Hemorrhoids

TABLE OF CONTENTS:

1. What are hemorrhoids?
2. Prognosis
3. Symptoms of hemorrhoids
4. Medical tests
5. What causes hemorrhoids?
6. Prevention
7. Treatment
8. Medical specialist

What are hemorrhoids?

Also known as piles, hemorrhoids are primarily swollen veins that are located in the lower rectum and anus.

Although the specific origin of hemorrhoids is unknown, it is a problem that affects a large number of people. In fact, it is estimated that three out of four adults may suffer from hemorrhoids at some point in their lives.

There are two variations of this pathology: external and internal. On the one hand, external hemorrhoids generate protrusions in the ring of the anus on the external side, so they are easier to diagnose and cause pain when sitting, as well as traces of blood when defecating. On the other hand, internal hemorrhoids occur inside the anus causing bleeding in the stool and itching in the anal region.

Finally, there are also thrombosed hemorrhoids, which form a clot and can cause severe pain, swelling and the appearance of a lump near the anus.

Prognosis of hemorrhoids

Hemorrhoids or piles are not a serious disease per se. It is a disease that is very prevalent, but whose symptoms do not involve more than discomfort, itching or bleeding and which does not develop into a more serious disease.

The blood present in hemorrhoids can lead to clot formation and death of the surrounding tissue. In these cases, it is necessary to perform hemorrhoid surgery, also known as hemorrhoidectomy, which is used in cases of severe bleeding or prolapse that have not responded positively to other therapies.

Rarely, heavy bleeding may also occur, and prolonged blood loss may cause anemia. In the event that the blood supply to the internal hemorrhoid is cut off, strangulation may occur, an event that causes extreme pain.

Symptoms of hemorrhoids

The signs and symptoms of hemorrhoids depend on the location of the hemorrhoid. If the location of the hemorrhoid is inside the rectum, we speak of internal hemorrhoids, which are usually asymptomatic. However, when straining or the irritation that occurs in the intestines during bowel movements can damage the external part of the hemorrhoid and cause bleeding.

Occasionally, straining can cause the internal hemorrhoid to protrude from the anus, which can cause irritation and pain.

If the hemorrhoid is external, they are more sensitive to touch, may hurt when sitting, itch and bleed.

In the case of thrombosed hemorrhoids may form a clot, severe pain and swelling.

Thus, in general the symptoms of hemorrhoids are as follows:

• Itching or irritation in the anal area
• Pain and/or discomfort
• Swelling around the anus
• Painless bleeding during bowel movements, with red stains on the toilet paper or in the toilet bowl
• Appearance of a lump near the anus, which may be tender to the touch and/or cause pain

Medical tests for hemorrhoids

When diagnosing the presence of hemorrhoids, a specialist can diagnose external hemorrhoids by simply looking at the affected area. Tests to diagnose internal hemorrhoids may include anal and rectal examination.

• Digital exam: During a digital rectal exam, the specialist will insert a lubricated gloved finger through the anus, and if anything unusual is felt, it may or may not indicate the need for further testing.
• Visual inspection: the physician may limit himself to examining the last part of the colon and rectum by means of an anoscope.

In turn, the specialist will need to completely analyze the colon by colonoscopy in the following cases:

• There are signs of disease of the digestive system.
• There are risk factors for colorectal cancer.
• The patient is middle-aged and has not had a colonoscopy for some time.

What are the causes of hemorrhoids?

Around the anus there are veins that tend to spread with pressure and may increase in size and swell. In this case, when the veins swell they become hemorrhoids, and these can develop due to an increase in pressure in the lower rectum because of the following:

• The patient is obese
• The patient is pregnant
• Follows a low-fiber diet
• The patient has had anal intercourse
• The patient is constipated
• The patient suffers from chronic diarrhea
• The patient feels strained during bowel movements.
• The patient sits for long periods of time on the toilet.

Can hemorrhoids be prevented?

The best way to try to prevent the appearance of hemorrhoids is for the patient to always try to have soft bowel movements so that they can be evacuated easily.

To prevent hemorrhoids and reduce their symptoms, you can follow a series of tips:

• Eat foods rich in fiber. Foods such as fruits, vegetables or cereals contain fiber, which softens the stool and increases its volume, thus avoiding the straining that can cause hemorrhoids.
• Drink plenty of fluids
• Consuming fiber supplements: in case the patient does not ingest enough fiber naturally, he/she can get it with supplements. In the case of taking them, you should drink plenty of water, otherwise constipation may worsen.
• Go to the bathroom as soon as you feel the need.
• Exercise: sport helps to avoid constipation and helps to lose weight.
• Avoid sitting for long periods of time
• Do not exert too much force when trying to have a bowel movement

Treatments for hemorrhoids

There are several ways to approach the treatment of hemorrhoids. On the one hand there are home remedies, which are mainly the following:

• Eating foods rich in fiber
• Using topical treatments
• Taking a warm bath
• Keeping the anal area sanitized and clean.
• Do not use dry toilet paper
• Applying cold reduces inflammation

If home remedies do not work, the patient should see a specialist.

In cases where hemorrhoids only cause mild discomfort, the specialist may recommend the application of ointments, suppositories or creams that relieve pain.

In the event that a clot occurs inside a hemorrhoid, it must be drained with an incision.

There are also minimally invasive procedures that can be performed on an outpatient basis:

• Rubber band ligation: two rubber bands are placed around the base of an internal hemorrhoid to cut off its circulation. The hemorrhoid dries up and falls off within a week. It can be uncomfortable and cause bleeding, but is usually not serious.
• Injection (sclerotherapy): the specialist injects a chemical solution into the hemorrhoid tissue to shrink it.
• Coagulation: coagulation techniques use heat or infrared laser.

Finally, there are surgical procedures, which are used only in cases where other procedures have not been successful.

• Hemorrhoid removal: the process is known as hemorrhoidectomy, which is usually performed under local anesthesia.

This is the most effective way to treat severe hemorrhoids, and may involve temporary difficulty emptying the bladder and infecting the urinary tract.

• Hemorrhoid stapling: This process blocks blood flow to the hemorrhoidal tissue and is usually used only for internal hemorrhoids. It is a less painful treatment than conventional hemorrhoidectomy, and allows for a faster recovery.

Which specialist treats hemorrhoids?

There are several specialists who can study, diagnose and treat hemorrhoids. The specialist in General Surgery, Digestive System or Proctology are the most qualified specialists to treat hemorrhoids.