Hemorrhoidal tissue is a normal component of the human anatomy. It is a thickening of the submucosa of the anal canal (end of the rectum) that contains a combination of venous and arterial vessels, smooth musculature and supportive tissue that acts as a cushion and contributes to a more effective closure of the anus. When this tissue hypertrophies, prolapses externally and produces a more or less severe symptomatology, it is when it is called hemorrhoids.
Types of hemorrhoids
On the one hand, external hemorrhoids, visible around the anus and covered with skin, and on the other hand, internal hemorrhoids, not visible because they are located above the anus, inside the rectum and covered with mucosa.
Hemorrhoids become a health problem when they cause symptoms to the patient. The most common and initial is bleeding but they can later evolve and cause pain, itching, staining of underwear, thrombosis.
Internal hemorrhoids are classified into 4 grades:
– Grade I: when defecating there is only bleeding.
– Grade II: they protrude during defecation but reintroduce spontaneously when the defecatory effort is stopped.
– Grade III: protrude on defecation but must be manually reintroduced.
– Grade IV: they are irreducible and are always prolapsed.
Recommended habits
There is no single treatment for hemorrhoids, nor should all patients with hemorrhoids undergo surgery. Depending on the degree of hemorrhoids there are different therapeutic options.
In grades I, II and in the initial III, non-surgical treatment is performed, which consists of following one or several measures at a time.
First of all, dietary measures such as ingesting a minimum amount of fiber (fruit, vegetables, additives such as plantago, ovata…), drinking plenty of fluids (1.5- 2 liters/day) and eliminating foods with spices, spicy foods, alcohol and coffee. On the other hand, do not stay more than 10 minutes in the toilet and do sitz baths with warm-hot water (3 or 4 a day with a duration of about 5 minutes).
These measures can be completed with the application of topical ointments that serve to reduce discomfort and inflammation. However, it should be borne in mind that this type of product does not cure, in no case should it be applied on a regular basis since its continued use can cause anal dermatitis and skin atrophy. In addition, venotonic substances can be used, but these are also purely symptomatic, not curative (Daflon, venoruton…).
In the case of lower grade hemorrhoids (I and II) there are a series of non-surgical methods that, performed in several sessions in the doctor’s office, achieve the reduction of hemorrhoids with little discomfort. These methods include: injection of sclerosing substances or coagulation with either infrared or non-surgical laser. Currently the most commonly used method is elastic band ligation.