What Causes Hemorrhoids?
Hemorrhoids are dilated veins that form in the anus or rectum. It is normal that the veins of the anal region swell slightly at the time of defecation. But unlike the normal veins, hemorrhoids remain dilated all the times. In this article, you will learn what causes hemorrhoid.
Approximately 1 adult in 2 over the age of 50 years is suffering from hemorrhoids. Constipation, pregnancy and the loss of tone of the tissues with age are the main causes. In pregnant women, hemorrhoid symptoms usually disappear after childbirth.
The symptoms are occasional and easily recognizable: itching near the anus, discomfort in sitting and bleeding when going to the toilet. Crisis of hemorrhoids takes a few days and then symptoms disappear.
Most people who suffer from hemorrhoids manage to relieve their symptoms with a variety of home remedies and with Over-the-counter medicines (OTC). Sometimes, hemorrhoids generate persistent pain or discomfort almost permanent. In these cases, medical treatment may be considered.
Types of hemorrhoids
There are 2 kinds of hemorrhoids:
External hemorrhoids appear under the skin at the opening of the anus. They can cause a swelling in the area. They are more sensitive than internal hemorrhoids, because there are more fiber sensory nerve in this region.
Internal hemorrhoids form in the anus or the lower part of the rectum. They form a small lump. They are classified according to their stage of evolution. They tend to progress from one level to the other if nothing is done to stop the progression.
- First stage of hemorrhoid: The hemorrhoid remains within the anus.
- Second stage of hemorrhoid: The hemorrhoid gets out of the anus at the time of defecation and returns to normal position to stop the effort.
- Third stage of hemorrhoid: The hemorrhoid must be put back gently with the fingers after defecation.
- Fourth stage of hemorrhoid: The hemorrhoid cannot be placed back inside of the anus.
Possible Complications Of Hemorrhoid
When discomfort or slight pain turns into intense pain, it is usually the sign that a blood clot has formed in a hemorrhoid. This is a thrombosis hemorrhoidal, painful, but safe. The symptoms normally subside in 1 or 2 weeks with the help of analgesics and stool softeners. After the resorption of the clot, it can form a small painless swelling at the anus (only in case of external hemorrhoids).
In rare cases, rectal (anal) ulceration may appear. It can also happen that significant blood loss results in anemia.
When to consult Doctor
It is recommended to consult a doctor without delay in case of anal bleeding, even if it is very intense. This symptom may be the sign of another type of condition of the anal region or a health problem more serious.
- Burning Sensation, itching or discomfort in the anal region
- Bleeding and mild pain at time of defecation
- Sensation that the inside of the rectum is swollen
- Oozing of mucus from the anus
- Exit through the anus protrusions bevome sensitive (only in the case of internal hemorrhoids the 2nd, 3rd or 4th degree)
People who are at risk to have hemorrhoid
- People with a close relative who suffers from hemorrhoids
- Pregnant women
- The women who have given birth by vaginal delivery
- People with cirrhosis of the liver
Hemorrhoid Risk factors
- Suffer from constipation or diarrhea on a regular basis
- Suffering from obesity
- Prolonged sitting on the toilet seat
- frequent lifting of heavy objects
- Practice of anal intercourse
How To Prevent Hemorrhoids
Basic preventive measures for hemorrhoids
Gradually increase the amount of fiber in your diet. It is the best prevention measure for hemorrhoid. Fruits, vegetables, cereals and whole grain breads are excellent sources of fiber. It is preferable to integrate them gradually to the diet. Fibers soften the stool and increase their volume which facilitates their evacuation. Improvement occurs in a few weeks. Drink enough water and other liquids during the day
Regular physical exercise
A twenty-minute walk per day at a good pace can stimulate the intestinal transit. Don’t stay seated for long hours.
The bowels move regularly. Do not delay the time to defecate. Do not stay sitting on the toilet seat longer than necessary (avoid reading). In this position, the muscles of the anus are released and cause an influx of blood.
