Hemorroids - Introduction
About half of the population in the U.S.A. will suffer from hemorrhoids at some point in life; for most, this will happen between ages 20 and 50. Although hemorrhoids occur in almost everyone, they become large and cause problems in only 4 percent of the general population.
Hemorrhoids are essentially varicose veins of the rectum. The hemorrhoidal veins are situated in the lowest area of the rectum and the anus. Sometimes they swell, so that the vein walls become stretched, slim, and irritated b passing bowel movements. When these veins bleed, itch, or hurt, they are known as hemorrhoids. Hemorrhoids can be divided in two categories: internal and external.
Picture of hemorrhoids
Veins in the rectum and anus are under considerable pressure whenever a stool is passed. Pushing or straining may cause veins in the rectal wall to lump, creating clusters of swollen, or dilated, veins called hemorrhoids. Internal hemorrhoids can form anywhere inside the anal canal, while external hemorrhoids are visible, or just below, the opening of the anus.
Internal hemorrhoids lie far inside the rectum. They do not usually hurt, because there are few pain sensing nerves in the rectum. Bleeding may be the only sign of their presence. Sometimes internal hemorrhoids prolapse, or enlarge and protrude outside the anal sphincter. If so, you may be able to see or feel them as moist, pink pads of skin that are pinker than the surrounding area. Prolapsed hemorrhoids may hurt, because the anus is dense with pain-sensing nerves.
External hemorrhoids are situated within the anus and are usually painful. If an external hemorrhoid prolapses to the outside you can see and feel it. Blood clots sometimes form within prolapsed external hemorrhoids, causing an extremely painful condition called a thrombosis. If an external hemorrhoid becomes thrombosed, it can look rather frightening, turning purple or blue, and possibly bleeding. Despite their appearance, thrombosed hemorrhoids are usually not serious and will resolve themselves in about a week.
Hemorrhoids - Info Site Topics
Symptoms of hemorrhoids
Symptoms of hemorrhoids depend on their location:
- Internal hemorrhoids can't be seen or felt. But straining or irritation from passing stool can harm a hemorrhoid's delicate surface and cause bleeding. You may notice small amounts of bright red blood on your toilet tissue or in the toilet bowl. Because internal anal membranes lack pain-sensitive nerve fibers, these hemorrhoids usually do not cause discomfort. However, you may experience a feeling of fullness in your rectum following a bowel movement. Occasionally, straining can push an internal hemorrhoid through the anal opening. If a hemorrhoid remains prolapsed, it can cause pain and irritation.
- The symptoms of external hemorrhoids are different than the symptoms of internal hemorrhoids. External hemorrhoids can be felt as bulges at the anus, but they usually cause few of the symptoms that are typical of internal hemorrhoids. External hemorrhoids tend to be painful. Sometimes blood may pool in an external hemorrhoid and form a clot (thrombus), causing severe pain, swelling and inflammation. When irritated, external hemorrhoids can itch or bleed.
Typical symptoms of hemorrhoids are:
- light red anal bleeding that may streak the bowel movement or the toilet paper.
- pain or tenderness during bowel movements.
- painful swelling or a lump at the anus.
- anal itching.
- mucous anal discharge.
Visit a doctor if:
-you notice occurrence of any anal bleeding for the first time, even if you believe you have hemorrhoids. Colon polyps , colitis , Crohn's disease , and colorectal cancer can also cause anal bleeding. An exact diagnosis is essential.
-you have been diagnosed with hemorrhoids, and you have anal bleeding that is chronic or more profuse than the streaking described above. Though rare, excessive hemorrhoidal bleeding can cause anemia.
Causes for hemorrhoids
Researchers are not certain what exactly causes hemorrhoids. "Weak" veins-leading to hemorrhoids and other varicose veins-may be inherited. It's likely that extreme abdominal pressure causes the veins to swell and become susceptible to irritation. Sources of this pressure include obesity, pregnancy, standing or sitting for long periods, liver disease, straining from constipation or diarrhea, coughing, sneezing, vomiting, and holding one's breath while straining to do physical labor.
