Hemorrhoids

Learn Hemorrhoids in 5 minutes

Overview

Hemorrhoids are swollen veins in the anus and lower rectum, similar to varicose veins. They can develop inside the rectum (internal hemorrhoids) or under the skin around the anus (external hemorrhoids). Symptoms depend on the type of hemorrhoid, with internal hemorrhoids usually being painless, while external hemorrhoids can cause itching, pain, and bleeding. Hemorrhoids can occur due to increased pressure in the lower rectum from factors like straining during bowel movements, sitting for long periods, being obese, pregnancy, or a low-fiber diet. Treatment often involves home remedies and lifestyle changes, but consult a healthcare provider for persistent symptoms or severe cases.

Understanding the disease

Symptoms

The symptoms of hemorrhoids can depend on the type of hemorrhoid. For internal hemorrhoids, symptoms may include painless bleeding during bowel movements, noticeable bright red blood on toilet tissue or in the toilet. External hemorrhoids may cause itching or irritation in the anal region, pain or discomfort, swelling around the anus, and bleeding. If a thrombosed hemorrhoid occurs, symptoms can include severe pain, swelling, and a hard, discolored lump near the anus. If hemorrhoids do not improve after a week of home care or if there is bleeding during bowel movements, it is recommended to consult a health care provider.

Risk Factors

The risk factors for developing hemorrhoids include:

1. Aging
2. Straining during bowel movements
3. Sitting for long periods of time, especially on the toilet
4. Having chronic diarrhea or constipation
5. Being obese
6. Being pregnant
7. Having anal intercourse
8. Eating a low-fiber diet
9. Regularly lifting heavy items It's essential to consult a healthcare provider if you have bleeding during bowel movements or if your hemorrhoids don't improve after a week of home care. Don't assume rectal bleeding is due to hemorrhoids; it can be a sign of other diseases, including colorectal cancer and anal cancer. Seek emergency care if you have large amounts of rectal bleeding, lightheadedness, dizziness, or faintness.

Development

Hemorrhoids develop as a result of increased pressure in the lower rectum, which causes the veins around the anus to stretch, bulge, and swell. This pressure can be caused by various factors, including straining during bowel movements, sitting for long periods of time, chronic diarrhea or constipation, being obese, pregnancy, anal intercourse, eating a low-fiber diet, and regularly lifting heavy items. Internal hemorrhoids develop inside the rectum, while external hemorrhoids develop under the skin around the anus.

Assessment and Diagnosis

Triage

You should see a doctor if hemorrhoids are suspected when there is bleeding during bowel movements or if the hemorrhoids don't improve after a week of home care. It's important to consult a healthcare provider if you have rectal bleeding, changes in bowel habits, or if your stools change in color or consistency, as these could be indicative of other diseases such as colorectal cancer or anal cancer. Additionally, seek emergency care if you experience large amounts of rectal bleeding, lightheadedness, dizziness, or faintness.

Diagnosis

Diagnosing hemorrhoids may involve a physical examination and visual inspection by a healthcare provider. Internal hemorrhoids might not be felt during a rectal exam, so your provider may use special tools like an anoscope, proctoscope, or sigmoidoscope to examine the lower part of your colon and rectum. If your symptoms suggest other digestive system diseases or if you have risk factors for colorectal cancer, your healthcare provider might recommend a colonoscopy to examine your entire colon.

Management and Treatment

Complications

Potential complications of hemorrhoids include anemia, strangulated hemorrhoid, and blood clot. Rarely, ongoing blood loss from hemorrhoids may cause anemia, and a strangulated hemorrhoid can cause extreme pain. Additionally, a blood clot can form in a hemorrhoid, which can be extremely painful and may need to be drained.

