Hemorrhoids – Symptoms and Treatment
Hemorrhoids, also called Piles may be another possible cause of blood in stools. The term hemorrhoid refers to a condition in which the veins around the anus or lower rectum are swollen and inflamed. Hemorrhoids may result from straining to move stools.
Other contributing factors include pregnancy, aging, chronic constipation or diarrhea, and anal intercourse.
Hemorrhoids are either inside the anus (internal) or under the skin around the anus (external).
These hemorrhoids protrude near the anus and are covered by a layer of very tender skin. Painful swelling is a result of a blood clot developing in the hemorrhoids. These feel like a hard, sensitive lump and will bleed if ruptured. External hemorrhoids are the more prevalent of the two types and are associated with the symptoms we most experience.
Internal hemorrhoids form within the anus and rectum area. Protrusion and painless bleeding during bowel movements are the most common symptoms. Internal hemorrhoids don’t normally hurt or itch.
Many anorectal problems, including fissures, fistulas, abscesses, or irritation and itching (pruritus ani), have similar symptoms and are incorrectly referred to as hemorrhoids. Hemorrhoids usually are not dangerous or life threatening. In most cases, hemorrhoidal symptoms will go away within a few days.
Although many people have hemorrhoids, not all experience symptoms. The most common symptom of internal hemorrhoids is bright red blood covering the stool, on toilet paper, or in the toilet bowl.
Symptoms of external hemorrhoids may include painful swelling or a hard lump around the anus that results when a blood clot forms.
In addition, excessive straining, rubbing, or cleaning around the anus may cause irritation with bleeding and itching, which may produce a vicious cycle of symptoms. Draining mucus may also cause itching.
Hemorrhoids are very common. For most women, hemorrhoids caused by pregnancy are a temporary problem.
Hemorrhoids are diagnosed by a thorough evaluation of the patient.
The doctor will examine the anus and rectum to look for swollen blood vessels that indicate hemorrhoids and will also perform a digital rectal exam with a gloved, lubricated finger to feel for abnormalities.
Closer evaluation of the rectum for hemorrhoids requires an exam with an anoscope, a hollow, lighted tube useful for viewing internal hemorrhoids, or a proctoscope, useful for more completely examining the entire rectum.
To rule out other causes of gastrointestinal bleeding, the doctor may examine the rectum and lower colon (sigmoid) with sigmoidoscopy or the entire colon with colonoscopy. Sigmoidoscopy and colonoscopy are diagnostic procedures that also involve the use of lighted, flexible tubes inserted through the rectum.
Treatment of hemorrhoids is aimed initially at relieving symptoms. Measures to reduce symptoms include warm tub baths several times a day in plain, warm water for about 10 minutes. Application of a hemorrhoidal cream or suppository to the affected area may also be required.
Preventing of the recurrence of hemorrhoids will require relieving the pressure and straining of constipation. It is recommended to increase fiber and fluids in the diet. Eating the right amount of fiber and drinking six to eight glasses of fluid (not alcohol) result in softer, bulkier stools. A softer stool makes emptying the bowels easier and lessens the pressure on hemorrhoids caused by straining. Eliminating straining also helps prevent the hemorrhoids from protruding.
Good sources of fiber are fruits, vegetables, and whole grains. In addition, a bulk stool softener or a fiber supplement such as psyllium (Metamucil) or methylcellulose (Citrucel) may be taken.
In some cases, hemorrhoids have to be treated endoscopically or surgically. These methods are used to shrink and destroy the hemorrhoidal tissue. The doctor will perform the procedure during an office or hospital visit.
Techniques used to remove or reduce the size of internal hemorrhoids include:
- Rubber band ligation– A rubber band is placed around the base of the hemorrhoid inside the rectum. The band cuts off circulation, and the hemorrhoid withers away within a few days.
- Sclerotherapy– A chemical solution is injected around the blood vessel to shrink the hemorrhoid.
- Infrared coagulation– A special device is used to burn hemorrhoidal tissue.
- Hemorrhoidectomy– Occasionally, extensive or severe internal or external hemorrhoids may require removal by surgery known as hemorrhoidectomy.