1. Constipation and hemorrhoids - what are they?

 

What is constipation?

 

Constipation is a common digestive disorder characterized by difficulty or inability to have regular bowel movements. This condition can be acute or chronic. Acute constipation is a temporary condition, often caused by dietary changes or stress. Chronic constipation, on the other hand, can last for months or even years and requires medical intervention.

 

Constipation can be characterized by several signs:

  • Infrequent bowel movements (less than three times a week);
  • Difficult or painful bowel movements;
  • A feeling of incomplete emptying of the bowels;
  • Hard or small stools.

 

The causes of constipation can be varied, including insufficient fiber intake, lack of fluids, lack of physical activity, stress, changes in routine or lifestyle, and use of certain medications.

Constipation can also be a symptom of other conditions, such as irritable bowel syndrome (IBS), hypothyroidism, or neurological disorders. Therefore, it is important to consult a doctor if symptoms of constipation persist or worsen.

 

What are hemorrhoids?

 

Hemorrhoids are swollen and inflamed veins in the area of ​​the rectum and anus that can be painful and uncomfortable. They are divided into two main types: internal and external hemorrhoids.

Internal hemorrhoids are located inside the rectum and are usually not visible or palpable. They usually do not cause pain, but can lead to bleeding during bowel movements.

External hemorrhoids are located under the skin around the anus and can be visible and palpable. They often cause pain, itching and bleeding. In some cases, blood clots can form in these hemorrhoids, making them even more painful.

Hemorrhoids can be the result of a variety of factors, including chronic constipation.

 

Symptoms of hemorrhoids include:

  • Bleeding during bowel movements;
  • Itching and irritation in the anus;
  • Pain and discomfort;
  • Swollen areas around the anus;
  • Protruding hemorrhoids that may feel like lumps around the anus.

 

It is important to note that these symptoms can also be caused by other diseases, so a medical examination is necessary for an accurate diagnosis and appropriate treatment.

 

2. Causes of constipation and hemorrhoids

 

Constipation

 

Constipation can be caused by a number of factors, usually related to lifestyle, eating habits or medical conditions. Let's look at them in more detail:

 

Nutritional factors

The most common cause of constipation is insufficient fiber intake. Fiber plays a key role in maintaining normal intestinal peristalsis. They add bulk to the stool, making it easier for it to move through the intestines.

 

Nutritional factors

 

Dehydration

Insufficient fluid intake can also lead to constipation. Water is needed to soften stools and facilitate their passage through the intestines. When the body is dehydrated, the intestines absorb more water from the stools, making them hard and difficult to pass.

 

Lack of physical activity

Physical activity stimulates intestinal peristalsis. Lack of exercise can slow down the digestive system and lead to constipation.

 

Delaying bowel movements

Delaying bowel movements can lead to constipation. When a person ignores the need to visit the toilet, it can lead to hardening of the stool and difficulty in expelling it. This often happens to people with stressful or busy work schedules.

 

Medical conditions and medications

Certain medical conditions, such as irritable bowel syndrome (IBS), diabetes, hypothyroidism, and neurological disorders, can cause constipation. Certain medications, including pain relievers, antidepressants, and antacids, can also have constipation as a side effect.

 

Hemorrhoids

 

Hemorrhoids are the result of increased pressure in the veins of the anus and rectum, which leads to their swelling and inflammation. Here are some of the main reasons for their occurrence:

 

Chronic constipation and straining during bowel movements

Constipation and straining during bowel movements are major factors in the development of hemorrhoids. The pressure placed on the veins in the lower part of the rectum can enlarge and inflame them, leading to hemorrhoids.

 

Diarrhea

Frequent diarrhea can also cause hemorrhoids. Prolonged diarrhea irritates the veins in the anus and rectum, which can lead to their inflammation.

 

Pregnancy

During pregnancy, increased pressure in the abdominal area due to the growing fetus can cause hemorrhoids. Hormonal changes during pregnancy can also play a role in the development of hemorrhoids.

 

Overweight and obesity

Being overweight increases the pressure on the veins in the anus and rectum. This is especially true for people with central obesity, where fat accumulates around the abdomen.

 

Prolonged sitting or standing

Prolonged sitting or standing can put pressure on the veins in the anus and rectum. This is a common problem for people with office jobs or occupations that require long periods of standing.

 

Old age

As we age, the tissues supporting the veins in the rectum and anus can weaken and stretch, increasing the risk of hemorrhoids.

 

3. Symptoms

 

Constipation symptoms

 

Constipation presents with a variety of symptoms that can range from mild to severe. Here are some of the main symptoms you may notice with constipation:

 

Constipation symptoms

 

Infrequent bowel movements

One of the main symptoms of constipation is a decrease in the frequency of bowel movements. It is usually considered constipated if you have fewer than three bowel movements per week. In some cases, people may only have bowel movements once or twice a month.

 

Difficulty with bowel movements

Constipation is often associated with straining and straining to have a bowel movement. Stools can be hard and dry, making it difficult to pass them.

