About Hemorrhoids (Piles)
Hemorrhoids, also known as piles, are swollen and inflamed veins located around the anus or in the lower rectum. There are two types of hemorrhoids:
- External hemorrhoids: These form under the skin around the anus.
- Internal hemorrhoids: These form in the lining of the anus and lower rectum.
Hemorrhoids can cause symptoms such as painless bleeding, discomfort or soreness in the anal area, itching or irritation, lumps and swelling in the anal region, and sometimes incontinence of feces. While some people may not notice they have hemorrhoids, others may experience mild symptoms. Rarely, complications such as anemia due to blood loss or thrombosed hemorrhoids (blood clot inside the hemorrhoid) can occur.
Hemorrhoids can be caused by chronic constipation, diarrhea, pregnancy, aging, obesity, heavy lifting, anal intercourse, or genetic factors. Treatment options are available to manage symptoms and provide relief. It is important to consult with a healthcare professional for proper diagnosis and guidance on treatment options.
The causes of hemorrhoids involve increased pressure on the veins around the anus. This can occur due to various factors.
Non-modifiable risk factors for hemorrhoids cannot be changed or controlled. These include:
- Family history of hemorrhoids
- Age over 50
Modifiable risk factors for hemorrhoids can be influenced or changed. These include:
- Obesity
- Prolonged sitting or standing
- Heavy lifting or strenuous activities
- Chronic constipation or diarrhea
- Pregnancy (enlarged uterus presses on the vein in the colon)
- Anal sexual intercourse, which can irritate hemorrhoids
It's important to note that these risk factors may increase the likelihood of developing hemorrhoids but do not guarantee their occurrence. If you have concerns about hemorrhoids, it's best to consult with your healthcare professional for personalized advice.
Common early symptoms of hemorrhoids include:
- Painless bright red bleeding with stools, on the toilet paper, or in the toilet water
- Itching or burning sensation around the anus
- Feeling of pressure or discomfort in the anal area
As hemorrhoids become more severe, additional symptoms may occur, such as:
- Anal swelling or lump
- Painful bowel movements
- Anal ache or pain, especially when sitting
- Rectal discharge
In some cases, hemorrhoids may prolapse, which means they can fall through the anal opening. This can cause further symptoms like:
- Hemorrhoid protrusion outside the anus
- Pain and discomfort in the anal area
It's important to note that not all anal symptoms are caused by hemorrhoids. If you experience rectal bleeding, especially for the first time, it's advisable to see a doctor to rule out any underlying conditions. Remember to consult with your healthcare professional for a proper diagnosis and treatment plan.
To diagnose hemorrhoids, doctors commonly perform the following examinations, tests, and procedures:
- Medical history assessment: Your doctor will ask about your symptoms, eating habits, toilet habits, enema and laxative use, and current medical conditions.
- Physical exam: Your doctor will visually examine the area around your anus for lumps, swelling, skin irritation, skin tags, and anal fissures. They may also perform a digital rectal exam to check for tenderness, blood, internal hemorrhoids, and lumps or masses.
- Anoscopy: This procedure involves using an anoscope to view the lining of your anus and lower rectum. It helps your doctor identify signs of lower digestive tract problems and bowel disease. Anoscopy is usually done during an office visit or at an outpatient center without anesthesia.
Additional examinations, tests, and procedures may include:
- Sigmoidoscopy: This test examines the last 2 feet of your colon using a small camera inserted into your rectum. It helps assess the extent of hemorrhoids and rule out other conditions.
- Colonoscopy: This comprehensive examination explores the entire colon using a small fiber-optic camera inserted through the rectum. It provides a detailed view of the rectum and colon to evaluate the severity of hemorrhoids and detect any other abnormalities.
Remember that these are general guidelines and individual cases may vary. Consult with your healthcare professional for personalized advice.
The goals of treatment for hemorrhoids are to reduce or eliminate symptoms rather than cure the condition itself. Here are the various treatment options and how they work to achieve these goals:
Medications:
- Topical treatments: Over-the-counter hemorrhoid creams, pads with numbing agents, or hydrocortisone suppositories can help alleviate symptoms by reducing inflammation and providing temporary relief.
Therapeutic Procedures:
- Injection therapy: Injections such as Shaobei injection, a traditional Chinese medicine extract, can reduce local tissue inflammation and promote mucosal repair and regeneration.
- Sclerotherapy: This procedure involves injecting a solution into the hemorrhoids to block blood supply, leading to shrinkage.
- Infrared photocoagulation: Using infrared light, this therapy blocks blood supply to the hemorrhoids, causing them to shrink.
- Rubber band ligation: A rubber band is placed near the base of the hemorrhoids to cut off blood supply, causing them to shrink and fall off.
- Hemorrhoidectomy: Surgical removal of the hemorrhoids using a scalpel.
Self-care and Health Behavior Changes:
- Eating more fiber: Increases stool bulk and reduces straining during bowel movements.
- Treating constipation: Helps prevent excessive straining during bowel movements.
- Staying physically active: Promotes regular bowel movements and improves overall digestive health.
- Good hygiene: Keeping the anal area clean and dry helps prevent irritation.
- Avoiding anal sex or penetration.
It's important to note that these recommendations may vary depending on individual circumstances. Always consult with a healthcare professional for personalized advice.
Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Side effects can occur. Check with your health care professional or read the information provided with your medication for side effect information.