Hemorrhoids bother about 89% of all Americans at some time
in their lives. Hemorrhoids caused Napoleon to
sit side-saddle, sent President Jimmy Carter to
the operating room, and benched baseball star George
Brett during the 1980 World Series. Over two thirds
of all healthy people reporting for physical examinations
have hemorrhoids. Hemorrhoids are cushions of tissue
and varicose veins located in and around the rectal
area. When they become inflamed, hemorrhoids can
itch, bleed, and cause pain. Unfortunately a hemorrhoidal
condition only tends to get worse over the years,
NEVER better. That is why we advocate safe, gentle,
and effective treatment for hemorrhoids, as soon
as they occur.
Internal hemorrhoids occur higher up in the anal canal,
out of sight. Bleeding is the most common symptom of internal
hemorrhoids, and often the only one in mild cases.
External hemorrhoids are visible-occurring out side the
anus. They are basically skin-covered veins that have ballooned
and appear blue. Usually they appear without any symptoms.
When inflamed, however, they become red and tender.
Sometimes, internal hemorrhoids will come through the anal
opening when straining to move your bowels. This is called
a prolapsed internal hemorrhoid; it is often difficult
to ease back into the rectum, and is usually quite painful.
When a blood clot forms inside an external hemorrhoid,
it often causes Severe pain. This thrombosed external hemorrhoid
can be felt as a firm, tender mass in the anal area, about
the size of a pea.
A thin slit-like tear in
the anal tissue, an anal fissure is likely to cause itching,
pain, and bleeding during a bowel movement.
What Are Hemorrhoids?
The term hemorrhoids refers to a condition in which the
veins around the anus or lower rectum are swollen and inflamed.
Hemorrhoids may result from straining to move stool. Other
contributing factors include pregnancy, aging, chronic
constipation or diarrhea, and anal intercourse. Hemorrhoids
are both inside and above the anus (internal) or under
the skin around the anus (external). Hemorrhoids (piles)
arise from congestion of internal and/or external venous
plexuses around the anal canal.
Hemorrhoids are classified into four degrees,
depending on severity, so that they can more easily be
for possible treatment.
What Are the Symptoms of Hemorrhoids?
Many anorectal problems, including fissures, fistulae,
abscesses, or irritation and itching (pruritus ani),
have similar symptoms and are incorrectly referred to
as hemorrhoids. Hemorrhoids usually are not dangerous
or life threatening. Rarely, a patient can have bleeding
so severe, that severe anemia or death may occur. In
some cases, hemorrhoidal symptoms simply go away within
a few days. But in most cases, hemorrhoidal symptoms
eventually return, often worse than they were before.
Although many people have hemorrhoids, not all experience
symptoms. The most common symptom of internal hemorrhoids
is bright red blood covering the stool, on toilet paper,
or in the toilet bowl. However, an internal hemorrhoid
may protrude through the anus outside the body, becoming
irritated and painful. This is known as a protruding
hemorrhoid. Symptoms of external hemorrhoids may include
painful swelling or a hard lump around the anus that
results when a blood clot forms. This condition is known
as a thrombosed external hemorrhoid. In addition, excessive
straining, rubbing, or cleaning around the anus may cause
irritation with bleeding and/or itching, which may produce
a vicious cycle of symptoms. Draining mucus may also
How Common Are Hemorrhoids?
Hemorrhoids are very common in both men and women. About
half of the population have hemorrhoids by age 50. Hemorrhoids
are also common among pregnant women. The pressure of
the fetus in the abdomen, as well as hormonal changes,
cause the hemorrhoidal vessels to enlarge. These vessels
are also placed under severe pressure during childbirth.
For most women, however, hemorrhoids caused by pregnancy
are a temporary problem.
How Are Hemorrhoids Diagnosed?
A thorough evaluation and proper diagnosis by the doctor
is important any time bleeding from the rectum or blood
in the stool occurs. Bleeding may also be a symptom of
other digestive diseases, including colorectal cancer.
The doctor will examine the anus and rectum to look for
swollen blood vessels that indicate hemorrhoids and will
also perform a digital rectal exam with a gloved, lubricated
finger to feel for abnormalities. Closer evaluation of
the rectum for hemorrhoids requires an exam with an anoscope,
a hollow, lighted tube useful for viewing internal hemorrhoids,
or a proctoscope, useful for more completely examining
the entire rectum. To rule out other causes of gastrointestinal
bleeding, the doctor may examine the rectum and lower colon
(sigmoid) with sigmoidoscopy or the entire colon with colonoscopy.