 

A feeling of heaviness

Many people with constipation feel that they cannot empty their bowels completely. This feeling of incomplete bowel emptying can be accompanied by discomfort and irritation in the abdominal area.

 

Abdominal pain and bloating

Constipation often leads to abdominal pain and bloating. These symptoms are the result of stool and gas retention in the intestines. The swelling can cause additional discomfort and a feeling of heaviness in the abdomen.

 

Anorexia and fatigue

Constipation can affect appetite and lead to anorexia. Some people lose interest in food, which can lead to weight loss. Chronic constipation can cause fatigue and general malaise.

 

Symptoms of hemorrhoids

 

Hemorrhoids present with a variety of symptoms that can vary in severity and intensity. Here are some of the most common symptoms of hemorrhoids:

 

Bleeding during bowel movements

One of the most common symptoms of hemorrhoids is bleeding during bowel movements. Bleeding is usually bright red and can be seen on the toilet paper or in the toilet bowl. This symptom can be alarming, but in most cases it is not serious.

 

Itching and irritation

Hemorrhoids often cause itching and irritation in the anus area. This itching can be very uncomfortable and lead to further irritation and inflammation if scratched.

 

Pain and discomfort

External hemorrhoids can be painful, especially if blood clots form in them. The pain can range from mild to severe and may worsen when sitting or having a bowel movement. Internal hemorrhoids are usually not painful unless they prolapse (go outside the anus).

 

Swollen areas around the anus

External hemorrhoids can appear as swollen lumps around the anus. These bumps can be painful to the touch and cause discomfort when sitting or walking.

 

Prominent hemorrhoids

Internal hemorrhoids can prolapse and protrude outside the anus, especially with straining during bowel movements. This condition can be painful and require the hemorrhoids to be returned back into the rectum.

 

4. Diagnosis

 

Constipation

 

Diagnosing constipation begins with a detailed medical history and physical examination. The doctor will ask questions about the symptoms, their duration and frequency, as well as the patient's eating habits and lifestyle.

 

Here are some of the main methods for diagnosing constipation:

 

1. Medical history and physical examination

The initial diagnosis involves discussing the patient's medical history, including the presence of chronic diseases, medication use, and family history of digestive problems. A physical examination may include palpation of the abdomen to look for signs of swelling or firmness.

 

2. Laboratory studies

Blood tests can help identify metabolic and hormonal disorders that may be causing constipation. Tests may include tests for glucose, calcium, and thyroid hormone levels.

 

3. X-ray

Abdominal X-rays may show stool accumulation in the bowel. Contrast radiography (barium enema) may be used to visualize the colon and rectum.

 

4. Colonoscopy and sigmoidoscopy

These endoscopic examinations allow direct visualization of the inside of the colon and rectum. They can detect obstructions, polyps, inflammatory bowel disease or cancer. A sigmoidoscopy examines only the lower part of the colon, while a colonoscopy examines the entire colon.

 

Hemorrhoids

 

Diagnosing hemorrhoids also begins with a medical history and physical exam. The doctor will ask questions about symptoms, such as bleeding, pain and itching, as well as about the patient's eating habits and lifestyle.

 

The main methods for diagnosing hemorrhoids include:

 

1. Visual inspection

External hemorrhoids are usually visible on examination of the anus. The doctor may identify swelling or inflamed veins around the anus.

 

2. Digital rectal examination

During a digital rectal exam, the doctor will insert a finger covered with a glove and lubricant into the patient's rectum. This helps to assess muscle tone and detect internal hemorrhoids or other abnormal formations.

 

3. Anoscopy

Anoscopy is a minimally invasive examination in which a special instrument (anoscope) is used to visualize the inside of the anus and the lower part of the rectum. This method allows direct examination of internal hemorrhoids.

 

4. Proctoscopy and sigmoidoscopy

Proctoscopy and sigmoidoscopy are endoscopic procedures that allow visualization of more of the rectum and colon. They are used to detect internal hemorrhoids, polyps, or other abnormalities.

 

5. Colonoscopy

If the patient has bleeding or other symptoms that require a more detailed examination, the doctor may recommend a colonoscopy. This procedure allows the entire colon to be examined and can help rule out more serious diseases such as colon cancer.

 

5. Treatment

 

Treatment of constipation

 

Treatment for constipation may include lifestyle changes, dietary adjustments, medications, and, in rare cases, medical procedures. Let's take a closer look at each of these options:

 

1. Lifestyle changes

One of the most effective ways to manage constipation is through lifestyle changes:

  • Increase physical activity: Regular exercise can stimulate the peristalsis of the bowels and help make bowel movements easier. Even daily walks can have a significant positive effect;
  • Establish a bowel routine: Try to have a bowel movement at the same time every day, preferably after meals when peristalsis is more active.

 

2. Changes in nutrition

Proper nutrition plays a key role in managing constipation:

  • Increase fiber intake: Eating more fruits, vegetables, whole grains, and legumes can significantly improve peristalsis. Aim for around 25-30 grams of fiber per day;
  • Drinking enough water: Staying well hydrated is essential to soften stools and make them easier to pass.

