What are hemorrhoids?
The term hemorrhoids refers to a condition in which the veins
around the anus or lower rectum are swollen and inflamed.
Hemorrhoids may result from straining to move stool. Other
contributing factors include pregnancy, aging, chronic constipation or diarrhea,
and anal intercourse.
Hemorrhoids are either inside the anus—internal—or under the skin
around the anus—external.
What are the symptoms of hemorrhoids?
Many anorectal problems, including fissures, fistulae, abscesses,
or irritation and itching, also called pruritus ani, have similar symptoms and
are incorrectly referred to as hemorrhoids.
Hemorrhoids usually are not dangerous or life threatening. In most
cases, hemorrhoidal symptoms will go away within a few days.
Although many people have hemorrhoids, not all experience
symptoms. The most common symptom of internal hemorrhoids is bright red blood
covering the stool, on toilet paper, or in the toilet bowl. However, an internal
hemorrhoid may protrude through the anus outside the body, becoming irritated
and painful. This is known as a protruding hemorrhoid.
Symptoms of external hemorrhoids may include painful swelling or a
hard lump around the anus that results when a blood clot forms. This condition
is known as a thrombosed external hemorrhoid.
In addition, excessive straining, rubbing, or cleaning around the
anus may cause irritation with bleeding and/or itching, which may produce a
vicious cycle of symptoms. Draining mucus may also cause
itching.
How common are hemorrhoids?
Hemorrhoids are common in both men and women. About half of the
population has hemorrhoids by age 50. Hemorrhoids are also common among pregnant
women. The pressure of the fetus on the abdomen, as well as hormonal changes,
cause the hemorrhoidal vessels to enlarge. These vessels are also placed under
severe pressure during childbirth. For most women, however, hemorrhoids caused
by pregnancy are a temporary problem.
How are hemorrhoids diagnosed?
A thorough evaluation and proper diagnosis by the doctor is
important any time bleeding from the rectum or blood in the stool occurs.
Bleeding may also be a symptom of other digestive diseases, including colorectal
cancer.
The doctor will examine the anus and rectum to look for swollen
blood vessels that indicate hemorrhoids and will also perform a digital rectal
exam with a gloved, lubricated finger to feel for
abnormalities.
Closer evaluation of the rectum for hemorrhoids requires an exam
with an anoscope, a hollow, lighted tube useful for viewing internal
hemorrhoids, or a proctoscope, useful for more completely examining the entire
rectum.
What is the treatment?
Medical treatment of hemorrhoids is aimed initially at relieving
symptoms. Measures to
reduce symptoms includetub baths several times a day in plain,
warm water for about 10
minutes application of a hemorrhoidal cream or suppository to the
affected area for a limited
time Preventing the recurrence of hemorrhoids will require
relieving the pressure and straining of constipation. Doctors will often
recommend increasing fiber and fluids in the diet. Eating the right amount of
fiber and drinking six to eight glasses of fluid—not alcohol—result in softer,
bulkier stools. A softer stool makes emptying the bowels easier and lessens the
pressure on
hemorrhoids caused by straining. Eliminating straining also helps
prevent the hemorrhoids
from protruding.Good sources of fiber are fruits, vegetables, and
whole grains. In addition,
doctors may suggest a bulk stool softener or a fiber supplement
such as psyllium
(Metamucil) or methylcellulose (Citrucel).
How are hemorrhoids prevented?
The best way to prevent hemorrhoids is to keep stools soft so they
pass easily, thus decreasing pressure and straining, and to empty bowels as soon
as possible after the urge occurs. Exercise, including walking, and increased
fiber in the diet help reduce constipation and straining by producing stools
that are softer and easier to pass.
What Causes Hemorrhoids?
Hemorrhoids may occur at any time in men and women but
generally become more common with advancing age, during pregnancy,
and
in women who have
had children.
Causes of hemorrhoids include:
* Genetic predisposition
* Constipation and straining during bowel
movements
* Prolonged sitting
* Diarrhea
* Pressure and strain due to standing for long
periods
*Lifting objects that are too heavy
* Vomiting
* Pregnancy
* Coughing
* Sneezing
Maintaining an active lifestyle, combined with
a high-fiber diet, is the essential components
to prevent hemorrhoids.