Nutrition and Diet hava a pivotal role in causing-and preventing-hemorrhoids. People who consistently eat a high-fiber diet are Sunlikely to get hemorrhoids, whereas those who prefer a diet high in refined foods can expect them. A low-fiber diet or inadequate fluid intake causes constipation, which contributes to hemorrhoids in two ways: It encourages straining to have a bowel movement and it also aggravates the hemorrhoids by producing hard stools that further irritate the swollen veins.
Diagnostics of hemorrhoids
The doctor will first visually examine the anal region and by inserting a lubricated gloved finger or an anoscope or a proctoscope.
Other procedures may be needed to identify internal hemorrhoids or rule out other ailments that frequently cause anal bleeding, such as anal fissure, colitis, Crohn's disease, and colorectal cancer. To see further into the anal canal (into the lower colon, or sigmoid), sigmoidoscopy may be used, or the entire colon may be viewed with colonoscopy. For both procedures, a lighted, flexible viewing tube is inserted into the rectum. A barium x-ray can show the entire colon's interior. First a barium enema is given, then x-rays are taken of the lower gastrointestinal tract.
Treatment of Hemorrhoids
Hemorrhoids do not usually go away completely once you have them, unless you undergo one of the procedures below. They can get improved, however, so that living with them is tolerable. Both conventional and alternative practitioners consider diet the best way for treating hemorrhoids.
A diet rich in high-fiber foods and low in refined and junk foods is essential. Probably half of all hemorrhoid sufferers find relief with dietary changes alone. Most hemorrhoid treatments aim to minimize pain and itching. Warm (but not hot) sitz baths are the most time-honored and oft-suggested therapy: Sit in about three inches of warm water for 10 minutes, few times a day, especially after a bowel movement. If you are pregnant, discuss any treatment, including dietary changes, with your doctor before proceeding.
You can also use some of the over-the-counter medications for hemorroidal treatment.
Alternative treatments for hemorrhoids
You can try one or several of these therapies to alleviate hemorrhoid discomfort. If symptoms continue regardless of your efforts at relief, contact your doctor.
Acupuncture for hemorrhoids
Acupuncture can help in relieving hemorrhoid pain. There are few responsive points for acupunctural therapy for hemorrhoids. See a licensed practitioner for treatment.
Herbal therapies for hemorrhoids
Applied twice daily, pilewort (Ranunculus ficaria) ointment can reduce the pain of external hemorrhoids: Simmer 2 tbsp fresh or dried pilewort in 7 oz petroleum jelly for 10 minutes. Allow to cool before using; store leftover ointment in a closed container. Pilewort may also be taken as tee.
More than a dozen remedies, each taken at 12x can help hemorrhoid pain. Choosing the right one requires attention to your symptoms and, usually, a homeopath's help. For a sore, bruised, and perhaps bleeding anus, try Hamamelis. Aesculus can ease sharp, spiking rectal pain that is worsened with bowel movements, and Sulphur can reduce burning and itching aggravated by warmth.
This technique moves matter through the intestines, helping to prevent the constipation that contributes to hemorrhoids. Lie on your back, and use your fingers or your palm to make long, sweeping strokes. Repeat each stroke three to six times. Begin on your left side. Just below your ribs, rub toward your feet; then rub across your abdomen from the right to left just below your rib cage. Finally, point your fingertips toward your feet, and drag your hand up your right side from pelvis to ribs.
Yoga for hemorrhoids
Yoga can encourage blood flow away from hemorrhoids, reducing pain, inflammation, and bleeding. You can practice the known yoga positions ; Half Shoulder Stand, Shoulder Stand, Plow and Bridge. Hold each posture for a few minutes each day. A good complement for these postures is lying on a slant board with your head down for 15 minutes each day.
Conventional treatments for hemorrhoids
If you have hemorrhoids, a high-fiber diet combined with sitz baths and acetaminophen should reduce discomfort within two weeks. If symptoms persist, your doctor may recommend one of the following procedures. All except laser coagulation and surgery can be performed in your doctor's office.
An internal hemorrhoid can be injected with phenol in oil, quinine, and urea, or morrhuate sodium, which creates a scar and closes off the hemorrhoid. The injection hurts only a little, as any injection does. With a success rate of 90 percent, this is many physicians' first choice. Results are not permanent, however; repeat injections may be needed every two or three years.
