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How to Cure Hemorrhoids ( courtecy;- medicineNet.com )
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Although most people think hemorrhoids are abnormal, everyone
has them
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What Do Hemorrhoids Look
Like?
Hemorrhoids are clumps
of dilated (enlarged) blood vessels in the anus and lower rectum. The rectum is
the last area of the large intestine before it exits to the anus. The anus is
the end of the digestive tract where feces leaves the body.
Sometimes hemorrhoids
swell when the veins enlarge and their walls become stretched, thin, and
irritated by passing stool. Hemorrhoids are classified into two general
categories:
·
internal, originating in
the rectum, and
·
external, originating in
the anus.
Hemorrhoids (also termed
piles) have caused pain and irritation throughout human history. The word comes
from Greek, “haimorrhoides,” meaning veins that are liable to discharge blood.
If you’ve had a bout of hemorrhoid pain, you’re not alone. It’s estimated that
three out of every four people will have hemorrhoids at some point in their
lives. Even Napoleon suffered from hemorrhoids, which distracted him with
severe pain during his defeat at Waterloo.
Enlarged Hemorrhoid Symptoms
Enlarged hemorrhoids are
associated with symptoms such as
·
itching,
·
mucus discharge,
·
burning at the anus,
·
severe pain,
·
a sensation that the
bowel is not really empty, and
·
bleeding without pain.
In this article, our
medical experts will explain where hemorrhoid pain comes from, what hemorrhoids
feel like, and how they are diagnosed. Then you will discover the various
treatments for hemorrhoids both at home and at hospital, along with the
positive attributes and drawbacks of each hemorrhoid treatment.
Internal Hemorrhoids
Internal
hemorrhoids sit in the inside lining of the rectum and are not obvious unless
they are substantially enlarged, in which case they can be felt. Internal
hemorrhoids are usually painless and become apparent because they cause bleeding
with a bowel movement.
Sometimes
internal hemorrhoids prolapse or protrude outside the anus. If so, you may be
able to see or feel them as moist pads of skin that are pinker than the
surrounding area. Prolapsed hemorrhoids may hurt because the anus is dense with
pain-sensing nerves. Prolapsed hemorrhoids usually recede into the rectum on
their own. If they don't, they can be gently pushed back into place.
External Hemorrhoids
External hemorrhoids are
located underneath the skin that surrounds the anus, and are lower than
internal hemorrhoids. They can be felt when they swell, and may cause
·
itching,
·
pain, or
·
bleeding with a bowel
movement.
If an external
hemorrhoid prolapses to the outside (usually in the course of passing a stool),
you can see and feel it.
Blood clots sometimes
form within prolapsed external hemorrhoids, which can cause an extremely
painful condition called a thrombosis. If an external hemorrhoid becomes
thrombosed, it can look rather frightening, turning purple or blue, and could
possibly bleed.
Despite their
appearance, thrombosed hemorrhoids usually are not serious, though they can be
very painful. They will resolve on their own in a couple of weeks. If the pain
is unbearable, your doctor can remove the blood clot from the thrombosed
hemorrhoid, which stops the pain.
Everyone Has Hemorrhoids
Although most
people think hemorrhoids are abnormal, everyone has them. Hemorrhoids help
control bowel movements. Hemorrhoids cause problems and can be considered
abnormal or a disease only when the hemorrhoidal clumps of vessels enlarge.
Hemorrhoids
occur in everyone, and an estimated 75% of people will experience enlarged
hemorrhoids at some point. However only about 4% will go to a doctor because of
hemorrhoid problems. Hemorrhoids that cause problems are found equally in men
and women, and their prevalence peaks between 45 and 65 years of age.
What Causes Hemorrhoids?
Hemorrhoids are caused
by swelling in the anal or rectal veins. This makes them susceptible to
irritation.
This swelling can be
caused by several things, including
·
obesity,
·
pregnancy,
·
standing or sitting for
long periods,
·
straining on the toilet,
·
chronic constipation or diarrhea,
·
eating a low-fiber diet,
·
coughing,
·
sneezing,
·
vomiting, and
·
holding your breath
while straining to do physical labor.
Hemorrhoids Causes: Diet
Diet is believed to have
a big impact in causing—and preventing—hemorrhoids. People who consistently eat
a high-fiber diet are less likely to get hemorrhoids, while those people who
prefer a diet high in processed foods face a higher hemorrhoid risk. A low-fiber
diet can cause constipation, which can contribute to hemorrhoids in two ways:
- It promotes straining on the
toilet; and
- It also aggravates the
hemorrhoids by producing hard stools that further irritate the swollen
veins.
