The position of the hemorrhoid determines the main classification described as either internal or external. Remember that the anus, or anal canal, is the opening, and the rectum is the final portion of the colon, or large intestine, that leads to this opening. Hemorrhoids can occur both above the anal canal (internal) or below the anal canal in the skin around the anus (external). However, they exhibit different symptoms depending on the location.
In most cases constipation can be handled by taking fiber and drinking water but sometimes a laxative is necessary. Steer away from taking laxatives that stimulate the intestine as these can actually increase the pressure in the area and cause symptomatic hemorrhoids. Try osmotic laxatives instead.
Jump up ^ Pescatori, M; Gagliardi, G (March 2008). “Postoperative complications after procedure for prolapsed hemorrhoids (PPH) and stapled transanal rectal resection (STARR) procedures”. Techniques in coloproctology. 12 (1): 7–19. doi:10.1007/s10151-008-0391-0. PMC 2778725 . PMID 18512007.
^ Jump up to: a b c d e f g h i j k l m n o p q r Beck, David E. (2011). The ASCRS textbook of colon and rectal surgery (2nd ed.). New York: Springer. p. 175. ISBN 978-1-4419-1581-8. Archived from the original on 2014-12-30.
Use suppositories, such as those made by Preparation H or Anusol, for 7 to 10 days to relieve irritation and to lubricate the anal canal during bowel movements. Some of these products contain substances that can harm anal tissues if they are used for too long.
Hemorrhoid cushions are a part of normal human anatomy and become a pathological disease only when they experience abnormal changes. There are three main cushions present in the normal anal canal. These are located classically at left lateral, right anterior, and right posterior positions. They are composed of neither arteries nor veins, but blood vessels called sinusoids, connective tissue, and smooth muscle.:175 Sinusoids do not have muscle tissue in their walls, as veins do. This set of blood vessels is known as the hemorrhoidal plexus.
Know when to see a doctor. Hemorrhoids are highly treatable and generally harmless; however, they may cause complications in some people. If you are experiencing complications associated with hemorrhoids, or if your condition does not improve after about a week with over-the-counter treatments, see a doctor immediately.
One way to both treat and help prevent hemorrhoids is to include fiber in your diet. Fiber supplementation moves stool through your system, and makes bowel movements smoother. Increasing fiber in your diet can help ease pain during bowel movements.
Straining during a bowel movement can be painful and make hemorrhoid problems even worse. Don’t wait too long before going to the toilet. Pay attention to your body’s signals, and when you feel an urge to use the bathroom, go right away. Otherwise the stool will become harder, and this will automatically make you push harder. When you’re at the toilet, take your time and relax your body. (6)
A systematic review and meta-analysis of 98 trials comprising 7827 patients and 11 surgical treatments for grades III and IV hemorrhoids found that open and closed hemorrhoidectomies resulted in more postoperative complications and slower recovery, but fewer hemorrhoid recurrences, whereas transanal hemorrhoidal dearterialization and stapled hemorrhoidectomies were associated with decreased postoperative pain and faster recovery, but higher recurrence rates.  The investigators did not find any significant differences between treatments for anal stenosis, incontinence, and perianal skin tags.
Hemorrhoids are swollen blood vessels in the rectum or anal region that are caused from extra pressure or straining. Blood can pool in the vessels around the anus, causing pain, itching, swelling, inflammation, and irritation. Hemorrhoids may be internal, in the rectum, or external, on the skin around the anus. Unfortunately, hemorrhoids are common in pregnant women and people over fifty, though there are a number of treatment options. Treatment options can include over-the-counter medications and applications or surgical procedures of varying degrees.
also may be used to increase the intake of fiber. Stool softeners and increased drinking of liquids also may be recommended. Nevertheless, the benefits of fiber, liquids, and stool softeners have not been well-tested with respect to hemorrhoidal control in scientific studies.
External and internal hemorrhoids are diagnosed by a physical exam and history by a health-care professional. Sigmoidoscopy or colonoscopy may be ordered to look for other causes of blood in the stool.
Numerous nonoperative methods to destroy internal hemorrhoids are available. Nonsurgical techniques function by rubber band ligation, ablation, sclerosis, or necrosis of mucosal tissues. [28, 29, 30] Despite several meta-analyses and considerable personal preference, there is no clear advantage of one technique over the others; however, all should be the first-line treatment of all first- and second-degree internal hemorrhoids that do not respond to conservative therapy. All nonoperative treatments have approximately similar efficacy when administered by an experienced clinician.
What causes hemorrhoids? Take this quiz to learn about internal and external hemorrhoids and how to get rid of hemorrhoids. How long do hemorrhoids last? Learn about home remedies for hemorrhoids, symptoms, and treatment.
Acute mesenteric ischemia is sudden blockage of blood flow to part of the intestines, which may lead to gangrene and perforation (puncture). If the person has typical symptoms of acute mesenteric ischemia, which of the following is usually done first?
