Hemorrhoid: Causes, Symptoms, and Treatments

Hemorrhoid: Causes, Symptoms, and Treatments

What is?

Hemorrhoids are nodules or masses of tissue in the anus that contain dilated blood vessels. Any increase in abdominal pressure can produce hemorrhoids, which can occur as a result of the following situations:

• A repeated effort to evacuate, especially in people who suffer from frequent constipation
• Pregnancy
• Repeated episodes of diarrhea
• Obesity

However, many patients do not have an apparent explanation for the formation of hemorrhoids.
Internal hemorrhoids. Internal hemorrhoids are found in the anal canal where they cause intermittent bleeding, usually with bowel movements and sometimes mucous discharge. Internal hemorrhoids are usually painless but can cause protrusion (prolapsed) out of the anus, which may look like bunches of grapes. Generally, the prolapsed hemorrhoid may be introduced back into the anus with the tip of the finger.

External hemorrhoids. They lie immediately outside the anal orifice and cause symptoms mainly edema or uncomfortable protrusions and sometimes discomfort. Edema and discomfort may occur only intermittently. External hemorrhoids can cause difficulties in keeping the anal area clean after evacuation. External hemorrhoids sometimes develop a blood clot inside them ("thrombosis"), often after a period of diarrhea or constipation. In this case, a sudden volume increase occurs. Hemorrhoid has a firm, painful consistency around the edge of the anus.

Many patients have both internal and external hemorrhoids.

Hemorrhoids are a very common health problem. They are more likely to develop in individuals who eat insufficient dietary fiber and who do not exercise enough, which can lead to repeated episodes of constipation and effort to evacuate.

Symptoms

Symptoms of hemorrhoids include:

Live red blood on toilet paper after a bowel movement, especially if the stool is too hard or too bulky. The blood can still appear on the surface of the stool or color the water inside the toilet.
In prolapsed hemorrhoids, a soft, grape-like mass protrudes from the anus and may produce mucus.
In external hemorrhoids, uncomfortable projections may arise and difficulty keeping the anal area clean after the bowel movement.
External hemorrhoids can cause mild edema, irritation, and discomfort intermittently, especially after a period of diarrhea or constipation.
In the thrombosis of external hemorrhoid, a painful projection or a firm mass appears at the edge of the anus. This mass may have a bluish or purple coloration and may bleed.

Severe pain is not a typical symptom of hemorrhoids (except thrombosis of external hemorrhoid).
Diagnosis

As with most anal or rectal problems, doctors diagnose hemorrhoids by inspecting the anal area, palpating the inside of the anus with the finger and looking inside the anal canal with an anoscope. If there is rectal hemorrhage, it is important that the doctor assesses other more dangerous causes of bleeding, for example, colorectal cancer. This evaluation is usually performed through a flexible endoscope ("proctosigmoidoscopy" or "colonoscopy").

Duration

Exacerbations of hemorrhoids (edema, irritation and mild discomfort) are usually short-lived and most of the symptoms disappear after a few days.

In pregnant women, the symptoms of hemorrhoids often improve or disappear after delivery.

Intermittent mild hemorrhages of hemorrhoids may last for months or years.

The painful edema associated with thrombosis of external hemorrhoid usually goes away after a few weeks.

Prevention

Hemorrhoids can be prevented by preventing constipation. Some of the following diet and lifestyle changes can help decrease stool consistency, establish a regular bowel movement, and avoid the strain that can lead to hemorrhoids:

Add more fiber to the diet. Set a target of 25 to 30 g of fiber per day from fiber-rich foods such as legumes, broccoli, carrots, bran, whole grains, and fresh fruit. As an alternative, many people find it more convenient to take a powdered fiber supplement, such as psyllium or methylcellulose. To avoid abdominal distension and flatulence, the fibers should be gradually added to the diet for several days.
Sufficient amounts of liquids should be ingested. In most healthy adults, this amount should be equivalent to 6 or 8 glasses of water per day.
Start a regular exercise program. Up to 20 minutes of brisk walking a day can stimulate the bowel to function regularly.

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