The signs and symptoms of hemorrhoids have a significant impact on the sufferer’s work and daily life.
In fact, it is estimated that up to 35% of the population between the ages of 25 and 50 and 50% of those over the age of 50 suffer from hemorrhoids.
Normally, hemorrhoids are not serious, although if they are not treated properly they can generate various complications, such as rectorrhagia -which can include anemia-, thrombosis, hemorrhoidal prolapse, itching and even anal pain, which can lead to a significant reduction in quality of life.
It should be noted that hemorrhoids are not a simple dilatation of the veins in the anal area, but are a set of anatomical structures formed by veins, mucosa, submucosa, elastic tissue, connective tissue, arteriovenous fistulas, arteries, etc. These structures form a kind of vascular layer along the anal canal.
Classification of hemorrhoids
Depending on their location, hemorrhoids are classified into internal hemorrhoids and external hemorrhoids.
- External hemorrhoids: this type are located below the dentate line (i.e. the anorectal, pectineal or crypt line) and are covered by a squamous epithelium. They usually appear as one or several nodules, and are usually asymptomatic, although they may occasionally cause itching and pain. In the case of external hemorrhoidal thromboses there is intense pain and anal lump.
- Internal hemorrhoids: internal hemorrhoids are located above the aforementioned dentate line and are covered by mucosa.
Depending on their development and the existence or not of prolapse, hemorrhoids can be classified into four grades.
- Grade I: initial internal formations with no external prolapse. It is identified by anuscopy.
- Grade II: there is an initial external prolapse that spontaneously reintroduces with straining during defecation.
- Grade III: there is an external prolapse during defecation that can be reintroduced with manual assistance.
- Grade IV: there is an external prolapse that is permanent. This is a prolapse that is difficult to reduce and can be reproduced after reduction.
Symptoms of hemorrhoids
Hemorrhoids can cause symptoms when there are structural alterations of the hemorrhoidal tissue, i.e., dilatation and ingurgitation and/or in the adjacent supporting tissues due to multiple causes, some of which would be:
- Constipation
- Effort and bad habits in defecation.
- Diet
- Sedentary lifestyle
- Prolonged standing
- Pregnancy
- Diarrhea
- Genetic inheritance
Symptoms of grade I hemorrhoids
- Anal itching
- Anal discomfort
- Rectorrhagia
- Anal itching
Symptoms of grade II, III and IV hemorrhoids
- Anal itching
- Anal discomfort
- Rectorrhagia
- Prolapse
In the case of internal hemorrhoids that have prolapsed and strangulated there is continuous pain and a strange bulky formation in the anus, although they are rarely manifested by thrombosis.
Hygienic-dietary preventive measures
There are a number of measures that can prevent and reduce hemorrhoidal pain, prolapse and bleeding.
- Treat constipation
- Eat a diet high in fiber and with adequate fluid intake.
- Avoiding spicy products, spices, alcohol and coffee.
- Sitz baths with cold water or local application of ice.
- Increased daily physical activity, but avoiding heavy exertion.
- Colon hydrotherapy
For more information, consult a specialist in General Surgery.