Hemorrhoids, also known as piles, are a common condition characterized by swollen veins in the anus and lower rectum. These can develop internally, inside the anus or rectum, or externally, under the skin around the anal opening. While everyone has hemorrhoidal tissue, they are only called hemorrhoids when enlarged and symptomatic.
Understanding What Causes Hemorrhoids and Their Symptoms
Hemorrhoids arise from increased pressure on veins in the anal and rectal regions. Straining during bowel movements is a common cause, elevating pressure within these blood vessels. Chronic constipation or persistent diarrhea can also contribute to their development by irritating the anal area.
Extended periods of sitting, especially on the toilet, can increase pressure and lead to hemorrhoid formation. Other factors include pregnancy, due to increased pelvic pressure, and regularly lifting heavy objects, which raises abdominal pressure. A diet low in fiber contributes to harder stools and straining.
Symptoms of hemorrhoids vary depending on whether they are internal or external. Internal hemorrhoids, located inside the rectum, often cause painless bleeding, seen as bright red blood on toilet paper or in the toilet bowl after a bowel movement. They do not cause discomfort unless they prolapse, pushing through the anal opening, which can result in pain and irritation.
External hemorrhoids, found under the skin around the anus, cause pain and discomfort due to many pain-sensing nerves. They can cause itching, irritation, swelling, and lumps around the anus. If a blood clot forms within an external hemorrhoid, it becomes a thrombosed hemorrhoid, which can be very painful and appear as a hard, discolored lump.
Strategies for Relief and Prevention
Managing hemorrhoids and preventing their recurrence involves home remedies and lifestyle adjustments. Warm baths, specifically sitz baths where you soak the anal area in warm water for 10 to 15 minutes, relieve pain and itching. Over-the-counter creams, ointments, or suppositories containing ingredients like witch hazel or hydrocortisone soothe discomfort and inflammation. Applying an ice pack wrapped in a towel to the affected area for 5 to 10 minutes at a time several times a day reduces swelling and pain.
Increasing dietary fiber intake aids both relief and prevention. Aim for 25-30 grams of fiber daily through fruits, vegetables, and whole grains to soften stools and add bulk, which aids easier passage and reduces straining. Drinking plenty of fluids, such as 6 to 8 glasses of water daily, is important to keep stools soft and prevent constipation.
Regular physical activity promotes healthy digestion and circulation, reducing pressure on rectal veins and combating constipation. Avoiding prolonged sitting, especially on the toilet, minimizes sustained pressure on the anal region. When experiencing the urge to have a bowel movement, go immediately to prevent stools from becoming harder to pass.
Should home treatments not provide relief after about a week, medical procedures may be considered. These range from in-office treatments like rubber band ligation, which cuts off blood supply to an internal hemorrhoid, causing it to wither and fall off. Sclerotherapy involves injecting a chemical solution into the hemorrhoid to shrink it. For larger or persistent hemorrhoids, surgical removal, known as hemorrhoidectomy, or stapling procedures may be recommended to remove or reposition the tissue and reduce blood flow.