Hemorrhoids are painful, swollen veins that can occur inside and outside the rectum. When they occur outside, they are called external hemorrhoids. When they occur inside the rectum, they are called internal hemorrhoids.
They can occur for several reasons, but the most common reason is from increased pressure within the veins in the rectal area.
Frequently, hemorrhoids can come from straining too hard during a bowel movement. They can also occur during pregnancy with the increased pressure from the weight of the baby in the lower abdomen. As we age, the supporting tissues around the rectum become weaker. As a result, hemorrhoids are more common in the elderly.
Factors that can cause hemorrhoids
- Sitting for long periods on the toilet
- Straining during bowel movements
- Chronic diarrhea or chronic constipation
- Pressure from pregnancy
- A diet low in fiber
- Anal sex
- Being overweight
- Being elderly
Hemorrhoid signs and symptoms
- Bleeding during bowel movements. This usually occurs without pain and may appear as red blood on the toilet tissue or in the water of the toilet bowl.
- Pain, discomfort, or an itchy feeling around the anus
- Rectal area swelling or nodule that may hurt
- Stool staining of underwear
With excessive pressure or straining, internal hemorrhoids can protrude out of the rectum. This protrusion is known as a prolapsed hemorrhoid. When external hemorrhoids around your anus get irritated, they itch or bleed.
External hemorrhoids can become very sensitive and bleed easily with wiping. If the hemorrhoids are large, the blood may clot within them, causing additional discomfort.
Hemorrhoid treatment
Most of the time, hemorrhoids can be treated with over-the-counter products such as suppositories, creams, ointments, and gentle cleansing pads. Most of these treatments contain medicines that are designed to reduce irritation and inflammation.
If these measures do not work satisfactorily, a doctor’s assistance may be required. If the problem is as simple as a clot in the vein, the doctor may make a tiny incision and remove it to the patient’s great relief. If the lesions are more complicated, other surgical interventions may be required.
Additional surgical treatment may include:
- Rubber band ligation
- Laser surgery
- Injection of medicines
- Surgical excision
The bottom line is that hemorrhoids are very common and quite a nuisance. Home therapies are often successful, but sometimes the help of a doctor is needed for best relief. Remember, if you have any of the symptoms described above, consult your doctor. Often it is hemorrhoids, but it could also be the signs of other medical conditions that need prompt attention.
Charles E. Crutchfield III, MD is a board-certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He has been selected as one of the top 10 dermatologists in the United States by Black Enterprise magazine and one of the top 21 African American physicians in the U.S. by the Atlanta Post. Dr. Crutchfield is an active member of the Minnesota Association of Black Physicians, MABP.org.
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