Hemorrhoids
(Piles)
Definition |
Causes |
Risk Factors |
Symptoms |
Diagnosis |
Treatment |
Prevention |
Organizations
Definition
Hemorrhoids are swollen blood vessels in and around the anus and lower rectum. They stretch under pressure and are similar to varicose veins in the legs. Hemorrhoids are either internal or external.
Internal Hemorrhoids - develop inside the anus. They are painless and sometimes bleed a lot. They protrude during bowel movements. If they protrude from the anal opening and cannot be pushed back, they can cause severe pain.
External Hemorrhoids develop under the skin around the anus and can easily be felt or seen. They bleed when broken by straining, rubbing, or scratching.
Causes
The exact cause of hemorrhoids is unknown. The major contributing factor appears to be too much pressure on the veins in the rectum. If the pressure continues, the veins become enlarged and protrude.
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition.
- Straining when trying to pass a stool
- Chronic constipation or diarrhea
- Sitting on the toilet for long periods of time
- Pressure on the veins from pregnancy and childbirth
- Sitting for long periods of time
- Advancing age
- Obesity
- Family members with hemorrhoids
- Chronic cough
- Liver disease
Symptoms
In most cases, symptoms will go away within a few days. Although many people have hemorrhoids, not all experience symptoms.
Common symptoms include:
- Bleeding from the anus that may appear:
- On the stool
- On the toilet paper
- In the toilet bowel
- Anal itching and burning
- Swelling and pain during bowel movements
- Sensitive lumps of various sizes around the anus
Diagnosis
The doctor will ask about your symptoms and medical history, and perform a physical exam. The doctor will examine the anus and rectum to look for swollen blood vessels and perform a digital rectal exam. This is accomplished by inserting a gloved, lubricated finger into the rectum to feel for abnormalities.
Bleeding from the rectum or blood in the stool can be a symptom of other digestive diseases or colon cancer. It is important to see a doctor if you have this type of bleeding.
Treatment
Initial medical treatment of hemorrhoids is aimed at relieving symptoms. Measures to reduce symptoms include:
Sitz Baths sitting in plain, warm water two to three times a day for about 10 minutes
Ice Packs putting cold packs on the anus to relieve pain and swelling
Medication hemorrhoidal creams or suppositories applied to the affected area
High-fiber Diet eating more whole fresh fruit, raw or cooked vegetables, and whole grains to help reduce constipation
Fluids drinking 6-8 glasses of nonalcoholic fluid daily to soften stools
Surgery may be used in some cases to shrink or destroy the hemorrhoidal tissue. Surgery is performed under anesthesia in the doctor's office or in the hospital.
Surgeries for internal hemorrhoids include:
Rubber Band Ligation a rubber band placed around the base of the hemorrhoid to cut off circulation and force the hemorrhoid to wither away within a few days
Sclerotherapy a chemical solution injected around the blood vessel to shrink the hemorrhoid
Surgeries for both internal and external hemorrhoids include:
Electrical or Laser Heat (Laser Coagulation) or Infrared Light (Infrared Photo Coagulation) special devices used to burn hemorrhoidal tissue
Hemorrhoidectomy permanent removal of hemorrhoids by cutting the tissue away
Prevention
The best way to prevent hemorrhoids is to keep stools soft so they pass easily. The following practices can help:
- Eating a high fiber diet
- Exercising regularly, especially walking
- Emptying bowels as soon as possible after the urge occurs
- Avoiding the overuse of laxatives
Organizations
American Society of Colon and Rectal Surgeons
http://www.fascrs.org
SOURCES:
National Institutes of Health
American Society of Colon and Rectal Surgeons
Last reviewed June 2001 by Medical Review Board
