What are hemorrhoids?

Hemorrhoids are a common medical problem that affects a large portion of the population. Although they are not a serious health threat, they can be very unpleasant and painful. In this article, we will look in detail at what hemorrhoids are, what are their causes, symptoms and ways of treatment and prevention.

 

What are hemorrhoids?

 

Hemorrhoids are enlarged veins in the lower part of the rectum and anus. They form when the walls of these veins widen and thin, causing swelling and inflammation.

 

Hemorrhoids can be classified into two main categories: internal and external.

 

Internal hemorrhoids

Internal hemorrhoids are located inside the rectum and are usually not visible. They often do not cause pain because there are not many pain-sensitive nerve endings in the rectum. However, they may bleed, especially during bowel movements. Sometimes internal hemorrhoids can move outside the anus (prolapse), which can cause pain and discomfort.

 

External hemorrhoids

External hemorrhoids are located under the skin around the anus. They can be painful, especially when sitting or having a bowel movement. External hemorrhoids can itch and feel like hard lumps. Sometimes a blood clot can form in external hemorrhoids, leading to a condition known as a thrombosed hemorrhoid, which can be extremely painful and require medical intervention.

 

Anatomy and function of hemorrhoids

 

Hemorrhoids are a normal part of every person's anatomy and play an important role in bowel control. They are vascular structures located in the anal canal that act as cushions and help close the anus. Under normal conditions, hemorrhoids help hold stool and gas until a person decides to release them.

Hemorrhoids are the result of a person's adaptation to walking upright. As the pressure on the veins in the lower body, especially in the rectum and anus increases, so does the likelihood of developing hemorrhoids.

 

Social and cultural aspect

 

Although hemorrhoids are a common problem, they are often a subject of shame and embarrassment. This can lead to delays in seeking medical help and more severe symptoms. In different cultures, there are different approaches to the treatment and prevention of hemorrhoids, ranging from traditional herbal methods to modern medical interventions.

 

Causes of hemorrhoids

 

Hemorrhoids develop as a result of increased pressure in the rectal veins. This pressure can be caused by various factors:

 

Constipation and straining during bowel movements

One of the main causes of hemorrhoids is chronic constipation. When people have difficulty having a bowel movement, they often strain hard to relieve themselves. This tension increases the pressure on the veins in the rectum and anus, which can cause the veins to dilate and become inflamed, forming hemorrhoids.

 

Diarrhea

Frequent diarrhea can also contribute to the development of hemorrhoids. Constant irritation and straining with frequent bowel movements can damage the rectal veins.

 

Pregnancy

The growing uterus puts pressure on the veins in the pelvis and lower rectum. Hormonal changes during pregnancy also lead to dilated veins. The combination of these factors often leads to the development of hemorrhoids in pregnant women.

 

 

Sedentary way of life

Prolonged sitting, especially on hard surfaces, increases the pressure on the rectal veins. People who spend long hours at work in a sitting position are particularly at risk.

 

Obesity

Obesity is a risk factor for many health problems, including hemorrhoids. Excess weight increases the pressure on the abdominal area and rectal veins.

 

Genetic predisposition

Some people have a genetic predisposition to developing hemorrhoids. If there is a family history of hemorrhoids, you are more likely to develop this condition as well. Genetic factors can affect the strength and elasticity of veins, increasing the risk of them expanding and becoming inflamed.

 

Weight lifting

Lifting heavy objects can also increase pressure in the abdominal area and rectal veins. People who frequently lift weights, whether for work or sports, are at a higher risk of developing hemorrhoids.

 

Lack of physical activity

Lack of physical activity can lead to stagnation of blood circulation in the lower body.

 

Symptoms

 

Hemorrhoids can cause a variety of symptoms that vary depending on their location and severity. Recognizing these symptoms is important for early diagnosis and treatment.

 

Bleeding

One of the most common symptoms of hemorrhoids is rectal bleeding. People often notice bright red blood on the toilet paper or in the toilet bowl after a bowel movement. Bleeding is especially common with internal hemorrhoids and is usually not associated with pain.

 

Pain and discomfort

External hemorrhoids can cause significant pain and discomfort, especially when sitting or during bowel movements. The pain is the result of inflammation and swelling of the veins. In the case of thrombosed external hemorrhoids, the pain can be sharp and intense, requiring immediate medical intervention.

 

 

Itching and irritation

Itching and irritation around the anus are common symptoms of hemorrhoids. These symptoms are due to inflammation of the skin and rectal tissues. Itching can be particularly bothersome and lead to further irritation and inflammation if scratched too hard.

 

Swelling

Swelling around the anus is another common symptom of external hemorrhoids. This swelling feels like hard lumps and can be very painful, especially with pressure. Swelling is the result of blood pooling in the veins, causing them to dilate.

