Hemorrhoids

What are hemorrhoids?

Hemorrhoids are a very common condition in which blood vessels of the anus and rectum become swollen from increased pressure, similar varicose veins in the legs.

They become more common as we age and may run in families.

There are two kinds of hemorrhoids:

  • Internal, occurring inside the anus
  • External, occurring under the skin around the anus

The most common symptom associated with hemorrhoids is minor rectal bleeding, and aren’t typically painful.

While the exact cause of hemorrhoid bleeding is unknown, it seems to be related to:

  • constipation
  • diarrhea
  • excessive sitting and standing
  • obesity
  • heavy lifting
  • pregnancy

They develop from an increase in pressure in the lower rectum and are more likely to occur as you age.

Some factors that can increase their likeliness are:

  • Straining during bowel movements
  • Sitting on the toilet for long periods of time
  • Chronic diarrhea or constipation
  • Obesity
  • Pregnancy
  • Anal intercourse
  • Low-fiber diet

External hemorrhoids may be easily visible, internal hemorrhoids may be found using diagnostic procedures.

These procedures include:

  • Digital rectal exam
    • Your doctor inserts a gloved, lubricated finger into your rectum. Then they feel for anything unusual
  • Visual inspection of your anal canal and rectum using an anoscope, proctoscope or sigmoidoscope. These are scopes that allow your doctor to see into your anus and rectum

Common treatments to alleviate hemorrhoid symptoms include:

  • The treatment of underlying constipation
  • Warm baths
  • Over-the-counter creams
  • Hydrocortisone suppository

Treatment for reduction of hemorrhoid size include:

  • Rubber band ligation
    • The placement of a rubber band around the base of a hemorrhoid helps to cut off its blood supply, causing the hemorrhoid to shrink. The rubber band falls off within a few days
  • Laser or infrared coagulation
    • The use of infrared light to burn the base of the hemorrhoid, cutting off its blood supply
  • Sclerotherapy
    • The injection of medicine directly into the hemorrhoids

Surgery to remove hemorrhoids may be required in severe cases or if symptoms persist despite rubber band ligation, coagulation or sclerotherapy.

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