Hemorrhoids are a common condition that affects a large part of the population at some point in their lives. Hemorrhoids are cushion-like structures found in the anal canal, in a normal state. There are usually three of them and they coincide with the corresponding hemorrhoidal vein.
It is postulated that they have some function in assisting anal continence. When these structures develop abnormally giving problems of bleeding, pain and itching, among others, is when we speak of a person suffering from hemorrhoids. Therefore, specialists in Coloproctology demystify the concept that many people have that hemorrhoids are like anal varicose veins.
Causes of hemorrhoids
- Constipation is the main cause of hemorrhoids. Indeed, people suffering from constipation suffer from increased pressure in the anal region leading to dilation of the hemorrhoidal veins which, over time, cause hemorrhoids.
- Another factor is pregnancy. The increased pressure in the pelvis leads to increased pressure in the hemorrhoidal veins. Although this situation is reversible, in most cases it is not.
- In recent times, there have been cases of hemorrhoids in people who practice anal sex. It is easy to understand that repeated trauma to the anal area can dilate these veins.
- Dietary factors do not cause hemorrhoids, but they can be triggers. This includes spicy foods, alcoholic beverages, coffee or sweet foods.
Types of hemorrhoids
There are two types of hemorrhoids: internal hemorrhoids and external hemorrhoids.
Internal hemorrhoids are located inside the anal canal and are covered with mucosa, while external hemorrhoids are located around the anal orifice and are covered with skin. This differentiation is not only anatomical, but there may be variations in their mode of presentation as will be seen later.
Symptoms of hemorrhoids
The main symptom of hemorrhoids is bleeding. It is usually in variable quantity, of bright red blood and coincides with bowel movements.
Pain is frequent, ranging from continuous discomfort to pain of varying intensity, which increases with bowel movements.
Occasionally, the so-called hemorrhoidal prolapse or outflow of hemorrhoidal tissue through the anal orifice during the effort of deposition may appear.
Another symptom, sometimes annoying, is anal itching and the presence of some secretions. Rectal tenesmus, which is the sensation of anal occupation with a desire for exoneration, can occur in large hemorrhoids.
As a general rule, internal hemorrhoids cause bleeding and prolapse, while external hemorrhoids are more painful and itchy.
Hemorrhoids: treatment
The treatment of hemorrhoids depends on their degree and the discomfort they cause. The grade of hemorrhoids refers to the degree of prolapse during defecation: from minimal (grade I hemorrhoids) to permanent hemorrhoidal prolapse (grade IV hemorrhoids). In cases of grade I and II, normalization of bowel movements by means of a fiber diet and/or laxatives is usually sufficient.
In grade III hemorrhoids, apart from the above, ligation with elastic bands and/or infrared coagulation is necessary.
Surgery is reserved for grade IV hemorrhoids or in those cases with lower grade but with associated pathology: anal fissure, internal and external hemorrhoids or others.
The surgical intervention consists in the removal of hemorrhoids, associating the solution of associated pathologies, especially anal fissure. This can be done by conventional surgery or by CO2 laser technique. This laser technique is a high intensity light energy that allows the dissection of hemorrhoids in a more precise way, with less damage to the surrounding healthy tissues, resulting in less postoperative pain and a faster recovery.
There has always been talk of the extremely painful postoperative period following hemorrhoid surgery. Currently, through careful technique, the use of lasers and the prescription of powerful analgesics, postoperative pain is controlled. The worst moments are the immediate postoperative period (first 24-48 hours) and the first bowel movement. After five to seven days, discomfort improves and patients can be discharged from work between the second and third postoperative week.
Postoperative complications such as bleeding, incontinence or infection may occur. However, these are very rare.