 

Prolapse

Prolapsed hemorrhoids occur when the internal hemorrhoids are displaced outside the anus. This can cause significant discomfort and pain. At first, prolapse may occur only during bowel movements, and then the hemorrhoids may return to the anus on their own. Over time, however, hemorrhoids can become permanently displaced and require manual retraction or medical intervention.

 

Mucous discharge

Hemorrhoids can cause a small amount of mucous discharge from the anus. This discharge can cause additional irritation and itching of the skin around the anus. Mucous discharge is more common with internal hemorrhoids.

 

Diagnosis

 

Diagnosing hemorrhoids involves a combination of physical examination, medical history, and specialized medical procedures.

 

1. Anamnesis

The first step in the diagnosis of hemorrhoids is a detailed history. The doctor will ask the patient about the symptoms they are experiencing, including bleeding, pain, itching and swelling. Factors such as diet, lifestyle and medical history will also be discussed.

 

2. Physical examination

The doctor will perform a visual examination of the anus and rectal area to check for external hemorrhoids, swelling, or other visible abnormalities. Internal hemorrhoids that are not visible may require additional diagnostic techniques.

 

3. Digital rectal examination

This procedure allows the doctor to feel the internal hemorrhoids and assess their size and condition. A T scan helps rule out other abnormalities such as tumors or polyps.

 

4. Anoscopy

Anoscopy is a specialized diagnostic procedure that allows the doctor to look inside the anus and the lower part of the rectum. It is performed using an instrument called an anoscope, which is a thin, rigid tube with a light.

 

5. Sigmoidoscopy and colonoscopy

In some cases, a more extensive diagnosis by sigmoidoscopy or colonoscopy may be necessary. These procedures involve the use of flexible tubes with a camera that allow the doctor to view larger parts of the colon and rectum. They are particularly useful if the patient has symptoms such as unexplained bleeding or a change in the rhythm of bowel movements, which may occur as a result of other diseases such as colorectal cancer or inflammatory bowel disease.

 

6. Laboratory studies

Laboratory tests are rarely needed to diagnose hemorrhoids, but they can be helpful in some cases. Blood tests can help rule out anemia caused by chronic bleeding. Stool analysis can be used to detect hidden blood that is not visible to the naked eye.

 

Treatment

 

Treatment for hemorrhoids depends on the severity of the condition and can range from home remedies to surgical interventions.

 

A change in lifestyle

Lifestyle changes play a key role in the treatment and prevention of hemorrhoids. Key measures include increasing fiber and water intake. Foods rich in fiber such as fruits, vegetables and whole grains support regular bowel movements and reduce the risk of constipation. Drinking enough water is also important to maintain soft stools.

 

 

Medications

Medical treatment of hemorrhoids includes various creams, ointments, suppositories and oral medications. These products relieve symptoms such as pain, itching and inflammation. Some of them contain active ingredients such as hydrocortisone or lidocaine, which reduce inflammation and numb the affected area.

 

Minimally invasive procedures

In more severe cases or when conservative treatment fails, minimally invasive procedures can be used. They include:

• Rubber band ligation: This is the most commonly used method for treating internal hemorrhoids. A small rubber band is placed around the base of the hemorrhoid, cutting off its blood supply. The hemorrhoid dries up and falls off after a few days;
• Sclerotherapy: In this method, a chemical solution is injected into the hemorrhoid, which causes the vein to shrink and contract. This procedure is effective for treating small and medium-sized hemorrhoids;
• Infrared coagulation: This technique uses infrared light to coagulate small blood vessels in the hemorrhoid, causing it to shrink in size.

 

Surgical intervention

In cases of severe hemorrhoids that do not respond to other methods of treatment, surgical intervention may be necessary. The main surgical methods include:

• Hemorrhoidectomy: This procedure involves surgical removal of the hemorrhoids. It is the most effective option for permanent removal of severe or recurrent hemorrhoids. Hemorrhoidectomy can be painful and require a longer recovery period;
• Stapler hemorrhoidopexy: This is a less invasive procedure in which a surgical instrument is used to remove part of the hemorrhoid and move the rest into the anus. This method is usually less painful and results in a faster recovery.

 

Folk and alternative methods

Some people prefer to use folk and alternative methods to relieve the symptoms of hemorrhoids. This includes the use of herbal extracts, essential oils and compresses. It is important to consult a doctor before starting any alternative treatment to avoid side effects and complications.

 

Prevention of hemorrhoids

 

The main methods of prevention include lifestyle changes, dietary habits and hygiene practices.

 

Here's how to prevent hemorrhoids.

