What are hemorrhoids?
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Hemorrhoids, also called piles, are swollen veins in your anus and lower rectum, similar to varicose veins. Hemorrhoids can develop inside the rectum (internal hemorrhoids) or under the skin around the anus (external hemorrhoids). They do cause pain, and severe discomfort depending on how bad your case is.
Nearly three out of four adults will have hemorrhoids from time to time. Hemorrhoids have a number of causes, but often the cause is unknown.
External hemorrhoids are the most common and most troublesome. Hemorrhoids cause pain, severe itching, and difficulty sitting. Fortunately, they are treatable.
Fortunately, effective options are available to treat hemorrhoids. Many people get relief from home treatments and lifestyle changes. We will be covering the causes, medical treatments, and other ways of treating the swelling.
Four Types of Hemorrhoids
These are under the skin around your anus. Signs and symptoms might include:
- Itching or irritation in your anal region
- Pain or discomfort
- Swelling around your anus
External hemorrhoids occur on your anus, directly on the surface of where your bowel movements come out. They’re not always visible but are sometimes seen as lumps on the anal surface.
External hemorrhoids aren’t usually a serious medical issue. But see your doctor if they cause pain or discomfort that interrupts your daily life.
The symptoms of external hemorrhoids are essentially the same as those of internal ones. But since they’re located on the outside of your rectal area, you may feel more pain or discomfort when you sit down, do physical activities, or have a bowel movement.
They’re also easier to see when they swell, and the bluish color of the dilated veins is visible beneath the anal skin surface.
See your doctor if an external hemorrhoid causes you pain or discomfort.
Internal hemorrhoids lie inside the rectum. You usually can’t see or feel them, and they rarely cause discomfort. But straining or irritation when passing stool can cause:
- Painless bleeding during bowel movements. You might notice small amounts of bright red blood on your toilet tissue or in the toilet.
- Hemorrhoid to push through the anal opening (prolapsed or protruding hemorrhoid), resulting in pain and irritation.
They can’t always be seen because they’re too deep in your anus to be visible. Internal hemorrhoids aren’t normally serious and tend to go away on their own.
Sometimes internal hemorrhoids can swell and stick out of your anus. This is known as a prolapsed hemorrhoid.
There aren’t any nerves that detect pain in your rectum, so you may not always notice internal hemorrhoids. But they can cause symptoms if they grow larger, including:
- pain or discomfort
- noticeable lumps or swelling near your anus
Feces traveling through your rectum can also irritate internal hemorrhoids. This can cause bleeding that you may notice on your toilet tissue.
See your doctor if an internal hemorrhoid causes you a lot of pain or discomfort.
A prolapsed hemorrhoid occurs when internal hemorrhoids swell and stick out of your anus. A doctor may assign a grade to a prolapsed hemorrhoid based on how far it sticks out:
- Grade one: Not prolapsed at all.
- Grade two: Prolapsed, but will retract by themselves. These may only prolapse when you put pressure on your anal or rectal area, such as by straining when you have a bowel movement, and then return to their normal position afterward.
- Grade three: Prolapsed and you have to push it back in yourself. These may need to be treated so that they don’t become too painful or infected.
- Grade four: Prolapsed, and you can’t push it back in without a lot of pain. These will usually need to be treated to prevent pain, discomfort, or further complications.
Prolapsed hemorrhoids look like swollen red lumps or bumps outside your anus. You may be able to see them if you use a mirror to examine this area. Prolapsed hemorrhoids may have no other symptom than the protrusion, or they may cause pain or discomfort, itchiness, or burning.
In some cases, you may need surgical treatment to remove or correct a prolapsed hemorrhoid so that they don’t cause you any pain or complications.
If blood pools in the external hemorrhoid and forms a clot (thrombus), it can result in:
- Severe pain
- A hard lump near your anus
A thrombosed hemorrhoid contains a blood clot (thrombosis) within the hemorrhoid tissue. They may appear as lumps or swelling around your anus.
Thrombosed hemorrhoids are essentially a complication of hemorrhoids, in which a blood clot forms.
Blood clots can happen in both internal and external hemorrhoids, and the symptoms may include:
- intense pain and itchiness
- swelling and redness
- bluish color around the area of the hemorrhoid
See your doctor as soon as possible if you notice increasing pain, itchiness, or inflammation around your rectal and anal area. Thrombosed hemorrhoids need to be treated quickly to prevent complications from a lack of blood supply to your anal or rectal tissue.
