What are Hemroids? What are Hemorrhoids?

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Main Category: GastroIntestinal / Gastroenterology
Also Included In: Dermatology;  Blood / Hematology
Article Date: 25 Feb 2009 - 1:00 PDT

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Hemroids (or hemorrhoids) are also known as piles. Although they can be extremely unpleasant and painful for many people, they can be easily treated and often prevented. As hemorrhoids generally get worse as time goes by, health care professionals say they should be treated as soon as they appear.

At least four-fifths of adults in Europe and North America will experience hemorrhoids at some point in their lives. Doctors say a large number of people who go and have a checkup are found to have hemorrhoids.

The older you are the more likely you are to suffer from hemorrhoids. 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.

What are hemroids / hemorrhoids?

When the veins around the anus or in the rectum are swollen or inflamed the patient has hemorrhoids. They can occur for the following reasons:

• pregnancy
• aging
• chronic diarrhea
• chronic constipation
• straining to move stool (related to the previous one)
• sitting for long periods (especially sitting for long periods at a time in the toilet)
• anal intercourse
• obesity
• 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

• bleeding, usually painless. The patient may notice red on the toilet paper or in the toilet bowl.
• itching and/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 (painful)
• 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, 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.

When should I see my doctor?

If you experience any of the symptoms related to hemorrhoids it would be advisable to contact your 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.

Your doctor can carry out a physical examination and perform other tests to determine whether or not you have hemorrhoids. If your hemorrhoids do not improve, even after using home remedies, you should see your doctor.

If your symptoms started with a significant alteration in bowel habits, or if your stools are very dark or even black, if there are blood clots or blood mixed in with the stools, you should see a doctor immediately so that they can determine whether your bleeding is taking place in another part of your digestive tract.

If your symptoms include large amounts of bleeding, dizziness and a sensation that you are going to faint you should immediately seek emergency care.

Hemorrhoids - four surgical classifications

1. First degree hemorrhoids. These bleed but do not protrude outside the anus.


2. Second degree hemorrhoids. These protrude (prolapsed) outside the anal canal when the patient is passing a stool, and then draw back immediately.


3. Third degree hemorrhoids. These need to be manually placed back inside the anal canal after protruding (prolapsing).


4. Fourth degree hemorrhoids. The protruding (prolapsing) hemorrhoids cannot be manually replaced. The tissue is thrombosed or strangulated.

Treatment for hemorrhoids

In the majority of cases the patient can take some simple measures which will alleviate symptoms while the problem gets better on its own. However, medicines and even surgery may sometimes be needed.

Medicines

Most hemorrhoid medicines are OTC (over-the-counter); this means you do not need a doctor's prescription to get them. 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 seven days (unless your doctor has told you otherwise).

Simple incisions

Your 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.

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 or stapling.

What you can do on your own

There are things you can do to relieve the symptoms. Bear in mind that they will not eliminate the hemorrhoids.

• Topical creams and ointments. You can apply an OTC cream or suppository which contains 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 if you think it will make the problem worse. Dry the area gently with a hair drier after bathing.


• Ice packs and cold compresses. If you apply these to the affected area it may help with the swelling.


• Sitz bath. Use warm water. The sitz bath is placed over the toilet. Some pharmacies sell them.


• Use moist towelletes. Dry toilet paper may aggravate the problem.


• Analgesics. Some painkillers, such as aspirin, ibuprofen and paracetamols (Tylenol) may alleviate the pain and discomfort.

How can I prevent hemorrhoids from appearing in the first place?

If your stools are always soft your chances of developing hemorrhoids are greatly reduced.

Nutrition. If you eat lots of fruits and vegetables, as well as whole grains, your stools will nearly always be soft. If you drink plenty of fluids your stools are more likely to be soft (this does not include alcohol).

Straining. When you go to the toilet try not to strain or hold your breath, as this creates pressure in the veins in the lower rectum.

Go when you need to. If you have the urge to go to the toilet, go. Do not wait. The longer you wait, the drier the stools will be.

Be physically active. Physical inactivity, sitting or standing still for long periods puts pressure on the veins.

Keep your bodyweight down. Obesity an overweight significantly raise a person's risk of having hemorrhoids.

Sources NIH, NHS (UK), The Mayo Clinic

What are Hemroids? What are Hemorrhoids?
Written by Christian Nordqvist

Original article date: 13 June 2007
Article updated: 25th February 2009

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