Sigmoidoscopy and colonoscopy are diagnostic procedures
that also involve the use of lighted, flexible tubes inserted
through the rectum.
What Is the Treatment?
Medical treatment of hemorrhoids is aimed initially at
relieving symptoms. Measures to reduce symptoms include · Warm
tub baths several times a day in plain, warm water for
about 10 minutes. · Application of a hemorrhoidal
cream or suppository to the affected area for a limited
time. Preventing of the recurrence of hemorrhoids will
require relieving the pressure and straining of constipation.
Doctors will often recommend increasing fiber and fluids
in the diet. Eating the right amount of fiber and drinking
six to eight glasses of fluid (not alcohol) result
in softer, bulkier stools. A softer stool makes emptying
the bowels easier and lessens the pressure on hemorrhoids
caused by straining. Eliminating straining also helps
prevent the hemorrhoids from protruding. Good sources
of fiber are fruits, vegetables, and whole grains.
addition, doctors may suggest a bulk stool softener
or a fiber supplement such as psyllium or methylcellulose.
In some cases, hemorrhoids must be treated endoscopically
or surgically. These methods are used to shrink and
the hemorrhoidal tissue. The doctor will perform the
procedure during an office or hospital visit. A number
of other methods may be used to remove or reduce the
size of hemorrhoids.
How Are Hemorrhoids Prevented?
The best way to prevent hemorrhoids is to keep stools soft
so they pass easily, thus decreasing pressure, and to empty
bowels without undue straining as soon as possible after
the urge occurs. Exercise, including walking, and increased
fiber in the diet, to help reduce constipation and straining
by producing stools that are softer and easier to pass.
Major surgery for hemorrhoids can generally be avoided
in favor of more sophisticated and often painless methods
of treatment. Non-surgical methods of treatment are available
to most patients as a viable alternative to a permanent
Bipolar electrotherapy is applied for a directed coagulation
effect of the mucous membrane near the hemorrhoid.
Specialized probe designs are effective for the treatment
internal hemorrhoids. Bipolar electrotherapy is applied
for a directed coagulation effect of the mucous membrane
near the hemorrhoid. Specialized probe designs are
effective for the treatment of bleeding internal hemorrhoids.
Hemorrhoidal Arterial Ligation (H.A.L.) is performed
using a modified proctoscope in conjunction with a
flowmeter. A needle and thread is passed beneath the
artery, and a knot is externally tied, to stop the
blood flow to
Therapeutic galvanic waves applied directly to the
hemorrhoid, produces a chemical reaction that shrinks
hemorrhoidal tissue. This technique is most effective
when it is used on internal hemorrhoids. Therapeutic
waves applied directly to the hemorrhoid, produces
a chemical reaction that shrinks and dissolves hemorrhoidal
This technique is most effective when it is used on
To shrink the hemorrhoid and its blood vessels, medicine
is injected into the mucous membrane near the hemorrhoid.
This method is reserved for the smallest of hemorrhoids.
A device called a photocoagulator focuses infrared
light into a fine point at the end of a probe, which
the hemorrhoid in place. This is used for hemorrhoids
that are actively bleeding.
Rubber Banding - Painless techniques for the treatment
A special instrument fits a small rubber band over
part of the hemorrhoid. A tight rubber band stops the
flow into the pinched-off portion, which falls off
in about a week. This technique is widely used for
into the anal canal.
For patients with a lesser degree of prolapse, Rubber
Band Ligation is currently the most widely used procedure
the United States and Europe for treatment of internal
hemorrhoids. In this procedure, the hemorrhoidal tissue
is pulled into a double sleeved cylinder to allow the
placement of latex/rubber bands around the tissue.
tissue below the bands dies off and is eliminated during
a bowel movement.
Rubber band ligation is absolutely
painless and can be performed in a doctor's office.
the need for more than one procedure to resolve a patient's
condition. Rubber band ligation is most effective when
combined with e.g., a sclerotherapy injection for prolapse.
A cryogenic device uses liquid nitrogen to super freeze
the hemorrhoid. This causes the affected tissue to
slough off, so that new healthy tissue can grow in
This technique is most effective when it is used on