Symptoms of Hemorrhoids:
Bleeding Hemorrhoid
The most common symptom
and sign from hemorrhoids is painless bleeding. A hemorrhoid sufferer may
notice bright red blood on the outside of the stools, on the toilet paper, or
dripping into the toilet.
The bleeding usually
resolves itself without treatment. Nevertheless, bleeding with a bowel movement
is never normal and should prompt a visit to a health care professional. While
hemorrhoids are the most common cause of bleeding with a bowel movement, there
may be other reasons for bleeding, including
·
inflammatory bowel
disease,
·
infection, and
·
tumors.
Learn more symptoms of
internal and external hemorrhoids in the following slides.
Hemorrhoids Pain: What
Does Hemorrhoids Feel Like?
Many physicians use a
grading system to categorize hemorrhoids along four stages:
·
First-degree
hemorrhoids: Hemorrhoids that bleed, but do not prolapse. These are slightly
enlarged hemorrhoids, but they do not protrude outside the anus.
·
Second-degree
hemorrhoids: Hemorrhoids that prolapse and retract on their own (with or
without bleeding). These may come out of the anus during certain activities
like passing stool, and then return back inside the body.
·
Third-degree
hemorrhoids: Hemorrhoids that prolapse and must be pushed back in by a finger.
·
Fourth-degree hemorrhoids:
Hemorrhoids that prolapse and cannot be pushed back in the anal canal.
Fourth-degree hemorrhoids also include hemorrhoids that are thrombosed
(containing blood clots) or that pull much of the lining of the rectum through
the anus.
Symptoms of Prolapsed Internal
Hemorrhoids
Internal hemorrhoids
prolapse when their blood vessels swell and extend from their location in the
rectum through the anus. In the anal canal, the hemorrhoid is exposed to the
trauma of passing stool, particularly hard stools associated with constipation.
The trauma can cause bleeding and sometimes pain when stool passes.
The presence of
·
stool,
·
inflammation, and
·
constant moisture
can lead to anal
itchiness (pruritus ani), and occasionally the constant feeling of needing to
have a bowel movement. The prolapsing hemorrhoid usually returns into the anal
canal or rectum on its own or can be pushed back inside with a finger, but it
prolapses again with the next bowel movement
Symptoms of Thrombosed
External Hemorrhoids
External hemorrhoids can
be felt as bulges at the anus, but they usually cause few of the symptoms that
are typical of internal hemorrhoids.
External hemorrhoids can
cause problems, however, when blood clots inside them. This is referred to as
thrombosis. Thrombosis of an external hemorrhoid causes an anal lump that is
·
very painful,
·
tender, and
·
often requires medical
attention.
The thrombosed
hemorrhoid may heal with scarring, and leave a tag of skin protruding in the
anus. Occasionally, the tag is large, which can make anal hygiene (cleaning)
difficult or irritate the anus.
How to Get Rid of
Hemorrhoids: Diagnosis and Treatments
Most individuals who
have hemorrhoids discover them by either
·
feeling the lump of an
external hemorrhoid when they wipe themselves after a bowel movement,
·
noting drops of blood in
the toilet bowl or on the toilet paper, or
·
feeling a prolapsing
hemorrhoid (protruding from the anus) after bowel movements.
With a history of
symptoms, a physician can begin diagnosis on the basis of a careful examination
of the anus and anal canal. Although the physician should try his or her best
to identify the hemorrhoids, it is perhaps more important to exclude other causes
of hemorrhoid-like symptoms that require different treatment such as
·
anal fissures,
·
fistulae,
·
perianal (around the
anus) skin diseases,
·
infections, and
·
tumors.
Seeing a Doctor About
Hemorrhoids
Many people are
embarrassed to go to their doctor about their hemorrhoid problems, which is
probably why only an estimated 4% of people see the doctor even if 75% of us
experience enlarged hemorrhoids at some point in time. Despite the
embarrassment, hemorrhoids should always be examined professionally. Getting a
medical exam will help your doctor recommend an effective treatment, and will
also rule out more serious causes for your symptoms.
When you visit your
doctor, you will probably be asked to describe your symptoms. The doctor will
perform an examination to see whether your anus is inflamed, and whether
enlarged hemorrhoids are present.
The doctor will want to
know if you have found blood in your stool, which may prompt a bowel endoscopy
examination. The doctor will likely feel for anything unusual through a digital
rectal examination.
Remember that while this
might be a little embarrassing and uncomfortable, hemorrhoid exams are usually
painless. Also, your doctor is accustomed to caring for this sort of problem,
which is very common.
