coagulate (clot) the dilated veins of the hemorrhoid. This causes the hemorrhoids to shrink, since the blood does not flow through the coagulated blood vessels.
- Hemorrhoidectomy - This procedure involves surgically removing the hemorrhoid groups in the anal canal, and is performed with a scalpel, cautery device or laser.
Self Care
Most hemorrhoids heal on their own in a week or two. Hemorrhoids have a tendency to return unless something is done to prevent them. The most effective preventive measures are:
- Eat between 25 and 30 grams of fiber a day.
- Drink at least 8 glasses of water a day.
- Increase your amount of daily physical activity.
- Add stool softeners or laxatives to diet. Consult with the doctor regarding the prolonged use of stool softeners and laxatives.
- Lose weight.
- Change bowel habits. Respond to the urge to defecate and stay relaxed to avoid straining.
- Exercise the buttocks muscles.
- Practice good personal hygiene. Keep the anal area clean and avoid using rough toilet paper.