Hemorrhoids occur when the veins surrounding the anus or in the rectum are inflamed. It can occur both inside and above the inside of the anus and can be Internal or External depending upon their location.
Externalhemorrhoids are painful and occur in the lowerpart of the anal canal.
Internal hemorrhoids are generally painless and occur above a point 2-4 cm inside the anus in the upper part of the anal canal. Internal hemorrhoids can further be classified into following grades depending upon their size and severity:
Grade 1 : are small swellings that cannot be seen or felt from outside the anus.
Grade 2 : are larger and may partly push out from the anus on toilet and go back inside again.
Grade 3 : are one or more small, soft lumps that hang from the anus and can be pushed back inside the anus with a finger.
Grade 4 : permanently hang down and cannot be pushed back inside.
Causes of Hemorrhoids :
The exact cause of hemorrhoids is not known but factors that lead to an increased pressure in and around the anus and anal canal can be a major cause in many cases:
Standing or sitting for long periods
Excessive straining on the toilet
Chronic constipation, coughing, sneezing & vomiting
Along with these, other factors that may cause piles include:
Low fibre diet
Inadequate fluid intake
Symptoms of Hemorrhoids :
In most of the cases hemorrhoids are not very serious and go away on their own after a few days. An individual may experience the following symptoms:
A painful swelling or hard lump may be felt around or protruding from the anus
Discomfort in anal region
Bright red blood after a bowel movement
Feeling of full bowel even on defecation
Anal itching and irritation
Mucus discharge when emptying the bowels
Tenderness or pain while defecating
Red and sore anal area
Feces may leak
Diagnosing Hemorrhoids :
A doctor first asks some questions and then performs physical and anal examination to diagnose hemorrhoids. This will be followed by a digital rectal examination (DRE) or use a proctoscope to see the anal canal and take a small tissue sample from inside the rectum, for lab analysis.
To see further into the anal canal, a sigmoidoscopy or colonoscopy may be performed. A barium X-ray can also be performed to view the entire interior colon.
Treatments for Hemorrhoids :
Majority of cases of hemorrhoids resolve on their own without any treatment by doing some lifestyle changes like increased intake of fibre, losing weight and being physically active etc. Treatment is required to reduce the discomfort and itching in many patients.
The symptomatic treatment for hemorrhoids may include the following:
Laxatives to treat constipation
Ointments, creams, pads and other OTC medications to soothe the redness and swelling around the anus area.
Corticosteroids to reduce inflammation and pain
Painkillers to reduce pain
In cases where hemorrhoids affects the quality of life of a patient, following treatment options may be selected by the doctor depending upon patient requirement:
Banding The prolapsed hemorrhoids are often removed by placing a rubber-band ligation at the base of the hemorrhoids inside the anus to cut off its blood supply. After few days the hemorrhoids fall off.
Sclerotherapy The hemorrhoids are shrinked by injecting a medicated solution
Infrared Coagulation – The hemorrhoid tissue is burnt by a device.
Diathermy and Electrotherapy The haemorrhoids are destroyed using an electrical current.
Haemorrhoidal Artery Ligation – The haemorrhoids are shrinked by ligating the small arteries that supply blood to the??piles.
Surgery It is performed particularly for large hemorrhoids of grades 3 or 4 and can be
Hemorrhoidectomy is an an operation to cut away the haemorrhoid(s)
Hemorrhoid stapling is the procedure to cut out a circular section of the lining of the anal canal above the??hemorrhoids that will eventually shrink the hemorrhoids.