Hemorrhoids (or hemroids) are also known as piles. Although they can be extremely unpleasant and painful, they can be easily treated and are very preventable.
As hemorrhoids generally get worse over time, doctors suggest that they should be treated as soon as they appear.
It has been suggested that up to 75 percent of adults in Europe and North America will experience hemorrhoids at some point in their lives.
Approximately 50 percent of those people aged 50 years and over will require treatment. However, it is striking that only around 4 percent actually seek medical treatment.
Hemorrhoids are most common among adults aged 45-65. This does not mean, however, that young people and children do not get them. Hemorrhoids are much more common among men than women. A woman is most likely to get them when she is pregnant.
This article will cover the causes, treatments, and symptoms of hemorrhoids. It will also discuss home remedies and medical treatment.
Fast facts on hemorrhoids
Here are some key points about hemorrhoids. More detail and supporting information is in the main article.
- Hemorrhoids are more common in men than women
- A female is more likely to get hemorrhoids while pregnant
- The likelihood of suffering from hemorrhoids increases as a person ages
- Hemorrhoids occur when the veins surrounding the anus are engorged or dilated (enlarged)
- Sometimes medicines and surgery are needed to treat hemorrhoids
Causes of hemorrhoids
Hemorrhoids can appear for a number of reasons.
When the veins around the anus or in the rectum are dilated (enlarged) or engorged with blood, the patient has hemorrhoids.
They can occur for the following reasons:
- Chronic diarrhea
- Chronic constipation - from straining to move stool
- Sitting for long periods (especially on the toilet)
- Anal intercourse
- Genetics - some people inherit a tendency to develop hemorrhoids
Hemorrhoids can occur both inside and above the inside of the anus. They can also appear externally, under the skin of the anus.
Symptoms of hemorrhoids
Symptoms of hemorrhoids often include:
- Bleeding, usually painless. The patient may notice red on the toilet paper or in the toilet bowl.
- Itching or irritation in the anal area.
- Discomfort and pain in the anal region.
- Lumps protruding from the anal region.
- Swelling in the anal region.
- A lump near your anus, this can sometimes be sensitive.
- Feces may leak (without your wanting it to happen).
Internal hemorrhoids, which lie inside the rectum, usually have no symptoms; the patient is not aware of them as they do not generally cause any discomfort. However, they may cause painless rectal bleeding if symptoms do appear.
Sometimes a person does not notice that they have internal hemorrhoids until they notice streaks of blood on their stool or blood on toilet paper.
Straining when passing a stool may cause them to bleed. Straining can also push an internal hemorrhoid so that it protrudes through the anus, this is called a protruding or prolapsed hemorrhoid and can be painful.
When a patient has external hemorrhoids, they will lie under the skin around the anus. They can become very itchy and may bleed. Sometimes, the blood may accumulate and form a thrombus (clot), which can be painful; the area will swell and become inflamed. External hemorrhoids are more likely to present with pain.
When to see a doctor
Anyone experiencing the symptoms outlined above should contact their doctor. Bear in mind that rectal bleeding can be caused by other things, including colorectal and anal cancers. It might be a mistake to assume that anal bleeding is simply the result of hemorrhoids and, because of this, decide not to see a doctor.
A doctor can carry out a physical examination and perform other tests to determine whether or not you have hemorrhoids. These tests may include a digital rectal exam - a manual inspection by the doctor using a gloved, lubricated finger.
Sometimes the exam includes an anoscope (a small, rigid, tubular instrument). If hemorrhoids do not improve, even after using home remedies, the individual should see a doctor.
If symptoms started with a significant alteration in bowel habits, if stools are very dark or even black, if there are blood clots or blood mixed in with the stools, it is important to see a doctor immediately.
The Doctor may perform examinations such as a colonoscopy, a sigmoidoscopy, or a barium enema X-ray to help determine the problem.
If symptoms include large amounts of bleeding, dizziness, and a fainting sensation, the individual should immediately seek emergency care.
Treatments for hemorrhoids
In the majority of cases, simple measures will alleviate symptoms while the problem gets better on its own. However, medicines and even surgery may sometimes be needed.
Most hemorrhoid medicines are OTC; they include ointments, pads, or suppositories. Such active ingredients as hydrocortisone and witch hazel are known to relieve itching and pain. These medicines should not be used for more than about 7 days (unless the doctor has said otherwise).
A doctor may carry out a simple incision if a clot has formed around an external hemorrhoid. These incisions are usually effective. More continuous bleeding may require rubber band ligation, sclerotherapy (injection), or coagulation.
Specialist ultrasonic device for hemorrhoid surgery.
Surgery to treat hemorrhoids
Surgery is recommended if the patient has not benefited from the simple procedures, or if the hemorrhoids are very large.
In some cases, the patient may go home straight after the procedure, while in others they may have to be hospitalized.
Surgery may involve hemorrhoidectomy (complete removal of the hemorrhoids) or stapling, where part of the intestine is stapled to reduce the chance of prolapse.
Home remedies for hemorrhoids
Although there are ways to relieve symptoms, they will not eliminate the hemorrhoids.
- Topical creams and ointments - OTC creams or suppositories which contain hydrocortisone. There are also pads which contain witch hazel, or a topical numbing agent.
- Bathing the affected area - bathe gently with warm water. Do not use soap. Dry the area gently with a hair drier after bathing.
- Ice packs and cold compresses - applying these to the affected area may help with the swelling.
- Sitz bath using warm water - the sitz bath is placed over the toilet. Some pharmacies sell them. These may relieve the burning or itching symptoms.
- Moist towelletes - dry toilet paper may aggravate the problem.
- Analgesics - some painkillers, such as aspirin, ibuprofen, and acetaminophen (Tylenol) may alleviate the pain and discomfort.
If an individual's stools are always soft, the chance of developing hemorrhoids is greatly reduced. Risk of hemorrhoids can be reduced in the following ways:
- Nutrition - eating plenty of fruits and vegetables, as well as whole grains, means stools will nearly always be soft. Similarly, drinking plenty of fluids helps keep stools soft (this does not include alcohol). You may also supplement your diet with store-bought fiber, which draws water into the colon and can also help soften stool.
- Straining - when using the toilet, try not to strain or hold the breath, this creates pressure in the veins in the lower rectum.
- Go when needed - people should not wait if they need to use the toilet. The longer the wait, the drier the stools will be.
- Physical activity - sitting or standing still for long periods puts pressure on the veins.
- Keep body weight down - being overweight significantly raise a person's risk of having hemorrhoids.