WHAT ARE HEMORRHOIDS

Hemorrhoids are enlarged bulging blood vessels in and about the anus and rectum.  These are often described as varicose veins of the anus and rectum.  There are two kinds of hemorrhoids, internal and external.

Internal (inside) hemorrhoids develop within the anus beneath the lining.  Painless bleeding and protrusion during bowel movements are the most common symptoms.  However, an internal hemorrhoid can cause severe pain if it is completely “prolapsed” – protruding from the anal opening – and cannot be pushed back inside.

External (outside) hemorrhoids develop near the anus and are covered by very sensitive skin.  If a blood clot develops in one of them (thrombosed hemorrhoid), a painful swelling may occur.  An external hemorrhoid feels like a hard, sensitive lump.  It bleeds only if ruptured.
 

          WHAT CAUSES HEMORRHOIDS

The exact cause of hemorrhoids is unknown.  Contributing factors include: Aging, chronic constipation or diarrhea, pregnancy, heredity, faulty bowel function due to overuse of laxative or enemas, straining during bowel movements, or spending long periods of time on the toilet (e.g., reading).
 
 
 

          SYMPTOMS OF HEMORRHOIDS:             Bleeding during bowel movements
                                                                            Protrusion during bowel movements
                                                                            Itching in the anal area
                                                                            Pain
                                                                            Sensitive lump(s)
 
 
 

          TREATMENT OF HEMORRHOIDS

Mild cases of hemorrhoids can be relieved frequently by increasing the amount of fiber and fluids in the diet.  Eliminating excessive straining reduces the pressure on hemorrhoids and helps prevent them from protruding.  A sitz bath can also provide some relief.  In cases of a thrombosed hemorrhoid, removal of the clot through a small incision under local anesthetic generally provides relief.

Rubber band ligation is used to treat internal hemorrhoids.  A small rubber band is placed over the hemorrhoid cutting off its blood supply.  The hemorrhoid and the band fall off in a few days.  The wound usually heals in a week or two.  The procedure sometimes produces a pressure feeling and light bleeding.

Sclerotherapy, or injection of medication, can be used on internal hemorrhoids that do not protrude.  This causes the hemorrhoid to shrivel up.

Surgical removal of hemorrhoids (hemorrhoidectomy) is the best method for permanent removal of hemorrhoids.  This is necessary when clots repeatedly from in external hemorrhoids, ligation fails to treat internal hemorrhoids, there is persistent bleeding, or a protruding hemorrhoid cannot be reduced.  A hemorrhoidectomy removes excess tissue that causes the bleeding and protrusion.  It is done under anesthesia.  Laser hemorrhoidectomy does not offer any advantage over standard operative techniques.  It is also quite expensive and, contrary to popular belief, no less painful.

Cryotherapy, popular 20 years ago, consists of freezing hemorrhoidal tissue.  This is not recommended for hemorrhoids because it is very painful.