Hemorrhoids Basics

No one likes to talk about hemorrhoids, let alone admit they are experiencing the itching, burning,  pain, and sometimes bleeding, that can accompany this problem. But the reality is that about one-half to three-fourths of all Americans will develop hemorrhoids at some time in their lives. Some people suffer in silence, either because they are embarrassed to talk about it or don't think that it's a serious enough condition to seek medical help. There are different types of hemorrhoids, some of which respond to basic self-care methods while others require you to see a doctor. The bottom line is you don't have to go it alone.

In this article, we will explore the causes and symptoms of hemorrhoids, as well as various treatment options available from traditional medicine to alternative cures. Let's get started with an overview of hemorrhoids.

Definition

Hemorrhoids can make a trip  to the bathroom excruciating.

Hemorrhoids are enlarged veins inside or just outside the anal canal, which is the opening at the end of the large intestine. As the veins swell, they can cause severe inflammation and discomfort.

Too much pressure can cause veins in the rectum and anus to swell and stretch out of shape. Internal hemorrhoids form just under the tissue that lines the inside of the rectum. They are not visible unless they become so big they prolapse, or fall down and protrude through the anus. External hemorrhoids form outside the rectum, in the veins surrounding the anus.

Either type of hemorrhoid can bleed, although external ones are more prone to bleeding, because they're easily irritated. The itching, burning, and pain typically associated with hemorrhoids result from the external variety.

If an internal hemorrhoid develops a fissure -- a tear or ulcer in the anal canal -- or forms a blood clot, it can cause severe pain. But normally, internal hemorrhoids don't burn or itch, because there are no nerve endings in the lining of the rectum. Indeed, in 1991 the Food and Drug Administration banned 30 over-the-counter hemorrhoid preparations from the market as unsafe or ineffective because they were purportedly designed to relieve discomfort inside the rectum. Now, products must be labeled "for external use only."

Causes

Below are a number of factors that contribute to hemorrhoids, some of which can be avoided.

• Poor toilet habits. In some cases, habitual postponement of bowel movements can lead to loss of rectal function and undesirable straining during elimination. Straining puts increased pressure on the veins and slows the flow of blood, thereby contributing to swelling and inflammation of veins. If bowel movements are postponed, the stools retained in the bowels may lose moisture. When feces become dry and hard, the added strain of constipation favors the development of hemorrhoids.

• Gravity. Humans stand upright, which causes a downward pressure on all veins in the body, including those in the anal canal and rectum.

• Family history. If one parent has hemorrhoids, it is more likely that his or her child will develop them in adult life; if both parents have hemorrhoids, it is a near certainty.

• Age. While hemorrhoids usually begin to develop when an individual is 20 years old or even earlier, symptoms usually do not appear until the 30s and beyond.
  

• Constipation. Difficulty in passing fecal matter creates pressure and possible injury to veins in the anal canal and rectum.

• Low-fiber diet. Highly refined foods (white flour products, sugar, foods high in fat and protein and low in complex carbohydrate) result in a fiber-deficient diet, with resulting constipation and hemorrhoids.

• Obesity. Added pounds put more pressure on veins. What's more, overweight individuals may be more likely to favor refined foods and a sedentary lifestyle.

• Laxatives. Improper use of these products is a major cause of constipation and therefore likely plays a leading role in the development of hemorrhoids.

• Pregnancy. As the fetus grows, it puts additional pressure on the rectal area. Moreover, prolonged pressure from pushing during labor and delivery can also lead to hemorrhoids. Pregnancy-related hemorrhoids usually retract after the baby is born, unless they were present beforehand.

• Sexual practices. Anal intercourse also puts pressure on veins in the anal canal.

• Prolonged sitting. Without some form of regular exercise, the heart muscle is less efficient at returning blood from the veins to the heart.

• Prolonged standing. The pull of gravity continues unabated on the body's veins in individuals who are on their feet all day.

Symptoms

When The Symptoms Are MisleadingHemorrhoids aren't the only cause of itching in the anal area. Poor anal hygiene, perianal warts, intestinal worms, medication allergies, psoriasis, other forms of dermatitis or local infection, or even too much coffee can cause itching. Pain can result from fissures -- small cracks in the skin around the anus. If you find blood in the area, don't assume it's from hemorrhoids. Bleeding can be a symptom of colorectal cancer, which kills 56,000 people every year, according to the American Cancer Society. While bright-red blood usually heralds hemorrhoids, don't try to make a diagnosis yourself. If you notice blood, see your doctor.

Hemorrhoids may take years to develop and almost always cause irritating symptoms.

The first signs of hemorrhoids include itching and discomfort during and after bowel movements. Continued straining during elimination will eventually produce slight swelling of the lining of the anal canal. This swelling may not be noticed until hard stools scrape the anal lining and cause bleeding -- an early clue that a hemorrhoid has developed.

With prolonged straining, a portion of the anal canal may jut out of the anus during a bowel movement. As long as the elastic connective tissue is still strong enough to pull the hemorrhoid back into the anal canal unassisted, the individual may not notice the growing problem. However, with persistent pressure, the protruding tissue may remain outside the anus after a bowel movement and need to be manually returned to the anal canal. Once outside the anal canal, the hemorrhoid creates a dull aching sensation or ulcerates and bleeds.

A more involved problem develops when the hemorrhoid is difficult or impossible to return within the anal canal, and permanent swelling at the anal opening interferes with elimination. The patient may then postpone bowel movements in an effort to avoid pain. Instead of helping, this avoidance of bowel movements intensifies the problem because it leads to constipation.

Diagnosis

To diagnose a hemorrhoid, a physician inspects the anal canal, often with special instruments. An anoscope (a short, lighted, tubelike instrument) inserted into the anus can reveal the presence of hemorrhoids. The proctosigmoidoscope, a longer instrument that provides a view of the lower portion of the large intestine, may be used to rule out other causes of rectal bleeding or pain.

Treatment

For severe cases of hemorrhoids, a doctor may recommend a surgical procedure called hemorrhoidectomy to remove dilated portions of the affected veins and to tie off the remaining parts of the vein. Newer procedures, such as cryosurgery and laser surgery, remove the hemorrhoid but with less pain and fewer postoperative complications. Laser surgery uses an intensified beam of light to burn off the hemorrhoid.

With cryosurgery, the hemorrhoid is frozen with an extremely cold probe; the frozen tissue dies, and the hemorrhoid falls off within several days. Many physicians can perform cryosurgery in their offices in a matter of minutes. Frequently, the only postoperative complaint is a slight watery discharge from the anal canal for a few days after the procedure.

Another technique used to eliminate hemorrhoids is rubber-band ligation. With this procedure, which can be performed in the physician's office, the blood supply of the hemorrhoid is cut off by tying a rubber band around the swollen tissue. The hemorrhoid usually drops off within three to nine days. Unfortunately, as is the case with the nonsurgical procedures, this procedure is not always suitable for all patients. As a result, it is often done only to remedy internal hemorrhoids.

Recurrence of hemorrhoids after any type of treatment is not uncommon.

As the old saying goes, an ounce of prevention is worth a pound of cure. In the next section, we will cover some steps you can take to prevent hemorrhoids from forming in the first place.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.