 

A healthy diet

Diet plays an important role in the prevention of hemorrhoids. Eating foods rich in fiber, such as fruits, vegetables, whole grains, and legumes, helps maintain soft stools and make bowel movements easier. This reduces the tension on the rectal veins and prevents constipation, which is a major factor in the development of hemorrhoids.

 

Regular physical movement

Regular physical activity improves circulation and helps maintain a healthy weight, which in turn reduces pressure on the rectal veins. Exercise such as walking, swimming and yoga can be helpful. Avoiding prolonged sitting and taking short breaks to move around during the work day can also help prevent hemorrhoids.

 

 

Avoiding straining during bowel movements

Straining during bowel movements is a major risk factor for hemorrhoids. To avoid this, it is important not to hold the stool and to go to the toilet as soon as the need is felt. Using soft toilet paper and gently cleaning the anal area can also reduce irritation and inflammation.

 

Proper hygiene

Maintaining good anal hygiene is essential to prevent hemorrhoids. Regular cleaning with a soft, damp cloth or using baby wipes can help prevent irritation.

 

Stress management

Stress can negatively affect the digestive system and contribute to bowel problems, including constipation and diarrhea. Stress management practices such as meditation, deep breathing, and yoga can help maintain digestive health and prevent hemorrhoids.

 

Avoiding heavy lifting

Lifting heavy objects can increase pressure in the abdominal and rectal areas, which contributes to the development of hemorrhoids. When lifting heavy objects, it is important to use proper techniques, such as bending the knees and keeping the back straight.

 

Paying attention to symptoms

Early recognition and treatment of hemorrhoid symptoms can prevent them from getting worse. If symptoms such as bleeding, pain or swelling occur, it is important to seek medical attention.

 

When to consult a doctor

 

Consultation with a doctor when hemorrhoids are suspected is essential for proper diagnosis and treatment.

 

Although many cases of hemorrhoids can be treated with home remedies and lifestyle changes, there are situations where it is necessary to seek medical attention.

 

Heavy bleeding

One of the main signals that it is time to consult a doctor is the presence of heavy or prolonged rectal bleeding. While light bleeding can be a symptom of hemorrhoids, heavy bleeding can be the result of a more serious condition, such as an anal fissure or even colorectal cancer.

 

Strong pain

Severe pain in the anal area, accompanied by swelling and hard lumps, may be a sign of thrombosed external hemorrhoids. This condition requires prompt medical intervention to prevent complications and relieve symptoms.

 

Changes in bowel movements

Unexplained changes in bowel movements, such as alternating between constipation and diarrhea, thin stools, or a feeling that the bowels are not emptying completely, can be a sign of serious problems in the digestive system. These symptoms require careful investigation to rule out conditions such as diverticulosis, inflammatory bowel disease, or colorectal cancer.

 

Symptoms that do not improve with home treatment

If hemorrhoid symptoms don't improve after two weeks of home treatment with dietary changes, increased fluid intake, and use of over-the-counter medications, it's time to see a doctor.

 

Presence of other health problems

Patients with chronic diseases such as diabetes, heart disease, or immunocompromised conditions should be especially careful with hemorrhoid symptoms. These conditions can complicate treatment and recovery, so it's important to consult with a doctor for personalized care.

 

Rectal masses or lumps

If you notice the presence of masses or lumps in the anal area that do not disappear or grow, you should immediately seek medical attention. This may be a sign of serious diseases such as abscess or cancer, which require timely diagnosis and treatment.

 

Complications after procedures

After performing minimally invasive procedures or surgery to treat hemorrhoids, the occurrence of complications such as infection, heavy bleeding or unbearable pain should be discussed with a doctor. Timely intervention can prevent more serious health problems.

 

Conclusion

 

Hemorrhoids are a common condition that can cause significant discomfort and inconvenience. They develop as a result of increased pressure on the rectal veins and can be caused by factors such as constipation, pregnancy, prolonged sitting and obesity.

Symptoms range from bleeding and pain to itching and swelling, necessitating accurate diagnosis through physical examinations and specialized procedures. Treatment can include lifestyle changes, medication, minimally invasive procedures and surgery, while prevention plays a key role through a healthy diet, regular physical activity and proper hygiene.

It is important to consult a doctor for heavy bleeding, severe pain, or if symptoms do not improve with home treatment, to ensure adequate care and to rule out other serious diseases.

 

SOURCES:

1. WebMD: Hemorrhoids: Symptoms, causes and treatment (26 Май 2024)
2. Harvard Health: Hemorrhoids and what to do about them (26 Май 2024)
3. MedicineNet: Benjamin Wedro, M. Hemorrhoids (Piles) (26 Май 2024)