Hemorrhoids Treatment and Prevention
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The term hemorrhoids refers to a condition in
which the veins around the anus or lower rectum
are swollen and inflamed.Hemorrhoids may
result from straining to move stool. Other
contributing factors include pregnancy, aging,
chronic constipation or diarrhea, and anal
intercourse.
Hemorrhoids
are either inside the anus (internal) or under
the skin around the anus (external).
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Many anorectal problems, including
fissures, fistulae, abscesses, or irritation and
itching (pruritus ani), have similar symptoms and
are incorrectly referred to as hemorrhoids. Hemorrhoids usually
are not dangerous or life threatening. In most
cases, hemorrhoidal symptoms will go away within
a few days.
Although
many people have hemorrhoids, not all experience
symptoms. The most common symptom of internal
hemorrhoids is bright red blood covering the
stool, on toilet paper, or in the toilet bowl.
However, an internal hemorrhoid may protrude
through the anus outside the body, becoming
irritated and painful. This is known as a
protruding hemorrhoid.
Symptoms of
external hemorrhoids may include painful swelling
or a hard lump around the anus that results when
a blood clot forms. This condition is known as a
thrombosed external hemorrhoid.
In
addition, excessive straining, rubbing, or
cleaning around the anus may cause irritation
with bleeding and/or itching, which may produce a
vicious cycle of symptoms. Draining mucus may
also cause itching.
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Hemorrhoids are very common in both
men and women. About half of the population have
hemorrhoids by age 50. Hemorrhoids are also
common among pregnant women. The pressure of the
fetus in the abdomen, as well as hormonal
changes, cause the hemorrhoidal vessels to
enlarge. These vessels are also placed under
severe pressure during childbirth. For most
women, however, hemorrhoids caused by pregnancy
are a temporary problem.
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A thorough evaluation and proper
diagnosis by the doctor is important any time
bleeding from the rectum or blood in the stool
occurs. Bleeding may also be a symptom of other
digestive diseases, including colorectal cancer. The doctor will
examine the anus and rectum to look for swollen
blood vessels that indicate hemorrhoids and will
also perform a digital rectal exam with a gloved,
lubricated finger to feel for abnormalities.
Closer
evaluation of the rectum for hemorrhoids requires
an exam with an anoscope, a hollow, lighted tube
useful for viewing internal hemorrhoids, or a
proctoscope, useful for more completely examining
the entire rectum.
To rule out
other causes of gastrointestinal bleeding, the
doctor may examine the rectum and lower colon
(sigmoid) with sigmoidoscopy or the entire colon
with colonoscopy. Sigmoidoscopy and colonoscopy
are diagnostic procedures that also involve the
use of lighted, flexible tubes inserted through
the rectum.
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Medical treatment of hemorrhoids is
aimed initially at relieving symptoms. Measures
to reduce symptoms include
- Warm
tub baths several times a day in plain,
warm water for about 10 minutes.
- Application
of a hemorroidal cream or suppository to
the affected area for a limited time.
Preventing
of the recurrence of hemorrhoids will require
relieving the pressure and straining of
constipation. Doctors will often recommend
increasing fiber and fluids in the diet. Eating
the right amount of fiber and drinking six to
eight glasses of fluid (not alcohol) result in
softer, bulkier stools. A softer stool makes
emptying the bowels easier and lessens the
pressure on hemorrhoids caused by straining.
Eliminating straining also helps prevent the
hemorrhoids from protruding.
Good
sources of fiber are fruits, vegetables, and
whole grains. In addition, doctors may suggest a
bulk stool softener or a fiber supplement such as
psyllium (Metamucil) or methylcellulose
(Citrucel).
In some
cases, hemorrhoids must be treated endoscopically
or surgically. These methods are used to shrink
and destroy the hemorrhoidal tissue. The doctor
will perform the procedure during an office or
hospital visit.
A number of
methods may be used to remove or reduce the size
of internal hemorrhoids. These techniques include
- Rubber
band ligation. A rubber band is
placed around the base of the hemorrhoid
inside the rectum. The band cuts off
circulation, and the hemorrhoid withers
away within a few days.
- Sclerotherapy.
A chemical solution is injected around
the blood vessel to shrink the
hemorrhoid.
- Infrared
coagulation. A special device is used
to burn hemorrhoidal tissue.
- Hemorrhoidectomy.
Occasionally, extensive or severe
internal or external hemorrhoids may
require removal by surgery known as
hemorrhoidectomy.
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The best way to prevent hemorrhoids
is to keep stools soft so they pass easily, thus
decreasing pressure and straining, and to empty
bowels as soon as possible after the urge occurs.
Exercise, including walking, and increased fiber
in the diet help reduce constipation and
straining by producing stools that are softer and
easier to pass. The U.S. Government does not endorse
or favor any specific commercial product or
company. Trade, proprietary, or company names
appearing in this document are used only because
they are considered necessary in the context of
the information provided. If a product is not
mentioned, this does not mean or imply that the
product is unsatisfactory.
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