Measures to prevent hemorrhoids recurrence
If necessary, take fiber supplements, such as psyllium (Metamucil®, Fibropur®, Prodiem®, etc) or other types of fibres (Fibramax®). They can be found in free sale in pharmacies. They can be taken long term without any problem. Ensure to drink a lot to avoid obstruction of the digestive tract.
Medical Treatment of Hemorrhoids
Tips and basic care for hemorrhoids are;
- Keep the anal area clean: take a bath or a shower on a daily basis. However, it is not necessary to use soap.
- In case of itching: Apply cold compresses on the anus for ten minutes for 3 or 4 times per day.
- In the case of a clot or of descent of hemorrhoids: Take a sitz bath in warm water for 10 to 15 minutes, 2 or 3 times a day to relieve the pain. Some pharmacies and specialty stores sell small bathrooms that you can install on the toilet. Do not add soap in the water. Dry gently and apply a powder unscented to keep the skin dry (for example, cornstarch or an antifungal powder).
- Wear cotton underwear.
- As long as the hemorrhoids are not cured, avoid drinks and foods that can irritate mucous membranes: Coffee (even decaffeinated), alcohol, mustard, hot pepper and other strong spices.
- Avoid lifting of heavy objects, this increases the pressure in the veins.
Changing Life Habits
In order to regularize the intestinal transit, doctors suggest to keep as far as possible the rules of hygiene and lifestyle habits described in the section on prevention.
Drugs for hemorrhoids
To relieve itching, you can use a product available over the counter: Ointment, cream or suppository. The majority of these products contain hydrocortisone or benzocaine. Specialty products are sold under the name Preparation H does not contain hydrocortisone or benzocaine, but rather of the shark liver oil. These products have little effect against the pain.
If the pain is troublesome or severe, it is possible to calm it down with a pain medication taken by mouth, such as acetaminophen (Tylenol®). You can also use an analgesic topical (applied locally). It is also possible to obtain by prescription an ointment made from nitroglycerin or nifedipine which relieves pain by reducing the pressure in the veins.
Do not use the medicinal product hydrocortisone or benzocaine for over a week, unless the doctor recommends it. In addition, do not use in case of local infection.
In case of pain related with hemorrhoids, avoid taking ibuprofen (Advil®, Motrin®) or aspirin can increase the bleeding.
For emergency treatment of external hemorrhoids
It is possible to relieve the acute pain caused by external hemorrhoids thrombosed (in which a clot of blood is formed) by surgery, under local anesthesia. A small area of skin around the anus is removed , including the affected veins.
The surgery must be performed within 72 hours after the onset of symptoms. Subsequently, the discomfort which is caused by the surgery may exceed the relief that it provides. It is the practice in some clinics and in hospital emergency departments.
Treatment of internal hemorrhoids
If the symptoms persist and affect quality of life, one or the other of the following interventions may be considered.
Rubber band ligation: This effective technique is the most commonly used but is not suitable for all cases. With the help of a device to ligate, a small elastic band is placed at the base of the vein to be dilated. Thus, the blood flow is blocked: the hemorrhoid shrinks and decomposes. It may be that there can be a slight bleeding 2 to 4 days after the procedure. There may be complications (pain, training of other hemorrhoids, infection, etc), but they are rare.
Coagulation: Hemorrhoids can also be eliminated by heat by directing infrared rays at the base of the vein that creates the bulge. The same effect can be obtained by using electric current.
Treatment sclerosing or sclerotherapy. The injection of a chemical at the base of the hemorrhoid will result in its curing.
Hemorrhoidectomy: Doctors usually have to choose this surgical procedure only when the hemorrhoids are large or that the other possible treatments have not been effective. This is Performed under general anesthesia or epidural. This method is more radical than the previous ones and reduces the risk of recurrence, but requires a longer recovery.