Table of contents
What is a hemorrhoid?
Frequently, it has been observed that hemorrhoids don’t cause any specific symptoms, and people suffering from hemorrhoids often do not realize that they have them. Hemorrhoids, commonly known as piles, are enlarged blood vessels that have swollen, found within the rectum and anus. Hemorrhoids aren’t generally painful until their blood supply slows down or is interfered with. If the issue gets more severe, symptoms could be apparent, like bleeding after stool passing and having an itchy bottom or lumpy structures protruding out of the anus that can be accompanied by being physically pulled back following the passage of the stool, discharge of mucus every time after passing stool, soreness, redness and a usual swelling of the anus.
What are the types of hemorrhoids?
- Internal hemorrhoid- These lie within the anal canal or rectum and are internal to the anal orifice.
- External hemorrhoid- They are situated on the surface of the anal opening and are covered by the skin.
- Prolapsed hemorrhoid- when an internal hemorrhoid bulges and comes out of the anus is known as prolapsed hemorrhoid. It is clinically classified into four grades. They are:
Grade 1- hemorrhoids remain within the anal canal and do not prolapse
The Grade 2- These prolapse during straining or pressure and return to normal position on their own.
Grade 3- hemorrhoid prolapsed and does not retract back on its own; one has to push it manually.
Grade 4- They remain prolapsed.
- Thrombosed hemorrhoid- whenever there is the formation of a blood clot within the hemorrhoidal tissue is referred to as a thrombosed hemorrhoid.
- Straining during bowel movements.
- Sitting for long periods on the toilet.
- Having chronic diarrhea or constipation.
- Being obese.
- Being pregnant.
- Having anal intercourse.
- Eating a low-fiber diet.
- Regular heavy lifting.
- Extreme itching around the anus.
- Irritation and pain around the anus.
- Itchy or painful swelling or lump around the anus.
- Fecal leakage.
- Painful bowel movements.
- Blood on the tissue after having a bowel movement.
How are hemorrhoids diagnosed?
A visual examination of the anus may be enough to diagnose hemorrhoids. To confirm the diagnosis, the doctor may do a different examination to check for abnormalities within the anus. They are:
- Digital rectal exam- During this procedure, the doctor will insert fingers into the anus to feel for swollen veins.
- Anoscope- During this procedure, an instrument is placed inside the anus to look for abnormalities in the anus and rectum.
- Proctoscopy- A lighted tube is inserted into the anus; this gives a view of the entire rectum.
The treatment option depends on the type and grade of hemorrhoid. The treatment plans include:
- Conservative management: The doctor will prescribe a few medications during the initial grade of hemorrhoids.
- Rubber band ligation: During this procedure, a small rubber band is placed around the base of hemorrhoid, which cuts off blood supply to the vein.
- Electrocoagulation: During this procedure, an electric current is used to stop blood flow to the it.
- Infrared coagulation: During this procedure, a small probe is inserted into the rectum and transmits heat to eliminate the condition.
- Sclerotherapy: A chemical is injected into the swollen vein to destroy hemorrhoid tissues during this procedure.
- Laser treatment: A laser beam is used to treat hemorrhoids during this procedure.
- Hemorrhoidectomy and hemorrhoidopexy: Large external or prolapsed internal hemorrhoids are treated surgically during this procedure.
- Stapler hemorrhoidectomy: During this procedure, a stapling instrument is used to remove internal hemorrhoids or pull a prolapsed internal hemorrhoid back inside the anus and hold it there.
Can hemorrhoids be prevented?
Hemorrhoids are most common in the older age group. The following steps can help prevent hard stools and constipation that can lead to the condition.
- Drink plenty of fluids and stay hydrated.
- Eat more fiber-rich food like green leafy vegetables, fruits, vegetables, etc. to prevent constipation
- Stay physically active and maintain a healthy lifestyle
- Take laxatives or use enemas to prevent passing hard stools.
- Avoid straining while passing stools.
- Exercise regularly to prevent becoming constipated.
- Try not to delay the urge for the stools.
- Avoid spicy food.
- Avoid long periods of sitting.
a) Gangrene or ulceration- it occurs secondary to thrombosis
c) Perianal sepsis
e) Strangulation- refers to the blockage of arteries feeding the hemorrhoidal tissue, which causes severe pain.
f) Blood clots
Risk factors of hemorrhoids are:
a) Obese people
b) Pregnant females
c) Eat a low-fiber diet
d) Regularly lift heavy objects
e) Have a family history of the condition
f) Age between 45-65 years old
g) Spending too much time on the toilet seat
h) Strain while having a bowel movement
i) Have chronic constipation or diarrhea.
Most of the people who are diagnosed with it and treated early have a good prognosis; they recover completely. Prolapsed hemorrhoids are generally time taking.