 

3. Medicines

In some cases, medications may be needed to treat constipation:

  • Laxatives: There are different types of laxatives, including bulking, osmotic, and stimulant laxatives. They are used in severe cases of constipation or when changes in diet and lifestyle are not enough;
  • Smectites and emollients: These medications can help soften stools and make them easier to pass.

 

4. Medical procedures

For chronic or complicated constipation, medical procedures may be necessary:

  • Biofeedback: This therapy helps patients learn how to control the pelvic floor muscles and improve bowel movements;
  • Surgery: In rare cases where constipation is the result of an anatomic problem or obstruction, surgical intervention may be necessary.

 

Treatment of hemorrhoids

 

Treatment for hemorrhoids varies depending on the severity of the symptoms and may include home care, medications, and medical procedures.

 

1. Domestic care

Many cases of hemorrhoids can be managed effectively at home:

  • Warm baths: Sitting in a warm bath for 10-15 minutes several times a day can help reduce pain and inflammation;
  • Good hygiene: Maintaining good hygiene in the anal area and avoiding the use of harsh or scented products can reduce irritation.

 

2. Medicines

Various medications can be used to relieve the symptoms of hemorrhoids:

  • Creams and ointments: Products containing hydrocortisone or other anti-inflammatory ingredients can reduce itching and pain;
  • Pain relievers: Medicines such as acetaminophen or ibuprofen can help relieve pain and inflammation.

 

3. Medical procedures

In more severe cases of hemorrhoids, the doctor may recommend medical procedures:

  • Sclerotherapy: Injection of a solution into the hemorrhoid that causes the veins to shrink and relieve symptoms;
  • Rubber band ligation: Small rubber bands are placed around the base of the hemorrhoid, which cuts off its blood supply and causes it to dry out and fall off;
  • Infrared Coagulation: Uses infrared light to coagulate the veins in the hemorrhoid;
  • Hemorrhoidectomy: Surgical removal of hemorrhoids, usually used in severe or persistent cases.

 

6. When to seek medical help?

 

Constipation and hemorrhoids are common conditions that can be treated successfully with home care and lifestyle changes. However, in some cases it is necessary to seek medical help to avoid complications or to receive more effective treatment.

 

When to seek medical attention for constipation?

 

Duration of symptoms

If constipation persists for more than three weeks despite diet and lifestyle changes, it's time to see a doctor. Chronic constipation can be a sign of more serious health problems that require medical intervention.

 

Strong pain

Severe abdominal pain that does not relieve after a bowel movement or is not explained by other factors requires immediate medical evaluation. This could be a sign of bowel obstruction or other serious conditions.

 

Bleeding

If you notice blood in your stool or rectal bleeding, you should seek medical attention immediately. Bleeding can be a symptom of an anal fissure, hemorrhoids, or more serious conditions such as colon cancer.

 

Unexplained weight loss

If you experience unexplained weight loss accompanied by constipation, it could be a sign of serious health problems, such as colon cancer. You should consult a doctor immediately.

 

When to seek medical attention for hemorrhoids?

 

Heavy or prolonged bleeding

Bleeding from the anus is a common symptom of hemorrhoids, but if the bleeding is heavy or lasts more than a few days, it's important to seek medical attention. This could be a sign of more serious conditions, such as colorectal cancer or anemia.

 

Strong pain

External hemorrhoids can be painful, especially if blood clots form. If the pain is severe and is not relieved by home remedies, it is time to consult a doctor. Clot removal or other medical intervention may be required.

 

Prolapse of hemorrhoids

If internal hemorrhoids prolapse and cannot return to the rectum, this may require medical intervention. Prolapsed hemorrhoids can cause significant discomfort and increase the risk of infection.

 

Lack of improvement after home treatment

If your hemorrhoid symptoms don't improve after two weeks of home treatment, it's time to seek medical attention. The doctor may recommend stronger medications or procedures such as sclerotherapy or rubber band ligation.

 

What specialists to turn to?

 

If you need medical help for constipation or hemorrhoids, you can consult various specialists:

  • Gastroenterologist: A specialist in the digestive system who can perform tests such as a colonoscopy and recommend appropriate treatment;
  • Proctologist: A specialist in rectal and anal diseases who can perform specific procedures to treat hemorrhoids;
  • General Practitioner: Can assess your symptoms and refer you to the appropriate specialist or suggest initial treatment.

 

7. Conclusion

 

Constipation and hemorrhoids are conditions that can be successfully managed and treated. With the right information, prevention and treatment, it is possible to minimize the impact of these problems on daily life. Do not ignore symptoms and seek medical attention as needed to maintain good health and quality of life.

 

SOURCES:

1. Mayo Clinic: Constipation symptoms and causes (26.05.2024)
2. NIDDK: Constipation (26.05.2024)
3. NIDDK: Hemorrhoids(26.05.2024)