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What are Hemorrhoids?

Hemorrhoids are swollen veins located around the anus or in the lower rectum. According to the American Society of Colon and Rectal Surgeons, millions of Americans suffer with hemorrhoids (ASCRS).
There are two types of hemorrhoids, internal and external. Internal hemorrhoids develop within the anus; external hemorrhoids develop outside of the anus. Hemorrhoids are also called piles.
Of the two forms of hemorrhoids, external hemorrhoids are the most common and the most troublesome. Hemorrhoids cause pain, severe itching, and difficulty sitting. The good news is that they are treatable.

How Do Hemorrhoids Develop?

Experts are not sure what causes hemorrhoids to develop. Several factors could be to blame, including:
• Straining during a bowel movement
• Complications from chronic constipation
• Sitting on the toilet for a long time
• Pregnancy (when the uterus enlarges it presses on the vein in the colon causing it to bulge)
If someone in your family had hemorrhoids, you are also more likely to develop them.

How Are Hemorrhoids Diagnosed?

A visual examination of your anus may be enough to diagnose hemorrhoids. To confirm the diagnosis, your doctor may wish to do a different examination to check for any abnormalities within the anus. This check is called a digital rectal exam. During this exam, your doctor inserts a gloved and lubricated finger into your rectum. If he feels anything abnormal, he may order an additional test, called a sigmoidoscopy.
A sigmoidoscopy is where your doctor uses a small camera to diagnose an internal hemorrhoid. This small fiber optic camera, called a sigmoidscope, is fitted into a small tube and then inserted into your rectum. From this test, your doctor gets a clear view of the inside of your rectum so that he or she can examine the hemorrhoid up close.

How Are Hemorrhoids Treated?

Hemorrhoids can be treated at home or by a doctor.
Pain Relief
To minimize pain, soak in a warm tub of water for at least 10 minutes every day. You can also sit on a warm water bottle to relieve the pain of external hemorrhoids. If the pain is too much to bear, you can use an over-the-counter medicated suppository, ointment, or cream to relieve the burning and itching.
Dietary Fiber
Home treatment can also include increasing your dietary fiber intake. Consuming foods that are high in dietary fiber can minimize the risk of developing hemorrhoids in the future.
Good dietary fiber sources include:
• Whole wheat
• Brown rice
• Oatmeal
• Pears
• Carrots
• Buckwheat
• Bran
Dietary fiber helps create bulk in the intestines, which softens the stool, making it easier to pass.
If you’re constipated, you can also use an over-the-counter fiber supplement to help soften your stool.
At the Doctor’s
If home treatments are not helping your case of hemorrhoids, your doctor might recommend getting a rubber band ligation. This procedure involves the doctor cutting off the circulation of the hemorrhoid by placing a rubber band around it. This causes loss of circulation to the hemorrhoid forcing it to shrink. Do not try this at home.
If rubber band ligation isn’t an option in your case, the doctor can inject a chemical into the blood vessel directly. This causes the hemorrhoid to reduce in size. This treatment is called injection therapy or sclerotherapy.

Hemorrhoid Surgery Overview

Hemorrhoids are swollen blood vessels that may occur inside the rectum (internal) or outside the rectum (external).
Hemorrhoids can usually be managed by eating a high-fiber diet and drinking eight to ten glasses of water per day. You may also need to use stool softeners to reduce straining during bowel movements. Your doctor may recommend over-the-counter topical ointments to ease occasional itching or irritation.
Sometimes, hemorrhoids can lead to other complications. External hemorrhoids may develop painful blood clots. Internal hemorrhoids may prolapse (drop through the rectum and bulge from the anus). External or prolapsed hemorrhoids can become irritated or infected and may require surgery.

Types of Hemorrhoid Surgeries

Some types of hemorrhoid surgery can be done in your doctor’s office without anesthetic. Other types of surgery need to be performed in a hospital.

Banding
Banding is a procedure used to treat internal hormones. A tight band is placed around the base of the hemorrhoid to cut off its blood supply. Banding usually requires two or more procedures that take place about two months apart. It is not painful, although you may feel pressure or mild discomfort.

Sclerotherapy
This procedure involves injecting a chemical into the hemorrhoid. The chemical causes the hemorrhoid to shrink and stops it from bleeding. Most people experience little or no pain with the shot.
Coagulation Therapy
This treatment uses infrared light, heat, or extreme cold to make the hemorrhoid retract and shrink. Most people experience only mild discomfort or cramping during treatment.

Hemorrhoidectomy
A hemorrhoidectomy is used for large external hemorrhoids and internal hemorrhoids that have prolapsed. This procedure usually takes place in a hospital. You and the surgeon will decide on the best anesthesia to use during the surgery. Choices include:
• General anesthesia (puts you into a deep sleep throughout the surgery)
• Regional anesthesia (medication delivered by a shot in the back which numbs the body from the waist down)
• Local anesthesia (numbs only the anus and rectum)
If you receive local or regional anesthesia, you may also be given a sedative to help you relax during the procedure.
Once the anesthesia takes effect, the surgeon will cut out the large hemorrhoids. When the operation is over, you will be taken to a recovery room for a brief period of observation. Once the medical team is sure that your vital signs are stable, you will be able to return home.

Hemorrhoidopexy

This procedure is sometimes referred to as stapling. It is usually handled as a day surgery and requires general, regional, or local anesthesia. Stapling is used to treat prolapsed hemorrhoids. A surgical staple fixes the prolapsed hemorrhoid back into place inside the rectum and cuts off the blood supply so that the tissue will shrink and be reabsorbed. Stapling recovery takes less time and is less painful than recovery from a hemorrhoidectomy.

Operation Time

40 minutes to 1 hour.

Hospitalisation Time

The procedure requires one night stay in the hospital after the operation.

Signs and Symptoms of Hemorrhoids

Symptoms of hemorrhoids include:
• Extreme itching around the anus
• Irritation and pain around the anus
• Itchy lump located near your anus
• Fecal leakage
• Painful bowel movement
• Blood on your tissue after having a bowel movement

Although hemorrhoids are painful, they are not life threatening and often go away on their own without treatment. If you have them often, you may develop symptoms of anemia such as weakness and pale skin, due to blood loss, though this is rare.

How Can I Prevent Hemorrhoids?

In order to prevent hemorrhoids, avoid straining during a bowel movement. Also, increase your water intake. Drinking adequate water can keep your stool from hardening.

Potential Complications From Hemorrhoids

Complications from hemorrhoids are rare but may include:
• Blood clots within the swollen vein
• Bleeding
• Iron-deficiency anemia (caused by blood loss)