HaemorroidsThey are swollen blood vessels that occurs in the lowermost part of the rectum and anus. They fall into two types:
Internal haemorrhoids
External haemorrhoids
The painless kind are called internal haemorrhoids because they’re inside the rectum and are generally not seen nor felt. But they can bleed, particularly during bowel movements, when straining or irritation occurs.
External haemorrhoids form under the skin surrounding the anus, which can also be painful and uncomfortable.
Most people experience relief from haemorrhoids with home remedies and lifestyle changes. Identifying the symptoms common with each is key to informing you how best to alleviate and treat your condition.
Common Symptoms:
What Do Haemorrhoids Feel Like?
Symptoms of haemorrhoids are dependent on their type.
Internal Haemorrhoids-
These haemorrhoids are formed inside the rectum and are generally not seen or felt, and therefore are less likely to create discomfort. But straining or irritating during a bowel movement may cause:
Painless bleeding: You may see a few drops of bright red blood on toilet tissue or in the toilet bowl.
Prolapsed Haemorrhoids: These may come out of the anus, which can cause pain and aggravation.
External Haemorrhoids –
These haemorrhoids, located just below the skin quality around the anus, can lead to symptoms like:
Anal itching or irritation
Pain or discomfort.
Swelling near the anus.
Bleeding.
Thrombosed Haemorrhoids –
This can occur when blood pools inside the external haemorrhoid and forms a clot, which is referred to as thrombosis. Thrombosed haemorrhoid symptoms may include:
Severe pain.
Swelling and inflammation.
A firm, discoloured lump near the anal region.
When to Consult a doctor?
If you notice any blood when passing a stool, or if your haemorrhoids aren’t improving after a week of at-home treatment, it’s time to see your health care provider. Do not assume rectal bleeding is because of haemorrhoids alone — particularly if you experience any changes in bowel habits or if there are alterations to the colour or condition of the stool. And such symptoms can also point to other serious conditions, including colorectal or anal cancer.
Get emergency treatment right away if you have large amounts of rectal bleeding with light headedness, dizziness or fainting.
Causes of Haemorrhoids
Haemorrhoids develop as a result of engorgement and swelling of the veins surrounding the anus due to increased pressure in the lower rectum. Several factors leading to this pressure include:
Straining a lot during bowel movements
Long time in a seated position, particularly on the toilet
Recurrent instances of chronic diarrhoea or constipation
Obesity
Pregnancy
Anal intercourse
A diet low in fibre
Frequent weightlifting
Risk Factors
The risk of developing haemorrhoids also increases with age as the supporting tissues in the rectum and anus can become less effective and stretch. And a major risk factor is pregnancy, when the weight of the baby puts pressure on the pelvic area.
Potential Complications
Although complications of haemorrhoids are rare, there are several issues to note:
Anaemia: In severe cases, chronic blood loss from haemorrhoids can result in anaemia, which refers to not having enough healthy red blood cells to carry oxygen around the body.
Strangulated Haemorrhoid: It is a condition with obstructed blood supply to internal haemorrhoid — strangulated haemorrhoid is very painful.
Thrombosed haemorrhoid: A clot may form inside the haemorrhoid, this is called a thrombosed haemorrhoid. While this is not a life-threatening ailment, it can be very painful and may require medical treatment to relieve discomfort.
Prevention of Haemorrhoids-
For the prevention of haemorrhoids, you need to keep your stools soft to ease their passage. Consider these strategies to maintain digestive health and reduce symptoms:
Eliminate foods high in sugar: Focus on fruits, vegetables, and whole grains They work by softening the stools and bulking them up, reducing the straining that can cause haemorrhoids. If you are adding fibre, do it slowly to reduce risk of windy discomfort.
Hydration is Key: Drink 8 to 12 glasses of water and other fluids a day to help keep your stool soft. Cutting back on alcohol can also help.
Try out Fiber Supplements: Most people fail to meet their daily need for fiber. Over-the-counter fibre supplements, such as psyllium (Metamucil, Konsyl, etc.) and methylcellulose (Citrucel), have been proven effective in reducing symptoms and bleeding from haemorrhoids.
Take your supplements with water: If you decide to use fibre supplements, drink lots of fluid — at least eight glasses a day if you can manage it. Not drinking enough fluid can cause constipation or make it worse.
Don’t Strain: Bending over or straining to pass a stool often leads to increased pressure in the rectal veins thus increasing prevalence of haemorrhoids.
Regular Exercise: Exercising regularly may help for constipation and reduce the pressure on the veins. Promoting better weight control in itself may also relieve symptoms from haemorrhoids, and exercise may help with this.
Avoid Sitting Extended Amounts of Time: Sitting for a long time, especially on the toilet, can increase pressure to the anal region.