Prevention

hemorrhoids can be prevented by following certain measures:

1. Eating a high-fiber diet: Consuming more fruits, vegetables, and whole grains can help soften the stool and decrease constipation, which may contribute to hemorrhoids.
2. Drinking plenty of fluids: Staying hydrated by drinking 6-8 glasses of water and other liquids daily can help keep stools soft and reduce the risk of constipation.
3. Exercise: Regular physical activity can help prevent constipation, reduce pressure on veins, and promote overall health.
4. Avoiding long periods of sitting: Sitting for extended periods, especially on the toilet, can increase pressure on the veins in the anus, exacerbating hemorrhoids.
5. Maintaining a healthy weight: Losing excess weight can help alleviate pressure on the veins and reduce the risk of hemorrhoids. By incorporating these preventive measures into your daily routine, you can help reduce the likelihood of developing hemorrhoids.

Home Remedies

Home remedies for hemorrhoids include:

1. Eating a high-fiber diet: Consuming more fruits, vegetables, and whole grains can help soften stools and reduce straining during bowel movements.
2. Drinking plenty of fluids: Staying hydrated by drinking 6-8 glasses of water and other liquids daily can help keep stools soft.
3. Fiber supplements: Over-the-counter fiber supplements, such as psyllium (Metamucil, Konsyl, others) or methylcellulose (Citrucel), can help reduce symptoms and bleeding from hemorrhoids when taken with sufficient fluids.
4. Avoiding straining: Reducing straining during bowel movements can help decrease pressure on the hemorrhoids.
5. Exercise: Engaging in regular physical activity can help prevent constipation and reduce pressure on veins.
6. Over-the-counter creams and ointments: Applying creams or ointments containing hydrocortisone or witch hazel can help relieve itching and swelling.
7. Sitz baths: Soaking in a warm bath with added Epsom salt can help relieve pain and itching.
8. Ice packs: Applying an ice pack wrapped in a cloth to the affected area can help alleviate swelling and pain. If hemorrhoids don't improve after a week of home care, or if you experience bleeding during bowel movements, it's best to consult a healthcare provider.

Treatment

There are several options available to treat hemorrhoids. Many people get relief with home treatments and lifestyle changes. Here are some recommended treatments for hemorrhoids:

1. Over-the-counter creams and ointments: Topical creams and ointments containing hydrocortisone or witch hazel can help reduce inflammation, itching, and pain.
2. Warm baths: Soaking in a warm bath can help alleviate pain, swelling, and itching. Add Epsom salt or baking soda to the water for additional relief.
3. Ice packs: Applying an ice pack wrapped in a cloth to the affected area can help reduce swelling and pain.
4. Sitz baths: A sitz bath is a warm, shallow bath that helps to cleanse the area and reduce inflammation. You can purchase a sitz bath or use a regular tub filled with warm water.
5. Home remedies: Try over-the-counter remedies like applying aloe vera gel, using a donut-shaped cushion while sitting, or taking warm baths with baking soda to alleviate discomfort.
6. Dietary changes: Eating high-fiber foods, drinking plenty of fluids, and avoiding low-fiber diets can help prevent constipation, which can exacerbate hemorrhoids.
7. Exercise: Engaging in regular physical activity can help improve bowel movements and reduce pressure on veins.
8. Medications: In some cases, healthcare providers may recommend pain relievers, such as acetaminophen or ibuprofen, to manage discomfort.
9. Medical procedures: If home remedies and lifestyle changes do not provide relief, medical procedures, such as rubber band ligation, sclerotherapy, or surgical hemorrhoidectomy, may be recommended. Always consult your healthcare provider for personalized advice and appropriate treatment options.

Preparing for medical consultation

To prepare for an appointment for hemorrhoids, you can follow these steps:

1. Note any symptoms: Make a list of any symptoms you're experiencing, including pain, itching, bleeding, or discomfort.
2. List medications and supplements: Create a list of all medications, vitamins, or supplements you're currently taking.
3. Gather personal information: Write down any key personal information, such as recent changes in your diet or lifestyle, any underlying medical conditions, or any other concerns you may have.
4. Bring a family member or friend: Consider bringing a family member or friend along to help you remember important information discussed during the appointment.
5. Prepare a list of questions: Compile a list of questions to ask your healthcare provider, such as treatment options, potential side effects, or if there are any lifestyle changes you can make to alleviate symptoms. By being well-prepared, you can ensure that you cover all the necessary information during your appointment and make the most of your time with your healthcare provider.