Hemorrhoids, commonly known as piles, are swollen veins in your rectum and anal region. Due to the increased pressure in the lower rectum region, the veins in this area gets swollen, resulting in hemorrhoids. In some cases, it may even cause bleeding. But not every case of rectal bleeding is due to hemorrhoids. Changes in your bowel habits or discoloration of the stool can also cause rectal bleeding. Anal cancer and colorectal cancer may also cause rectal bleeding.

What are Hemorrhoids?

Hemorrhoids are a common medical condition that causes the veins in the rectum and anus to swell and bulge. Hemorrhoids are common and almost three out of four individuals develop them. There are two types of hemorrhoids - internal hemorrhoids and external hemorrhoids.

Internal hemorrhoids develop inside the rectum, whereas external hemorrhoids develop under the skin around the anus.

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What are the symptoms of Hemorrhoids?

Different types of hemorrhoids show different signs and symptoms.

• Internal Hemorrhoids

Internal hemorrhoids are found deep inside the rectum. You can’t see or feel them. Generally, they don’t hurt as much because of a few pain-sensing nerves present there. You may notice these symptoms:

• Painless bleeding when you pass a stool
• Pain or irritation when you pass a stool
• Bloodstains on the toilet bowl or toilet paper

• External Hemorrhoids

External hemorrhoids are found under the skin around your anus. These hemorrhoids hurt more because several pain-sensing nerves are present in this region. The signs and symptoms include:

• Bleeding
• Irritation or itching in your anus
• Discomfort or pain
• Swelling around the anus region

• Thrombosed Hemorrhoids

Sometimes, external hemorrhoids turn into a blood clot or a  thrombus. It is called a thrombosed hemorrhoid. You may notice symptoms such as:

• Inflammation
• Itching
• Severe pain
• Swelling
• Bleeding
• A hard lump in the anus region

If you notice any of these symptoms, visit a doctor to get yourself checked.

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What are the causes of Hemorrhoids?

Sometimes, the veins present in your anus region stretch under pressure and may swell. Hemorrhoids occur because of the increased pressure in the lower rectum due to:

• Obesity
• Pregnancy
• Chronic diarrhea or constipation
• Sitting for a prolonged time on the toilet
• Eating a low-fiber diet
• Anal sex
• Regular heavy lifting
• Straining during bowel movements

What are the risk factors associated with Hemorrhoids?

The risk of developing hemorrhoids increases as you age. It is because the tissues that support the vein in your rectum may stretch or start to thin out. Sometimes, pregnancy can also increase the risk of developing hemorrhoids in women. During pregnancy, the baby’s weight may put excess pressure on the anal region, which may also cause hemorrhoids.

What complications can arise if Hemorrhoids are left untreated?

Since it resolves on its own in most cases, the complications of hemorrhoids are rare. Some of the complications that may still arise are:

• Blood clot

Sometimes, a blood clot can form in the hemorrhoids, known as thrombosed hemorrhoids. It is not dangerous but may cause extreme pain.

• Strangulated hemorrhoid

In some cases, the blood supply to an internal hemorrhoid gets cut off, resulting in strangulated hemorrhoids which may cause severe pain and discomfort.

• Anemia

Though extremely rare, the blood loss from hemorrhoids can cause anemia.

• Infection

Some external hemorrhoids can get infected and cause pain.

Can Hemorrhoids be prevented?

To prevent hemorrhoids or reduce its symptoms, follow these preventive measures:

• Drink plenty of water

Water will help you avoid constipation and hard stools. It will minimize the strains during bowel movements.

• Eat high-fiber food

Food items high in fiber help food pass through your body easier. You can go for food items such as fruits, vegetables, whole grains, beans, seeds, legumes, and nuts.

• Exercise regularly

Physical activity, such as walking at least for half an hour a day, will keep your blood and bowels moving. Exercising will also help you lose weight, which is one of the causes of hemorrhoids.

• Don’t ignore the urge

Go to the toilet as soon as you feel the urge. If you wait, your stool could dry out, and it can be difficult to pass out later.

• Don’t strain

Holding your breath or straining during a bowel movement creates more pressure on the veins in the lower rectum.

How are Hemorrhoids diagnosed?

External hemorrhoids may be diagnosed with a physical examination. However, to diagnose internal hemorrhoids, your doctor may conduct a  rectal and anal canal examination. It includes:

• Digital Examination

Your doctor will insert a lubricated, gloved finger inside your rectum to feel for unusual growths.

• Visual Inspection

In most cases, internal hemorrhoids are too soft to feel through a physical exam. So your doctor will use a proctoscope, anoscope, or sigmoidoscope to examine the lower portion of the rectum and colon.

Home Remedies for hemorrhoids

If your symptoms and pain are mild, you can try out these home remedies-

• Eat high-fiber food

Eat food that contains high fiber such as whole grains, vegetables, and fruits. It will soften the stool and make it easier for it to pass.

• Soak in warm water

To soften the stool, soak your anal area in warm water for about 10 to 15 minutes. Do this two to three times a day.

• Oral pain relievers

You can use aspirin, acetaminophen, or ibuprofen to relieve the pain and discomfort.

• OTC ointments

On over-the-counter cream containing hydrocortisone or lidocaine can be applied to the area. If you are using an over-the-counter steroid cream, consult with your doctor first. Its prolonged use can thin out your skin.

What are the treatment options for Hemorrhoids?

If your symptoms get severe, your doctor will devise a treatment plan for you.

The treatment options include:

• Medications

If your symptoms are mild, the doctor will prescribe over-the-counter ointments, creams, or pads. These products contain ingredients such as hydrocortisone or lidocaine that help relieve the itching and pain.

• External Hemorrhoid Thrombectomy

If a blood clot develops within an external hemorrhoid, your doctor will perform a procedure to remove the blood clot. The procedure is more effective when performed within three days of developing the blood clot.

• Minimally Invasive Procedures

For painful hemorrhoids or persistent bleeding, your doctor will perform minimally invasive procedures, which include:

• Rubber band ligation: Your doctor will place one or two small rubber bands around the internal hemorrhoid to cut off its blood circulation. Hemorrhoid shrinks and falls off in a week.
• Sclerotherapy: Your doctor will shrink the hemorrhoid tissue by injecting a chemical solution into it. The injection will cause little or no pain.
• Coagulation: This procedure uses laser or infrared light to cause small hemorrhoids to harden and shrivel. It causes little discomfort and has few side effects.

• Surgical Procedures

In rare cases, patients suffering from hemorrhoids may require surgery. If other treatment options don’t work or you have large hemorrhoids, your doctor may suggest one of these surgical treatment options:

• Hemorrhoidectomy: Using this procedure, the surgeon will remove excess tissues that cause the bleeding. The surgery can be performed with local anesthesia combined with spinal anesthesia, general anesthesia, or sedation.
• Stapled hemorrhoidopexy: Also known as hemorrhoid stapling, this procedure will block the blood flow to the tissues of the hemorrhoids. Typically, this procedure is performed for internal hemorrhoids.

Frequently Asked Questions (FAQs)

1. Can Hemorrhoids be popped?

   Hemorrhoids are uncomfortable, and popping them will cause more pain and discomfort. It may also lead to serious infections and damage to delicate tissues.

2. Do Hemorrhoids smell?

   Hemorrhoids can cause leakage of anal mucus and feces. They may also make it difficult for you to clean the anus region after a bowel movement. Due to this, hemorrhoids may produce a bad smell.

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