Prolapsed hemorrhoids are often removed using rubber-band ligation. A special tool secures a tiny rubber band around the hemorrhoid, shutting off its blood supply almost instantly. Within a week, the hemorrhoid shrivels and falls off. This painless method is successful about 75 percent of the time.
Coagulation or cauterization
Using either an electric probe, a laser beam, or an infrared light, a tiny burn painlessly seals the end of the hemorrhoid, causing it to close off and shrink. This is most useful for prolapsed hemorrhoid.
For internal hemorrhoids or really uncomfortable external hemorrhoids (such as thrombosed hemorrhoids that are too painful to live with), your physician may elect traditional surgery, called hemorrhoidectomy. In the hospital, under general anesthesia, the hemorrhoid is removed. After the operation, expect a week or so of bed rest, with analgesics prescribed for discomfort.The success rate for hemorrhoid removal approaches 95 percent, but unless dietary and lifestyle changes are made, hemorrhoids may recur.
Over the counter relief for hemorrhoids
Are hemorrhoid medicines efficient? Controversy continues to rage about the effectiveness of hemorrhoid medicines. In the U.S. , annually are spent around $200 million on ointments, creams, and suppositories that promise to relieve inflammation and pain.
The basic ingredient in all these medicines is a lubricant such as lanolin, cocoa butter, vegetable oil, or one of many others. Some also include an anesthetic such as benzocaine or lidocaine, or an astringent such as tan-nic acid or zinc compounds, purported to reduce swelling by constricting capillaries.
Hemorrhoids, however, are not capillaries; they're veins, and astringents may have no effect on them. Anesthetics may provide short-term relief, but only in cream or ointment form: Suppositories usually go too far up into the anal canal to help the hemorrhoids below.
Nutrition and diet for hemorrhoids.
The doctors consider diet the best tool for treating hemorrhoids.
Practice high-fiber diet. Meals and snacks should consist primarily of vegetables, fruit, nuts, and whole grains, and as few refined foods and meats as possible. If this is a big change for you, introduce the new foods slowly, to avoid gas.
If you aren't able to eat enough high-fiber food, supplement your diet with psyllium stool softeners or bulk-forming agent. (Avoid laxatives, which cause diarrhea that can further irritate the swollen veins.) Drink at least nine glasses of water dayli; if your life is especially active or you live in a hot climate, you will need more water. It's almost impossible to drink too much water. Monitor your sodium intake. Excess salt in the diet causes fluid retention, which means swelling in all veins, including hemorrhoids.
At-Home remedies for hemorrhoids
- Do not sit for hours, but if you must, take breaks regularly: Once every hour, get up and move around for at least five minutes. A doughnut-shaped cushion can make sitting more comfortable and ease hemorrhoid pressure and pain.
- Place petroleum jelly just inside the anus to make bowel movements less painful.
- Apply witch hazel (Hamamelis virginiana), a soothing anti-inflammatory agent, on irritated hemorrhoids to reduce pain and itching.
- Do not scratch hemorrhoids, as it makes everything worse: The inflamed veins become more irritated, the skin around them becomes damaged, and the itching itself intensifies. Instead, to help stop the itching, apply an over-the-counter 0.5 percent hydro-cortisone cream to the skin (not inside the anus-on the outside only) and a cold pack.
- As a pain reliever, try acetaminophen. Avoid ibuprofen and aspirin, which foster bleeding.
- Bathe frequently to keep the anal area clean, but be gentle: Excessive scrubbing, especially with soap, can intensify burning and irritation.
- Do not sit on the toilet for more than five minutes at a time, and when wiping, be gentle. If toilet paper is irritating, try dampening it first, or use cotton balls or alcohol-free baby wipes.
- When performing any task that requires exertion, be sure to breathe evenly. It's common to hold your breath during exertion, and if you do, you're straining, and contributing to hemorrhoid pain and bleeding.
Prevention of hemorroids
A healthful diet and lifestyle are good insurance for preventing hemorrhoids, whether you already suffer hemorrhoid symptoms or are intent on never experiencing them.Regular exercise is also important, especially if you work a sedentary job. Exercise helps in several ways: keeping weight in check, making constipation less likely, and enhancing muscle tone.You can also practice the alternative choices mentioned before. Also read carefully the nutrition and diet instructions.