What causes hemorrhoids?
Anything that puts pressure or strain on your anus or rectum can cause the veins to dilate. Some common causes and risk factors include:
- being overweight
- straining while having a bowel movement
- having diarrhea or constipation
- not having regular bowel movements
- sitting for a long time
- being pregnant or giving birth
- Not eating enough fiber in your diet
- using too many laxatives
- getting older, as tissues lose strength and elasticity as you age
Internal hemorrhoids can become prolapsed hemorrhoids if you continue to do any of these things that may have caused your hemorrhoid in the first place.
External hemorrhoids are more likely to become thrombosed, although there’s no specific risk factor known to cause this to happen.
When to see your doctor?
See your doctor if you start to notice pain and discomfort around your anus, especially when you sit or have a bowel movement.
Seek emergency medical attention if you notice any drastic worsening of your symptoms or any of these other symptoms, especially if they’re interfering with your daily activities:
- feeling extremely itchy around your anus
- burning around your anus
- noticeable lumps or swelling near your anus
- bluish discoloration of your skin near areas of swelling
How are they diagnosed?
Your doctor may perform one or more tests to examine the anal or rectal area for hemorrhoids:
- Looking at the anus or rectum for visible signs of hemorrhoids. A doctor should be able to easily diagnose an external or prolapsed internal hemorrhoid through a visual examination.
- Doing a digital rectal exam. The doctor will insert a finger covered with a lubricated glove into the anus or rectum to feel for signs of hemorrhoids with the fingers.
- Using an imaging scope to look at the inside of your rectum to examine for internal hemorrhoids. This usually consists of inserting a thin tube with the light on the end into your rectum. Tools used for this diagnosis may include an anoscope or sigmoidoscope.
How are they treated?
Treatment may vary by type, degree of prolapse, or severity of your symptoms.
Here are some home remedies to try if your symptoms aren’t too severe:
- Use an over-the-counter hemorrhoid cream or witch hazel solution to relieve swelling and pain.
- Take pain medications, such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol), to reduce pain.
- Use a cold compress (an ice pack or even just a frozen vegetable bag wrapped in a thin towel) to relieve pain and swelling.
- Sit in warm water for 10 to 15 minutes. You can either fill a bathtub with warm water or use a sitz bath.
In some cases, your hemorrhoids may need to be removed to prevent pain and long-term complications. Some procedures for removal include:
Possible complications of hemorrhoids
Complications of hemorrhoids are rare. If they do happen, they may include:
- Strangulation. Arteries feeding fresh blood to the hemorrhoid can become blocked, preventing blood supply from reaching the hemorrhoid. This can cause extremely intense and unbearable pain.
- Anemia. If hemorrhoids bleed too much, they can deprive your red blood cells of oxygen. This can cause fatigue, shortness of breath, headaches, and dizziness as the blood supply carries less oxygen around your body.
- Prolapse. Prolapsed hemorrhoids can cause pain or discomfort when you sit or pass a bowel movement.
- Blood clots. Thrombosis is more likely to be a complication of an external hemorrhoid. Blood clots can cause increasingly unbearable pain and itching.
- Infection. Bacteria can get into hemorrhoids that are bleeding and infect the tissue. Untreated infections can sometimes cause serious complications, such as tissue death, abscesses, and fever.
To prevent or avoid worsening hemorrhoids, avoid straining during a bowel movement. Also, try to increase your water intake. Drinking enough water can keep your stool from hardening.
Use the restroom as soon as you feel a bowel movement coming on to prevent hemorrhoids from developing. Exercise regularly to prevent becoming constipated and don’t sit for long periods, especially on hard surfaces like concrete or tile.
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
Dietary fiber helps create bulk in the intestines, which softens the stool, making it easier to pass.
Complications from hemorrhoids are rare but can include:
- Blood clots in the swollen vein
- iron-deficiency anemia caused by blood loss
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Hemorrhoids can be uncomfortable or even painful, but most of the time you won’t experience any noticeable symptoms, and complications are very rare.
Internal or external hemorrhoids that don’t prolapse or thrombose are more likely to heal without causing any symptoms or complications. Prolapsed and thrombosed hemorrhoids are much more likely to cause discomfort or increase your risk of complications.
Seek emergency medical attention if your hemorrhoids cause pain and discomfort, or if you notice any symptoms like bleeding or prolapse. Hemorrhoids that are treated quickly have a better chance of healing without causing any further complications.