Diagnosis of Haemorrhoids
External haemorrhoids are typically easily diagnosed by a healthcare provider. If internal haemorrhoids are suspected, certain examinations may be required:
Digital Exam: Your provider may perform a digital rectal exam to feel or check for anything abnormal by inserting a gloved finger into the rectum.
External examination: Internal haemorrhoids are usually soft and fine, External examination cannot be done. In these situations, your provider may insert an anoscope, proctoscope, or sigmoidoscope to examine the lower colon and rectum.
Your health care provider might order a colonoscopy to examine your entire colon if she suspects that you have a different digestive disorder, has identified you as having risk factors for colorectal cancer or if you’re middle-aged and due for a screening.
However, most of the time, treatment is required.
Most mild discomfort, swelling, and inflammation caused by haemorrhoids can be addressed with home remedies. Here are some best practices:
Include more fibre in your diet — Adding fibre-rich foods to your diet softens your stool and increases its bulk, reducing your risk of straining during a bowel movement. If your diet is low in fibre, introduce it slowly to avoid gas-type problems.
Topical solutions: Over-the-counter (OTC) haemorrhoid creams or suppositories containing hydrocortisone can help. Pads with witch hazel or numbing agents can be soothing, too.
Sitz Bath (Warm Soaks): Sitting in a few inches of warm water to cover the affected area for 10 to 15 minutes, two to three times a day, after passing stool, may make you feel more comfortable. A sitz bath that fits over the toilet can help with this.
Pain relievers: OTC pain medications like acetaminophen (Tylenol), aspirin, or ibuprofen (Advil, Motrin IB) can provide temporary relief and help alleviate any pain.
You should also get better within a week. If the discomfort persists, it’s a good idea to speak with your health care provider. Get help right away if you experience extreme pain or a lot of bleeding.
Products that aid in the relief of haemorrhoids-
For haemorrhoids that result in only mild discomfort, your health care provider may suggest a number of nonprescription topical medications, including creams, ointments, suppositories or pads. Some of these products also include ingredients such as hydrocortisone and lidocaine that can help to temporarily relieve pain and itching.
Hydrocortisone is a steroid, and long-term use can cause skin thinning, so keep that in mind. Hence, it is necessary to check with your healthcare provider about the duration of use of this blend.
If you get a painful blood clot in an external haemorrhoid this can be removed quickly by your healthcare provider, providing instant relief. This ideally needs to be done within 72 hours of the clot forming and is done under local anaesthetic/spinal anaesthesia.
Minimally Invasive Therapies-
For persistent bleeding or painful haemorrhoids, your provider might recommend one of several minimally invasive procedures, typically done in the office or outpatient setting with no anaesthesia required:
Rubber Band Ligation: It is done by putting small rubber bands at the base of internal haemorrhoids to halt blood supply to the haemorrhoids. The haemorrhoid usually shrinks and falls off within one week.
Sclerotherapy: A chemical solution is injected into the hemorrhoidal tissue, causing it to shrink. The method is typically low on ache but could be less effective than band ligation.
Coagulation Technique: This technique also uses laser or infrared light, which is directed at the bleeding internal haemorrhoids, causing them to harden and shrink. These procedures typically involve mild side effects and discomfort.
Check with your health care provider to see what is best in your case.
Surgical procedures
Just a small portion of patients suffering haemorrhoids will need to be handled by means of surgical procedure in order to find actual relief. If previous treatments have not worked or you have larger haemorrhoids, your healthcare provider may recommend one of the following surgical treatments:
Open Haemorrhoidectomy — surgical removal of excess tissue that causes bleeding You can have it done using a local anaesthetic and a sedative to help you relax, or spinal or general anaesthesia. Surgical removal of haemorrhoids (haemorrhoidectomy) is considered the most complete treatment for the treatment of severe or recurring haemorrhoids. Patients may have pain in the days after the procedure, but this can be relieved with medication. Warm baths can also be soothing. An example of a concern that should be a temporary concern would be when patients experience a trouble urinating, particularly after having spinal anaesthetic as this may lead to an increased risk of urinary infections.
Haemorrhoid Stapling: The ultimate goal of haemorrhoid stapling (also called stapled haemorrhoidopexy) is to reduce blood flow to the hemorrhoidal tissue. Patients tend to have less pain than after a haemorrhoidectomy and return to normal activities sooner. However, stapling might present a higher risk of recurrence and rectal prolapse, in which part of the rectum protrudes through the anus. Other potential complications are bleeding, trouble emptying the bladder and pain. In rare cases, the virus can lead to a severe infection called sepsis.
Have a discussion with your healthcare provider about these options to find the right approach for your situation.
