Cochin Cardiac Club

Health Blog by Dr.Uday Nair

HEMORRHOIDS OR PILES






What are Hemorrhoids or Piles?


Hemorrhoids are painful, swollen veins in the lower portion of the rectum or anus.
Hemorrhoids are cushions of tissue and varicose veins located in and around the rectal area. When they become inflamed, hemorrhoids can itch, bleed, and cause pain. Unfortunately a hemorrhoidal condition only tends to get worse over the years. That is why safe, gentle, and effective treatment for hemorrhoids is recommended as soon as they occur.


What are the Causes?




This condition is very common, especially during pregnancy and after childbirth. Hemorrhoids result from increased pressure in the veins of the anus. The pressure causes the veins to bulge and expand, making them painful, particularly when you are sitting.

The most common cause is straining during bowel movements. Hemorrhoids may result from constipation, sitting for long periods of time, and anal infections. In some cases they may be caused by other diseases, such as liver cirrhosis.

Internal hemorrhoids occur just inside the anus, at the beginning of the rectum. External hemorrhoids occur at the anal opening and may hang outside the anus.




How Common Are Hemorrhoids?


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. 


What are the Symptoms?




Symptoms of hemorrhoids include:
  • Anal itching
  • Anal ache or pain, especially while sitting
  • Bright red blood on toilet tissue, stool, or in the toilet bowl
  • Pain during bowel movements
  • One or more hard tender lumps near the anus


How is it diagnosed?

A doctor can often diagnose hemorrhoids simply by examining the rectal area. If necessary, tests that may help diagnose the problem include:
  • Stool guaiac (shows the presence of blood)
  • Sigmoidoscopy
  • Anoscopy

How are Hemorrhoids treated?



Over-the-counter corticosteroid creams can reduce pain and swelling. Hemorrhoid creams with lidocaine can reduce pain. Witch hazel (applied with cotton swabs) can reduce itching. Other steps for anal itching include:
  • Wear cotton undergarments.
  • Avoid toilet tissue with perfumes or colors.
  • Try not to scratch the area.
Sitz baths can help you to feel better. Sit in warm water for 10 to 15 minutes.

Stool softeners help reduce straining and constipation.

For cases that don't respond to home treatments, a surgeon or gastroenterologist can apply heat treatment, called infrared coagulation, to shrink internal hemorrhoids. This may help avoid surgery. Surgery that may be done to treat hemorrhoids includes rubber band ligation or surgical hemorrhoidectomy. These procedures are generally used for patients with severe pain or bleeding who have not responded to other therapy.


Expectations (prognosis)

Most treatments are effective, but to prevent the hemorrhoids from coming back, you will need to maintain a high-fiber diet and drink plenty of fluids.


Complications of Hemorrhoids.

The blood in the enlarged veins may form clots, and the tissue surrounding the hemorrhoids can die. Hemorrhoids with clots generally require surgical removal.
Severe bleeding may also occur. Iron deficiency anemia can result from prolonged loss of blood. Significant bleeding from hemorrhoids is unusual, however.


How can you Prevent Hemorrhoids?




Avoid straining during bowel movements. You can help prevent hemorrhoids by preventing constipation. Drink plenty of fluids, at least eight glasses per day. Eat a high-fiber diet of fruits, vegetables, whole grains. Consider fiber supplement.


Points to Remember

  • Hemorrhoids are swollen and inflamed veins around the anus or in the lower rectum.
  • Hemorrhoids are not dangerous or life threatening, and symptoms usually go away within a few days.
  • A thorough evaluation and proper diagnosis by a doctor is important any time a person notices bleeding from the rectum or blood in the stool.
  • Simple diet and lifestyle changes often reduce the swelling of hemorrhoids and relieve hemorrhoid symptoms.
  • If at-home treatments do not relieve symptoms, medical treatments may be needed.


Please note


Call for an appointment with your doctor if hemorrhoid symptoms do not improve with home treatment. You should also be seen if you have rectal bleeding. Your doctor may want to check for other, more serious causes of the bleeding, especially if you have never bled from hemorrhoids before.
Call emergency if blood loss is significant or if you feel dizzy, lightheaded, or about to faint.




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