~ Hemorrhoids ~

What are hemorrhoids?


 The term hemorrhoids refers to a condition in which the veins around the anus or lower rectum become
wollen and inflamed. Several groups of veins surround the rectum and anus -one group is known as internal hemorrhoidal veins, and the others are known as external hemorrhoidal veins.


There are two types of hemorrhoids: internal and external. As the name suggests, internal hemorrhoids affect the internal hemorrhoidal veins; external hemorrhoids affect the internal hemorrhoidal veins.

What Causes Hemorrhoids During Pregnancy?


During pregnancy, hemorrhoids are caused by an increase in pressure within either the internal or external hemorrhoidal veins. There are several reasons why pressure may increase during pregnancy. Some of these reasons include:

• The fetus and uterus are growing, which puts more pressure on veins in the lower pelvic area.
• Hormonal changes cause the hemorrhoidal vessels to enlarge.
• Severe pressure to the hemorrhoidal veins occurs during childbirth.
• Frequent constipation during pregnancy. Constipation increases straining and pressure during bowel movements.

Symptoms Of Hemorrhoids

• Many anorectal problems, including fissures, fistulae, abscesses, or irritation and itching, also called pruritus ani, have similar symptoms and are incorrectly referred to as hemorrhoids.
• Hemorrhoids usually are not dangerous or life threatening. In most cases, hemorrhoidal symptoms will go away within a few days.
• Although many people have hemorrhoids, not all experience symptoms. The most common symptom of internal hemorrhoids is bright red blood covering the stool, on toilet paper, or in the toilet bowl. However, an internal hemorrhoid may protrude through the anus outside the body, becoming irritated and painful. This is known as a protruding hemorrhoid.
• Symptoms of external hemorrhoids may include painful swelling or a hard lump around the anus that results when a blood clot forms. This condition is known as a thrombosed external hemorrhoid.
• In addition, excessive straining, rubbing, or cleaning around the anus may cause irritation with bleeding and/or itching, which may produce a vicious cycle of symptoms. Draining mucus may also cause itching.

How are hemorrhoids diagnosed?


A thorough evaluation and proper diagnosis by the doctor is important any time bleeding from the rectum or blood in the stool occurs. Bleeding may also be a symptom of other digestive diseases, including colorectal cancer.
The doctor will examine the anus and rectum to look for swollen blood vessels that indicate hemorrhoids and will also perform a digital rectal exam with a gloved, lubricated finger to feel for abnormalities.

Closer evaluation of the rectum for hemorrhoids requires an exam with an anoscope, a hollow, lighted tube useful for viewing internal hemorrhoids, or a proctoscope, useful for more completely examining the entire rectum.

THE FIGURE SHOWED TYPES OF HEMMORHOIDS

To rule out other causes of gastrointestinal bleeding, the doctor may examine the rectum and lower colon, or sigmoid, with sigmoidoscopy or the entire colon with colonoscopy. Sigmoidoscopy and colonoscopy are diagnostic procedures that also involve the use of lighted, flexible tubes inserted through the rectum.

The Internal Type of Hemorrhoids

Internal hemorrhoids occur when there is too much pressure on the internal hemorrhoidal veins. Frequently, the only sign that internal hemorrhoids exist is bright-red blood that appears on the surface of the stool, in the toilet bowl, or on the toilet paper. But, if the pressure and swelling continue, the hemorrhoidal veins may stretch out of shape, sometimes so much that they bulge through the anus to the outside of the body. 
Pain is not usually common with internal hemorrhoids, unless a blood clot forms or an infection occurs.
 
 

 
The External Type of Hemorrhoids


The external hemorrhoidal veins around the anus can also become swollen, causing external hemorrhoids. These swollen veins bleed easily, either from straining or rubbing, and irritation from draining mucus may cause itching in the anal area. If blood clots form in these hemorrhoids, the pain can be severe.
 
 

 


Medical Treatment


Medical treatment of hemorrhoids is aimed initially at relieving symptoms. Measures to reduce symptoms include :

• tub baths several times a day in plain, warm water for about 10 minutes
• application of a hemorrhoidal cream or suppository to the affected area for a limited time
• Preventing the recurrence of hemorrhoids will require relieving the pressure and straining of constipation.
• Doctors will often recommend increasing fiber and fluids in the diet.
• Eating the right amount of fiber and drinking six to eight glasses of fluid—not alcohol—result in softer, bulkier stools.
• A softer stool makes emptying the bowels easier and lessens the pressure on hemorrhoids caused by straining. Eliminating straining also helps prevent the hemorrhoids from protruding.
• In addition, doctors may suggest a bulk stool softener or a fiber supplement such as psyllium (Metamucil) or methylcellulose (Citrucel).

Surgical Treatment

In some cases, hemorrhoids must be treated endoscopically or surgically. These methods are used to shrink and destroy the hemorrhoidal tissue. The doctor will perform the procedure during an office or hospital visit.

A number of methods may be used to remove or reduce the size of internal hemorrhoids. These techniques include:

1. Rubber band ligation. A rubber band is placed around the base of the hemorrhoid inside the rectum. The band cuts off circulation, and the hemorrhoid withers away within a few days.
2. Sclerotherapy. A chemical solution is injected around the blood vessel to shrink the hemorrhoid.
3. Infrared coagulation. A special device is used to burn hemorrhoidal tissue.
4. Hemorrhoidectomy. Occasionally, extensive or severe internal or external hemorrhoids may require removal by surgery known as hemorrhoidectomy.