Hemorrhoids understanding and prevention

What is hemorrhoids?

The term hemorrhoids refers to a condition in which the veins around the anus or lower rectum are swollen and inflamed.

Hemorrhoids are normal anatomic feature that play a role in providing a watertight seal to the anus. Hemorrhoids occurs equally in men and women. However, the common age group for a presentation is 45-65 years.

Approximately 60-85% of individuals will have symptomatic hemorrhoids at some point in their life.

Types of hemorrhoids

There are two types of hemorrhoids:

Internal hemorrhoids

Internal hemorrhoids involve swelling inside the rectum. Since internal hemorrhoids lack nerves, they are painless.

Almost entirely patients presents without symptoms. People describe it as pressure or fullness. However, bleeding is the most common presenting symptom.

Also, it can prolapse and decrease the ability to form a tight seal at the anal verge and thus symptoms of fecal soiling can be noted as well.

External hemorrhoids

External hemorrhoids involve vein swelling outside the anus on the skin and can be tender, especially if a blood clot forms.

Pain commonly described as itching and burning.

Symptoms such as itching and perianal moisture are likely due to difficulty in cleansing the perianal region.

The skin covered external hemorrhoids may appear red swollen at times due to scratching and vigorous cleansing attempts.

This swelling can lead to anal discomfort, which can lead to more scratching and irritation by the patient. External hemorrhoids originate below the edentate line and can cause pain, since this area is well innervated by pain fibers.

However, external hemorrhoids are usually painless unless they form a blood clot.

Risk factors for hemorrhoids

Some of risk factors for hemorrhoids include:

• Constipation
• Diarrhea
• Pregnancy
• Advancing age
• Prolonged sitting on the toilet and chronic straining
• Obesity
• Family history
• Heavy lifting

Treatment of hemorrhoids

Non-drug measures

These are more of prevention and lifestyle changes which include:

• Drink plenty of fluids. Drink anywhere between six to eight glasses of water daily.
• Eat high fiber diet to prevent constipation. Eating more fruits and vegetables can help reducing the constipation.
• Consider taking a fiber supplement. Fibers can improve overall symptoms and bleeding from hemorrhoids.
• Do not ignore the urge to go the bathroom. By ignoring the urge, the stool could become more dry and harder to pass.
• Avoid straining. Straining can create pressure in the veins in the lower rectum.
• Exercise. Staying active can help you lose excess weight that may be contributing having symptoms.
• Limit the long periods of sitting. Prolonged sitting can increase the pressure on the veins in the perianal area.

Drug measures

Although it can be self limiting disease, treatment of symptoms can be very helpful.

If you have any mild discomfort, your physician might recommend over the counter creams, ointments or suppositories. These can include ingredients of:

Zinc sulfate monohydrate 0.5%. Zinc helps with the itching, burning and irritation,

Hydrocortisone. Corticosteroids reduces redness, itching and swelling.

Lidocaine. Smaller than pea-sized dot can help you with hemorrhoidal pain.

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When to see your doctor

If you have any of these symptoms/diseases, please see your doctor:

• Excessive or frequent fresh blood
• Tarry or black stools
• Symptoms longer than 7 days with no improvement
• Severe pain
• Protrusion or prolapse
• Fecal incontinence
• Irritable Bowel Disease
• History of colon cancer.

What to read next

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