Hemorrhoids (aka piles) are quite common in adults from 20 years onwards. Increased pressure can cause sagging of blood vessels around the rectum and anus, similar to varicose veins in the legs. They can be caused by chronic constipation, strained and prolonged defecation, pregnancy or can be age related. Further, obesity and lack of exercise can increase the risk as well. There are two types of hemorrhoids, internal and external. Internal hemorrhoids are located in the lower rectum and external develop around the anus.
Common symptoms are discomfort and pain, itching or irritation, and they can swell and bleed. Blood clots can form in these excrescence, called thrombosed hemorrhoids, which cause severe pain, swelling and feel like hard lumps near the anus.
Progression is divided into four stages, according to the severity of the disease:
- Stage 1 hemorrhoid is still in the anus, often causes bleeding after defecation
- Stage 2 tissue emerges through the rectum after deflation and then retracts itself
- Stage 3 tissue protrudes through the anus, can be manually pushed back
- Stage 4 tissue protrudes through the anus all the time and cannot be pushed back
How are Hemorrhoids diagnosed?
If you experience the before mentioned symptoms, or you have blood on the toilet paper or in the toilet bowl, see a specialist. The diagnosis of hemorrhoids is quite straight forward, the doctor visually examines the anus, digital rectal examination and sometimes a rectoscopy is necessary to examine abnormalities further.
How can it be treated?
Treatment depends on the severity of the disease and individual treatment options have to be discussed with the doctor. In general, treatment options are as follows:
- Behavior modification, such as excretion behavior eating exercise
- Medication such as laxatives, pain relievers, suppositories
- Injections for hemorrhoids to subside for patients with minor hemorrhoids
- Rubber band litigation extracts the hemorrhoid head and compresses the base, which causes the hemorrhoids to shrink. This treatment is suitable for patients with prolapsed hemorrhoids.
- Surgery is suitable for some patients in stage 3 and stage 4.
Prevent and reduce the risk for hemorrhoids?
Reduce the risk of hemorrhoids by eating a high fiber diet and drink sufficient water, generally 6-8 glasses of water a day are advised. Control your body weight in a healthy range and exercise regularly. Avoid sitting for a prolonged period of time, especially on the toilet. Avoid forceful defecation, if you are constipated see your doctor for treatment and do not hold your stools unnecessarily.
Hemorrhoids are treatable and symptoms can mask more serious conditions, therefore do not hesitate to seek specialist advice. If you are over 45 years of age, we recommend that your annual health screening includes a stool exam and an occult blood test, to detect blood that is not visible.
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