If you seem to have
enlarged hemorrhoids, the doctor will probably recommend a proctoscopy. During
a proctoscopy, a short tube with light and a lens will be used to examine the
membranes lining your rectum. This will let your doctor see the enlarged
hemorrhoids and determine their size. Again, this procedure is usually
painless.
How to Cure Internal
Hemorrhoids: Diagnosis
The diagnosis of an
internal hemorrhoid is easy if the hemorrhoid protrudes from the anus. Although
a rectal examination with a gloved finger may uncover an internal hemorrhoid
high in the anal canal, the rectal examination is more helpful in excluding
rare cancers that begin in the anal canal and adjacent rectum.
A more thorough
examination for internal hemorrhoids is done visually using an anoscope, which
is similar to a proctoscope, but smaller. Whether or not hemorrhoids are found,
if there has been bleeding, the colon above the rectum needs to be examined to
exclude other important causes of bleeding other than hemorrhoids such as
·
colon cancer,
·
polyps, and
·
colitis.
How to Cure External Hemorrhoid: Diagnosis
External
hemorrhoids appear as a bump and/or dark area surrounding the anus. If the lump
is tender, it suggests that the hemorrhoid is thrombosed. Any lump needs to be
carefully followed, however, and should not be assumed to be a hemorrhoid since
there are rare cancers of the anal area that may masquerade as external
hemorrhoids.
What Is the Treatment
for Hemorrhoids?
Treating enlarged
hemorrhoids is important, because they tend to get worse over time. Hemorrhoids
are treated with a variety of measures including diet, over-the-counter
medicine like
·
creams,
·
lotions,
·
gels,
·
pads, and
·
wipes,
and various procedures
like
·
sclerotherapy,
·
rubber band ligation,
and
·
surgery.
Treatment for
Hemorrhoids: Diet
Individuals with
hemorrhoids should soften their stools by increasing the fiber in their diets.
Fiber is found in
numerous foods, including
·
fresh and dried fruits,
·
vegetables,
·
grains, and
·
cereals.
In general, 20 to 30
grams of fiber per day is recommended, whereas the average American diet
contains less than 15 grams of fiber. Supplemental fiber like the following:
·
psyllium,
·
methylcellulose, and
·
calcium polycarbophil
also may be used to
increase the intake of fiber. Stool softeners and increased drinking of liquids
also may be recommended. Nevertheless, the benefits of fiber, liquids, and
stool softeners have not been well-tested with respect to hemorrhoidal control
in scientific studies.
Hemorrhoid Treatment:
Over-the-Counter Medications
Products used to treat
hemorrhoids are available as
·
ointments,
·
creams,
·
gels,
·
suppositories,
·
foams, and
·
pads.
When used around the
anus, ointments, creams, and gels should be applied as a thin covering. When
applied to the anal canal, these products should be inserted with a finger or a
"pile pipe." Pile pipes are most efficient when they have holes on
the sides as well as at the end. Pile pipes should be lubricated with ointment
prior to insertion. Suppositories or foams do not have advantages over
ointments, creams, and gels.
How to Heal Hemorrhoids: Warm Sitz Baths
A sitz bath
refers to sitting in a few inches of warm water three times a day for 15 to 20
minutes. A sitz bath may help decrease the inflammation of hemorrhoids. Drying
off the anal area completely after each sitz bath is important for minimizing
moisture that irritates the skin surrounding the anus.
Hemorrhoids Treatment: Stool Softeners
Stool softeners
may help, but once hemorrhoids are present, even liquid stools may cause
inflammation and infection of the anus. Your health care professional and
pharmacist are good resources for discussing the use of stool softeners as
hemorrhoid treatments.
Hemorrhoids Treatment: Sclerotherapy
Sclerotherapy
is one of the oldest forms of treatment for hemorrhoids. During sclerotherapy,
a liquid (phenol or quinine urea) is injected into the base of the hemorrhoid.
The veins
thrombose, inflammation sets in, and ultimately scarring takes place.
Ultimately sclerotherapy causes the hemorrhoid to shrink. Pain may occur after
sclerotherapy, but usually subsides by the following day. Symptoms of
hemorrhoids frequently return after several years and may require further
treatment.
Hemorrhoids Treatment: Rubber Band Ligation
The principle
of ligation with rubber bands is to encircle the base of the hemorrhoidal clump
with a tight rubber band. The tissue cut off by the rubber band dies, and is
replaced by an ulcer that heals with scarring.
