Postoperative pain remains the major complication, with most patients requiring 2-4 weeks before returning to normal activities. Other possible complications include urinary retention, anal stenosis, and incontinence.
In those instances, an initial small abrasion may turn into a fissure (split that won’t heal), a fistula (duct from anus into perianal region), or an abscess (encapsulated pus) — conditions that, considering the location and “traffic,” are extremely painful, infection-prone, and hard to treat and heal.
Hemorrhoids are highly sensitive, and perfumes and other chemicals may make symptoms worse. It is also important not to wash the anus with soap while hemorrhoids are present. This can dry out and irritate hemorrhoids even more.
Jump up ^ Quijano, CE; Abalos, E (Jul 20, 2005). “Conservative management of symptomatic and/or complicated haemorrhoids in pregnancy and the puerperium”. Cochrane Database of Systematic Reviews (3): CD004077. doi:10.1002/14651858.CD004077.pub2. PMID 16034920.
Hemorrhoids are classified by their anatomic origin within the anal canal and by their position relative to the dentate line; thus, they are categorized into internal and external hemorrhoids (see the following image).
Hemorrhoids are normal tissue occurring in all people. Hemorrhoids can become large, can bleed, and can become tender. There is no single cause for hemorrhoidal symptoms but some factors may play a part:
Jump up ↑ von Roon, Alexander C.; Reese, George E.; Tekkis, Paris P. (2009-01-29). “Haemorrhoids: haemorrhoidal artery ligation”. BMJ Clinical Evidence 2009. ISSN 1752-8526. PMC PMC2907769. PMID 19445775.
Butcher’s broom can help reduce swelling and inflammation of hemorrhoids. A 2002 study conducted in Germany found that butcher’s broom was an effective means of treatment for patients suffering from chronic venous insufficiency, a condition where the flow of blood through the veins is inadequate, causing the blood to pool. (7)
Excisional hemorrhoidectomy is a surgical excision of the hemorrhoid used primarily only in severe cases. It is associated with significant postoperative pain and usually requires 2–4 weeks for recovery. However, the long-term benefit is greater in those with grade 3 hemorrhoids as compared to rubber band ligation. It is the recommended treatment in those with a thrombosed external hemorrhoid if carried out within 24–72 hours. Evidence to support this however is weak. Glyceryl trinitrate ointment after the procedure helps both with pain and healing.
If you deal with persistent or repeated piles, attempt losing some weight. Lugging additional weight, especially around the waist and hips, puts extra pressure on your stomach cavity. This can after that mean raised stress in the blood vessels in the rectal location, causing heightening of your hemorrhoid issue.
The diagnosis of hemorrhoids is based on a medical history and physical examination. A digital rectal examination and an anoscopy may be the only tests needed at first. Your doctor will decide which tests to use. If hemorrhoids are the obvious cause of rectal bleeding, you are younger than age 50, and you do not have risk factors for colon cancer, you may not need more tests.
Rubber band ligation. This procedure is often done on prolapsed hemorrhoids, internal hemorrhoids that can be seen or felt outside. Using a special tool, the doctor puts a tiny rubber band around the hemorrhoid, which shuts off its blood supply almost instantly. Within a week, the hemorrhoid will dry up, shrink, and fall off.
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.
Staples. An alternative to traditional hemorrhoidectomy is called stapled hemorrhoidopexy. This procedure treats bleeding or prolapsed internal hemorrhoids. The surgeon uses a stapling device to anchor the hemorrhoids in their normal position. Like traditional hemorrhoid removal, stapled hemorrhoidopexy is performed under general anesthesia as day surgery.
Hall-of-Fame baseball player George Brett was removed from a game in the 1980 World Series due to hemorrhoid pain. After undergoing minor surgery, Brett returned to play in the next game, quipping “…my problems are all behind me.” Brett underwent further hemorrhoid surgery the following spring. Conservative political commentator Glenn Beck underwent surgery for hemorrhoids, subsequently describing his unpleasant experience in a widely viewed 2008 YouTube video. Former U.S. President Jimmy Carter had surgery for hemorrhoids in 1984. Cricketers Matthew Hayden and Viv Richards also had the condition.
Using toilet paper after a bowel movement can aggravate existing hemorrhoids. Instead, using wipes can help keep you clean without causing further irritation. For an added boost, you can find wipes with soothing, anti-hemorrhoid ingredients like witch hazel or aloe vera. Make sure that the wipes you choose do not have alcohol, perfume, or other irritants in them. These substances could aggravate symptoms instead of relieving them.
Keep this important point in mind: if blood emanates from upper intestinal tract organs (esophagus, stomach, duodenum, small intestine), the bleeding may have started at least 24 hours before you see the first signs of it. That’s how long it normally takes for chyme to turn into stool and reach the toilet bowl. For people who are severely constipated it may take even longer. This means that by the time the blood in stools is detected, the loss of blood may be considerable.
Natural witch hazel is an astringent, which is a substance that causes tissue to shrink. It also has antioxidant and anti-inflammatory properties, according to research in the Journal of Inflammation. Witch hazel is known to reduce bruising.
External hemorrhoids usually are not removed with surgery (hemorrhoidectomy) except if they are very large and uncomfortable or if you having surgery on the anal area for another reason, such as internal hemorrhoids or a tear (anal fissure). If a blood clot develops in the external hemorrhoid, the clot may need to be removed to relieve pain.
The anal canal expands to 35 mm without apparent harm when there are no enlarged internal hemorrhoids to constrict it. Anything beyond that size is bound to cause pain. If an individual is tense, he or she may not be able to completely relax the external anal muscle, and may experience pain even from smaller stools.
^ 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.