What are hemorrhoids ?
A swollen vein in the lower portion of the rectum and anus is medically known as hemorrhoids. It is one of the primary causes of rectal bleeding. Hemorrhoids are categorized into two:
- Internal hemorrhoids – It is located inside the rectum. A person who has it won’t even notice it because internal hemorrhoids do not usually hurt considering the fact that there is a few sensory nerves there. The only definitive sign is bleeding.
- External hemorrhoids – It is found under the skin just around the anal area. It is the painful type as there are pain sensing nerves in the anus. This type of hemorrhoid bleeds and hurt a lot. External hemorrhoids are prone to prolapse and bulges outside the anal sphincter. It will most likely hurt when you poop. Eventually, a blood clot forms in the external hemorrhoid leading to thrombosis (thrombosed external hemorrhoids). (1, 2, 3, 4)
Image 1: A patient with a prolapsed internal hemorrhoids.Photo Source: image.slidesharecdn.com
Picture 2: A clinical presentation of an external hemorrhoid.Image source: www.mhc.com.pk
Image 3: A before and after treatment for hemorrhoids.Picture Source: ae01.alicdn.com
Photo 4: An image outlining the internal and external hemorrhoids.Image Source: hakimyilma.com
Picture 5: A closer view of a patient undergoing hemorrhoidectomy.Photo Source: f6publishing.blob.core.windows.net
Clinical manifestations
- Pain and itching sensation around the anus.
- Blood stain after using the bathroom.
- Bump bulging out from the anus, which looks purplish to bluish in color. (2, 3)
Hemorrhoids causes
- Heredity. If any of the family members have hemorrhoids there is a huge possibility that others will more likely get hemorrhoids too.
- Weight gain. During pregnancy, a woman gains extra weight, which leads to build up of pressure in the lower rectum. It affects the normal flow of blood causing the veins in the lower rectum to swell.
- Other possible causes include pushing hard during bowel movement, standing or sitting for a long period of time, and straining during physical exertion. (4, 5, 6)
Diagnosis
- Physical examination – The doctor will thoroughly check your rectum. He will put his lubricated gloved finer in your anus. Some doctors used an instrument called anoscope, which allows the doctor to view a portion of the rectum.
- Sigmoidoscopy – It views the lower colon (sigmoid).
- Colonoscopy – It views the entire colon. (7, 8, 9)
How long do hemorrhoids last if untreated?
Mild cases of external hemorrhoids go away by themselves, but the symptoms should be treated as they can cause inconveniences and discomforts. There are natural remedies that can make the symptoms go away quickly. These include not sitting on the toilet for a long period of time.It prevents the build-up of pressure around the anal area. Some types of hemorrhoids do need medical and surgical interventions. Internal hemorrhoids require extensive treatment. In case of prolapse, the doctor will need to surgically remove it.It would take a few weeks for the patient to be completely healed.
How long do external hemorrhoids last?
How long do external hemorrhoids last
External hemorrhoids are located beneath the skin around the anal area. There is a possibility of blood clot, which could lead to thrombus causing extreme pain. External hemorrhoids can be gotten rid of, especially if proper care is given before the condition gets worst.The pain and swelling usually subside in just a few weeks provided proper medical care is given. For the hemorrhoids to completely go away, you should increase your intake of fluids and dietary fiber. You should also address constipation.For pain relief, an anti-inflammatory medication is needed. Mild external hemorrhoids can heal on its own but supportive care and management should be given. An advanced stage hemorrhoid that is left untreated could last your whole life. (3, 5, 7, 9)
How to make hemorrhoids go away fast using natural remedies?
Warm sitz bath
It helps alleviate pain and soothes itching. It also reduces swelling in the anal area. Sit in 3 inches of warm water for 15 minutes after pooping.
Use over-the-counter ointments
Over-the-counter creams and ointments help make pooping hurt less. They can also relieve itching.
Diet modification
Eat foods rich in fiber such as fruits and vegetables. They facilitate normal bowel movement and prevent constipation. If you don’t like the taste of fruits and vegetables, then you can ask your doctor for stool softener or fiber supplement.You should avoid gas forming foods. As much as possible, you should not take laxative as it causes diarrhea, which could worsen your hemorrhoids. (1, 5, 10)
Medical procedures/clinical procedures
- Injection – A special solution is injected in the internal hemorrhoid to hasten scar formation and eventually close off the hemorrhoid.
- Laser – A procedure that uses laser can help shrink the bulge. It is a non-invasive procedure that can be completely done in the doctor’s office. (4, 5, 8)
Surgical Approach
If the hemorrhoids are large and become extremely painful, the doctor will opt for a surgery. It is most of the time effective. One of the commonly performed procedures is hemorrhoidectomy. A small cut around the anus is made to slice away the affected part.Depending on the severity of hemorrhoids, the patient can be put on a local anesthesia or general anesthesia (severe hemorrhoids). Right after the procedure, the patient can go home. Although, the area can be painful and tender right after the procedure. Stitches are needed too since cuts are made. The patient can recover two weeks post hemorrhoidectomy.Another possible surgical procedure is stapled hemorrhoidectomy. A stapler-like device is used to cut off the blood supply and reposition the hemorrhoids. Over time, it will eventually shrivel and die without blood supply. (3, 6, 8, 9)
What to expect after the surgical procedure?
Patients usually complains of pain, especially when pooping. In such scenario, the doctor will usually prescribe over the counter pain relievers. The doctor also prescribes stool softener, especially during the first week post-surgery.With surgical approach to treating hemorrhoids, there is always a possibility of bleeding, infection, and adverse reaction to anesthesia. The muscles usually swell, which makes it hard for you to pee after the procedure. There is also a tendency that your anal sphincter will be damaged during the surgical procedure.One of the clinical manifestations of anal sphincter damage is fecal incontinence. You should immediately call your doctor if you have profuse anal bleeding, has a fever, or can’t pee or poop. These are not normal and could suggest an underlying health issue. If you notice any unusual changes, you should immediately consult your doctor. (3, 9, 10)
How to prevent hemorrhoids?
- Diet – You should eat the right kind of foods. Ideally, a person should eat fiber-rich foods such as fruit, vegetables, nuts, beans, edible seeds, and whole grains.
- Hydrate – You should increase your intake of fluid to soften the stool and prevent strain during bowel movement.
- Exercise – Simple forms of exercise like walking and jogging facilitate proper blood flow and bowel movement.
- Go to the toilet whenever you feel the urge to do so. (3, 6, 7)
When to seek medical help?
If you notice blood coming from your anus, you should immediately consult your doctor. A rectal bleeding is not only indicative of hemorrhoids. It could also be a symptom of colon polyps, colorectal cancer, diverticulitis, colitis, and other serious medical condition.If you have been experiencing hemorrhoids and it does not improve despite treating them by yourself, you should inform your doctor right away. (3, 4, 8, 10)References:
- https://www.webmd.com/digestive-disorders/understanding-hemorrhoids-basics
- https://www.mayoclinic.org/diseases-conditions/hemorrhoids/symptoms-causes/syc-20360268
- https://en.wikipedia.org/wiki/Hemorrhoid
- https://www.medicinenet.com/hemorrhoids_piles/article.htm
- https://www.medicalnewstoday.com/articles/73938.php
- https://www.onhealth.com/content/1/hemorrhoid_treatment
- https://www.healthline.com/health/hemorrhoids
- https://www.emedicinehealth.com/hemorrhoids/article_em.htm
- https://www.health.harvard.edu/diseases-and-conditions/hemorrhoids_and_what_to_do_about_them
- https://www.fascrs.org/patients/disease-condition/hemorrhoids-expanded-version
