Hemorrhoid

Hemorrhoids are the swelling and inflammation of veins in the rectum and anus.

Table of contents

1 Types and symptoms of hemorrhoids
2 Prevalence
3 Prevention
4 Treatments
5 External links

Types and symptoms of hemorrhoids

Two of the most common types of hemorrhoids are external and internal hemorrhoids. External hemorrhoids are those that occur outside of the anal opening. They are usually painful, and are often accompanied by pruritus ani or itching, swelling, and burning sensation. If the vein ruptures and a blood clot develops, the hemorrhoids become a thrombosed hemorrhoid.

Internal hemorrhoids are those that occur inside the rectum. As this area lack sensitive nerve endings, internal hemorrhoids are usually not painful and most people are not aware that they have them. Internal hemorrhoids, however, may bleed when irritated.

Untreated internal hemorrhoids can lead to two severe forms of hemorrhoids: prolapsed and strangulated hemorrhoids. Prolapsed hemorrhoid is an internal hemorrhoid that are so distended that it is pushed outside of the anus. If the anal sphincter muscle goes into spasm and trap the prolapsed hemorrhoid outside of the anal opening, the supply of blood is cut off, and the hemorrhoids become a strangulated hemorrhoid.

Prevalence

Hemorrhoids are very common. It is estimated that approximately half of all Americans have this condition by the age of 50. However, only a small number seek medical treatment. Annually, only about 500,000 people are medically treated for hemorrhoids, with 10 to 20% of them requiring surgeries.

The causes of hemorrhoids include genetic predisposition (weak rectal vein walls and/or valves), excessive time (over 1 minute daily) and straining during bowel movements, and chronic bowel straining or pressure due to poor posture or muscle tone. Constipation, bouts of diarrhea, poor bathroom habits (reading on the toilet or multiple cleaning attempts), pregnancy, and fiber-deprived Western diet can all foster the conditions that cause hemorrhoids.

Prevention

Prevention of hemorrhoids includes drinking more fluids, eating more fiber, exercising, practicing better posture, and reducing bowel movement strain and time. Hemorrhoid sufferers should avoid using laxatives and should strictly limit time straining at stool to well under 1 minute (ideally 10 seconds) daily.

Treatments

For many people, hemorrhoids are temporary conditions that are healed either serendipitously or by the same measures recommended for prevention. In these cases, warm sitz bath, cold compress, or topical analgesic (such as Preparation H), is sufficient to provide temporary relief. Chronic hemorrhoids or those that flare up from time to time can be medically treated by:

dilation: stretching of the anal sphincter muscle. Although no longer popular, this treatment can be successfully applied to select cases of strangulated hemorrhoids.
rubber band ligation: elastic bands are applied onto an internal hemorrhoid to cut off its blood supply. Within several weeks, withered hemorrhoid is sloughed off during normal bowel movement.
sclerotherapy (injection therapy): sclerosant or hardening agent is injected into hemorrhoids. This causes the vein walls to collapse and the hemorrhoids to shrivel up.
cryosurgery: a frozen tip of a cryoprobe is used to destroy hemorrhoidal tissues.
laser, infared or BICAP coagulation: laser, infrared beam, or electricity is used to cauterize the affected tissues.
hemorrhoidectomy: a true surgical procedure to excise and remove hemorrhoids.

Severe cases of hemorrhoids, such as prolapsed, thrombosed, or strangulated hemorrhoids, surgery may be the only treatment option.

Natural treatments for hemorrhoids include applying the prevention measures, taking herbs and dietary supplements that strengthen vein walls, such as butcher's broom, horse chestnut, bromelein, and japanese pagoda tree extracts.

Natural astringents and soothing agents, such as witch hazel, cranesbill and aloe vera, may also be used topically. Lastly, fiber-rich bulking agents such as plantain and psyllium can be used to help create soft stool that is easy to pass to lessen the irritation of existing hemorrhoids or to achieve the daily limit of well under 1 minute (ideally 10 seconds) straining at stool.