Home Remedies And Tips To Fight Hemorrhoids Naturally
Soak In A Warm Sitz Bath
Sitting in a warm bath that covers your hips and buttocks can help when you have hemorrhoids. This kind of bath is known as a hip or “sitz” bath (from the German word “sitzen,” meaning “to sit”). Soak in some warm water 2 to 3 times a day. You can use special tubs meant for this which fit over your toilet seat. Also, a 20-minute sitz bath is recommended right after you have a bowel movement. Remember not to wipe hard afterward. Instead, gently pat the area dry to avoid irritating your hemorrhoids.
Try Glycerin And Epsom Salts
These two commonly available ingredients can help you deal with painful hemorrhoids, fighting the inflammation and burning sensation. Mix equal quantities of glycerin and Epsom salts and apply them to the affected area with a gauze pad. Leave it on for about 15 to 20 minutes to ease the pain. Repeat this process every 4–6 hours if needed. You can also add this mixture to the sitz bath.
Use An Ice Pack
Placing an ice pack against the affected area for a few minutes can help reduce swelling and pain.
Plain old petroleum jelly can also help with hemorrhoids by forming a protective barrier. Apply it over the anal area to stop further damage and reduce itching.
Wear Cotton Underwear
Cotton underwear can prevent moisture from building up and irritating your hemorrhoids. You should also wear loose clothing that allows easy movement to ease pressure on your anal area.
Avoid Putting Unnecessary Pressure On The Anal Area
If you have hemorrhoids, it’s a good idea to avoid putting pressure on the affected area. For instance, you can try sitting on a cushion or an inflatable ring if you need to be seated for a while. It’s also best to avoid the strain caused by lifting heavy objects. And be careful not to hold your breath when you lift things.
Bed rest for a day or so can help take off pressure from irritated and inflamed veins. Sleeping on your stomach with a pillow placed beneath your hips to elevate them can reduce swelling. If you’re pregnant, sleeping on your side may be a better and more comfortable position, though.
Fight Constipation With Fiber, Water, Probiotics, And Exercise
Unnecessary straining while having a bowel movement can aggravate your hemorrhoids. The right diet and exercise can help keep constipation at bay.
Drinking water can soften stools and reduce constipation and straining during a bowel movement. Get in about 6 to 8 glasses of water in a day.
Use a teabag for hemorrhoid relief
External hemorrhoids can be soothed by applying a warm, wet tea bag. The tannic acid in the tea will help reduce swelling, ease the pain, and promote blood clotting to stop the bleeding.
Aloe vera is an herbal supplement that has many medicinal uses. Due to its astringent and wound-healing properties, it has gained favor as an herbal remedy for hemorrhoids when applied directly to the inflamed area. Its ability to soften stools when ingested makes it a double-edged sword in the battle against hemorrhoids.
The active ingredient in butcher’s broom, ruscogenin, helps to tone and reduce the inflammation in blood vessels. It also helps strengthen the vein and capillary walls to reduce irritation and rupture. Studies have shown that this herb helps facilitate the movement of blood out of the legs and back toward the heart. These properties make Butcher’s broom one of the several herbs for natural hemorrhoid treatment.
Bilberry is another herbal supplement for natural hemorrhoid relief that works to strengthen the vein and capillary walls. As a tonic for the blood vessels, it helps to keep the blood moving through the vessels and reduces the chance of inflammation and rupture.
Horse chestnut is another of the herbal remedies for hemorrhoids that act as a vasoconstrictor and venotonic. It also helps to stop the enzymes that destroy damaged veins. Increasing the tone and reducing the rate of breakdown of these veins decreases the inflammation and the loss of strength in these vessels.
Witch hazel is a great treatment for the painful burning and itching associated with hemorrhoids. It is a cooling and soothing astringent. It helps to temporarily relieve the pain when applied topically. The cooling sensation, along with a temporary reduction in the inflammation, provides immediate pain relief.
Psyllium falls under the category of constipation relief. The psyllium seeds absorb water in the stomach and intestines causing them to swell and help move waste along the lower intestinal tract. This constipation relief helps relieve the cause of the hemorrhoids, as well as many of the symptoms.
Other natural herbs have been used for hemorrhoid relief and treatment.
- Great mullein
- Gotu kola
- Ginkgo biloba
- St. John’s Wort
Before using any herbal treatments it is a good idea to consult with your doctor first.
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