Teach the patient the importance of a high-fiber diet, increased fluid intake, mild exercise, and regular bowel movements. Be sure the patient schedules a follow-up visit to the physician. Teach the patient which analgesic applications for local pain may be used. If the patient has had surgery, teach her or him to recognize signs of urinary retention, such as bladder distention and hemorrhage, and to contact the physician at their appearance.
Internal hemorrhoids can deposit mucus onto the perianal tissue with prolapse. This mucus with microscopic stool contents can cause a localized dermatitis, which is called pruritus ani. Generally, hemorrhoids are merely the vehicle by which the offending elements reach the perianal tissue. Hemorrhoids are not the primary offenders.
Patients presenting with hemorrhoidal disease are more frequently white, from higher socioeconomic status, and from rural areas. There is no known sex predilection, although men are more likely to seek treatment. However, pregnancy causes physiologic changes that predispose women to developing symptomatic hemorrhoids. As the gravid uterus expands, it compresses the inferior vena cava, causing decreased venous return and distal engorgement.
Sclerotherapy In this quick, often painless procedure, the doctor injects a chemical into the hemorrhoidal blood vessel, causing scar tissue to form in order to shrink the hemorrhoid. (3) The principle behind this is the same as rubber band ligation, though it’s not always as effective. This procedure can be used in patients taking blood thinners, for whom rubber band ligation may not be recommended. (4)
Patients with hemorrhoids may delay seeking treatment because of embarrassment relating to the location. Provide privacy and foster dignity when interacting with these patients. Inform the patient of every step of the procedure. Provide comfort during examination.
Most of the patients suffering from hemorrhoids have their symptoms alleviated through diet therapy, fiber supplements, hemorrhoid cream and medical treatments, such as sclerotherapy, rubber band ligation and infrared coagulation.
If you have a hemorrhoid, you may feel a tender lump on the edge of your anus. You may also see blood on the toilet paper or in the toilet after a bowel movement. You may feel itchy in that area. Or you may feel pain. Pain is most likely to occur after a bowel movement or strenuous activity.
The list below is far from being comprehensive. Any drug that affects the functions of muscles, nerves, neurotransmitters, electrolytes, digestive and endocrine functions, and other bodily functions has a potential for enlargement and/or hardening of stools. In general, these medicines will have constipation and/or diarrhea listed as one of their side effects:
Sometimes the symptoms of enlarged hemorrhoids are so bad that treating the symptoms alone is no longer enough. Then there are various procedures that can be done to remove the tissue that is causing problems.Hemorrhoids are normal “cushions” of tissue filled with blood vessels, found at the end of the rectum, just inside the anus. If they become enlarged, they can cause unpleasant symptoms. The most suitable type of treatment will mainly depend on the size of the hemorrhoids and the severity of symptoms. Each approach has its own advantages and disadvantages. Depending on the procedure, side effects can occur – some more severe than others.Sclerotherapy and “rubber ligation” (“banding”) are generally carried out as day procedures, without an anesthetic. If someone has grade 3 or grade 4 hemorrhoids, doctors often recommend surgery. A general or local anesthetic is usually needed for this. You then have to stay in the hospital for a few days, and stay off work for some time too.
Watch for pain that lasts longer than a week, blood loss along with weakness or dizziness, or infection – these are all situations that should be brought to your doctor’s attention. Your doctor should also be consulted about bleeding not brought on by a bowel movement, blood that’s dark in colour, or bleeding that is recurrent. This can signal more serious problems higher in the colon, unrelated to hemorrhoids.
Internal hemorrhoids often do not cause a visible lump or pain, but they can bleed. Bleeding from internal hemorrhoids typically occurs with bowel movements, causing blood-streaked stool or toilet paper. The blood may turn water in the toilet bowl red. However, the amount of blood is usually small, and hemorrhoids rarely lead to severe blood loss or anemia.
Fourth-degree hemorrhoids: Hemorrhoids that prolapse and cannot be pushed back in the anal canal. Fourth-degree hemorrhoids also include hemorrhoids that are thrombosed (containing blood clots) or that pull much of the lining of the rectum through the anus.
It is difficult to determine how common hemorrhoids are as many people with the condition do not see a healthcare provider. However, symptomatic hemorrhoids are thought to affect at least 50% of the US population at some time during their lives, and around 5% of the population is affected at any given time. Both sexes experience about the same incidence of the condition, with rates peaking between 45 and 65 years. They are more common in Caucasians and those of higher socioeconomic status.
If non-medical treatments don’t work, there are relatively painless procedures that can be done to treat hemorrhoids. For extreme cases, an outpatient surgery called a hemorrhoidectomy may be required.
The medical profession is also in universal agreement that straining (related either to diarrhea or constipation) and large stools (type 2 and 3) are the primary reasons behind recurring prolapses of internal and/or external hemorrhoids. In other words, to prevent and treat hemorrhoidal disease you must have small, soft, regular stools and you must not strain.
Try non-surgical treatment options. There are a number of options your doctor can counsel you on that do not require surgery. These options are generally safe and effective, are minimally invasive, and can usually be done in an outpatient setting.