A similar
procedure was described in 460 BC by the Greek physician Hippocrates:
“And
hemorrhoids … you may treat by transfixing them with a needle and tying them
with very thick and woolen thread, for application, and do not foment until
they drop off, and always leave one behind; and when the patient recovers, let
him be put on a course of Hellebore.”
Rubber band
ligation can be used with first-, second-, and third-degree hemorrhoids, and
may be more effective than sclerotherapy. Symptoms frequently recur several
years later, but usually can be treated with further ligation.
The most common
complication of ligation is pain. However, bleeding one or two weeks after
ligation or bacterial infection in the tissues surrounding the hemorrhoids
(cellulitis) may occur.
Hemorrhoid Treatment:
Heat Coagulation
There are several
treatments that use heat to destroy hemorrhoidal tissue, and promote
inflammation and scarring, including
·
bipolar diathermy,
·
direct-current
electrotherapy, and
·
infrared photocoagulation.
Such procedures destroy
the tissues in and around the hemorrhoids and cause scar tissue to form. They
are used with first-, second-, and third-degree hemorrhoids. Pain is frequent,
though probably less frequent than with ligation, and bleeding occasionally
occurs. Other methods such as laser and radiowave ablation have been done.
Non-surgical treatments are usually done on hemorrhoids graded I to II and some
grade III; you should discuss the treatment and its projected outcome and
recurrence rates with your doctor.
Hemorrhoids Treatment: Surgery
The vast
majority of patients can manage their symptom-causing hemorrhoids with
non-surgical techniques. Non-operative treatment is preferred because it is
associated with less pain and fewer complications than operative treatment. It
is estimated that fewer than 10% of patients require surgery if the hemorrhoids
are treated early.
Surgical
removal of hemorrhoids, known as a hemorrhoidectomy or stapled
hemorrhoidectomy, is reserved for patients with third- or fourth-degree
hemorrhoids.
History of Hemorrhoid
Surgeries
Surgery for
hemorrhoids dates back to ancient times. Ancient Greeks, Romans, and Indians
all described surgeries used to alleviate the pain and discomfort of enlarged
hemorrhoids. These procedures improved greatly by the 13th century, and
surgical treatments accelerated once again in the 19th century.
How to Get Rid of Hemorrhoids: Hemorrhoidectomy
During a
hemorrhoidectomy, the internal hemorrhoids and external hemorrhoids are cut
out. The wounds left by the removal may be sutured (stitched) together (closed
technique) or left open (open technique). The results with both techniques are
similar.
A proctoplasty,
which extends the removal of tissue higher into the anal canal so that
redundant or prolapsing anal lining is also removed, is sometimes also performed.
Postsurgical pain is a major problem with hemorrhoidectomy, and potent pain
medications (narcotics) are usually required.
How to Get Rid of
Hemorrhoids: Stapled Hemorrhoidectomy
The stapled
hemorrhoidectomy is a newer surgical technique that is rapidly becoming the
treatment of choice for third-degree hemorrhoids. This surgery does not remove
the hemorrhoids, but rather the expanded hemorrhoidal supporting tissue that
has allowed the hemorrhoids to prolapse downward.
This procedure involves
several steps:
·
A circular, hollow tube
is inserted into the anal canal and a suture (a long thread) is placed through
it and woven circumferentially within the anal canal above the internal
hemorrhoids.
·
The ends of the suture
are brought out of the anus through the hollow tube.
·
The stapler is placed
through the hollow tube and the ends of the suture are pulled, expanding the
hemorrhoidal supporting tissue into the jaws of the stapler.
·
The hemorrhoidal
cushions are pulled back up into their normal position within the anal canal.
·
The stapler is then
fired, cutting off the circumferential ring of expanded hemorrhoidal supporting
tissue trapped within the stapler.
·
At the same time staples
bring together the upper and lower edges of the cut tissue.
Stapled hemorrhoidectomy
is less painful and faster than a traditional hemorrhoidectomy. It takes
approximately 30 minutes to perform.
Hemorrhoids: Prevention
The best way to
prevent hemorrhoids is to keep your stools soft so they are easy to pass and
don't require straining. Eating a high-fiber diet and drinking plenty of fluids
(six to eight glasses each day) can help you stay regular and keep your stools
soft, and may reduce constipation and the need to strain on the toilet,
lowering your risk of developing new hemorrhoids.
Reviewed by Charles Patrick Davis, MD, PhD on Monday,
December 05, 2016
How to Get Rid of
Hemorrhoids: Causes and Treatments
This tool does not provide medical advice
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