Hemorrhoid Symptoms And Diagnosis: Internal And External Hemorrhoids
Itching, pain, and bleeding in the anal area are common signs of hemorrhoids.
Itching, pain, and bleeding in the anal area are common signs of hemorrhoids.
Hemorrhoids occur when veins in the skin around the anus or in the lower rectum get swollen and inflamed. Its not exactly clear what causes people to get hemorrhoids, but there are some common, accepted risk factors and conditions that lead to their development.
Aging can decrease muscle tone in the area, weakening the tissue and causing hemorrhoids to bulge, while obesity and pregnancy can increase the risk for hemorrhoids due to increased pressure on tissue in the area.
Repeated straining to make a bowel movement, as well as constipation, are also associated with hemorrhoids.
Hemorrhoids are generally not dangerous or life-threatening, but they may be painful.
Whom Do Hemorrhoids Affect
Although most people think hemorrhoids are abnormal, almost everyone has them. Hemorrhoids help control bowel movements. Hemorrhoids cause problems and can be considered abnormal or a disease only when the hemorrhoidal clumps of vessels enlarge.
Hemorrhoids occur in almost everyone, and an estimated 75% of people will experience enlarged hemorrhoids at some point. However only about 4% will go to a doctor because of hemorrhoid problems. Hemorrhoids that cause problems are found equally in men and women, and their prevalence peaks between 45 and 65 years of age.
How Do Healthcare Providers Treat Hemorrhoids
You should see your healthcare provider if symptoms get worse or interfere with your daily life or sleep. Also seek help if signs dont improve after a week of at-home treatments. Your provider may treat hemorrhoids with:
- Rubber band ligation: A small rubber band placed around the base of a hemorrhoid cuts off blood supply to the vein.
- Electrocoagulation: An electric current stops blood flow to a hemorrhoid.
- Infrared coagulation: A small probe inserted into the rectum transmits heat to get rid of the hemorrhoid.
- Sclerotherapy: A chemical injected into the swollen vein destroys hemorrhoid tissue.
Surgical treatments include:
- Hemorrhoidectomy: Surgery removes large external hemorrhoids or prolapsed internal ones.
- Hemorrhoid stapling: A stapling instrument removes an internal hemorrhoid. Or it pulls a prolapsed internal hemorrhoid back inside the anus and holds it there.
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When To Seek Medical Advice
See your GP if you have persistent or severe symptoms of haemorrhoids. You should always get any rectal bleeding checked out, so your doctor can rule out more potentially serious causes.
The symptoms of haemorrhoids often clear up on their own or with simple treatments that can be bought from a pharmacy without a prescription . However, speak to your GP if your symptoms don’t get better or if you experience pain or bleeding.
Your GP can often diagnose haemorrhoids using a simple internal examination of your back passage, although they may need to refer you to a colorectal specialist for diagnosis and treatment.
Some people with haemorrhoids are reluctant to see their GP. However, theres no need to be embarrassed, because GPs are very used to diagnosing and treating haemorrhoids.
Read more about diagnosing haemorrhoids.
What Are The Possible Complications
There are a number of complications that can potentially develop in severe instances of hemorrhoids:
- It is possible for an abnormal passage or a fistula to form linking the hemorrhoid mass to the skin of the anal region.
- The patient could also develop anemia on account of the excessive loss of blood, although this is very uncommon.
- The swollen vein could lose its blood supply or become strangulated. This condition is very painful.
- The swollen mass could become infected.
- The patient could also develop fecal incontinence as a result of severe or untreated hemorrhoids.
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Medicines For Treating Piles
Theres a range of medicines that can help to relieve the symptoms of piles. Always read the patient information leaflet that comes with your medicine and ask your pharmacist for advice if you have any questions.
- If youre passing hard poo, a fibre supplement such as ispaghula husk or mild laxative such as lactulose will soften it.
- Over-the-counter painkillers, such as paracetamol, may help to ease any pain from piles. Dont take painkillers that have an opioid in them , as these could make you constipated and add to your problems.
- Soothing creams, ointments and suppositories may ease any pain and itchiness from piles. There are lots of different products available over the counter. Some contain a local anaesthetic such as lidocaine. Only use these for a few days as they may affect the sensitivity of your skin ask your pharmacist for more information.
- Products that contain corticosteroids, such as Anusol HC and Proctosedyl, may reduce swelling and pain. Dont use these for more than a week as they can damage the skin around your anus. Most are available over the counter and others on prescription.
It can sometimes take up to a month for self-help measures and medicines to work. If your symptoms dont improve after this time, contact your GP. They may refer you to a specialist.
They Keep Getting Back On The Wagon
Vacations, holidays, and stressful life situations happen, and no one eats according to plan all the time. That’s OK. The trick is to get back on course as soon as possible. Make it a learning experience, not a failure. Remember that you can move on from setbacks, and maintenance is a marathon, not a sprint.
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Hemorrhoids Treatment: Rubber Band Ligation
The principle of rubber band ligation is to encircle the base of the hemorrhoidal clump with a tight rubber band. The tissue cut off by the rubber band dies, and is replaced by an ulcer that heals with scarring.
A similar procedure was described in 460 BC by the Greek physician Hippocrates:
And hemorrhoids you may treat by transfixing them with a needle and tying them with very thick and woolen thread, for application, and do not foment until they drop off, and always leave one behind and when the patient recovers, let him be put on a course of Hellebore.
Rubber band ligation can be used with first-, second-, and third-degree hemorrhoids, and may be more effective than sclerotherapy. Symptoms frequently recur several years later, but usually can be treated with further ligation.
The most common complication of ligation is pain. However, bleeding one or two weeks after ligation or bacterial infection in the tissues surrounding the hemorrhoids may occur.
How Long Do Hemorrhoids Last
Some hemorrhoids can last for few days while others may take time to heal. Some hemorrhoids can heal on their own with some lifestyle changes and would need medical intervention while others may require treatments and even surgeries.
Internal hemorrhoids like prolapsed hemorrhoids can be painful like external hemorrhoids if they protrude out of the anus. These hemorrhoids may take time to heal and need treatments.
Many women develop hemorrhoids during pregnancies. During pregnancy, there is increased pressure on the fetus on the abdomen, especially during the third trimester. The veins of the anus and rectum may swell up and cause hemorrhoids. These hemorrhoids generally resolve after childbirth.
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How To Get Rid Of Hemorrhoids: Diagnosis And Treatments
Most individuals who have hemorrhoids discover them by either
- feeling the lump of an external hemorrhoid when they wipe themselves after a bowel movement,
- noting drops of blood in the toilet bowl or on the toilet paper, or
- feeling a prolapsing hemorrhoid after bowel movements.
With a history of symptoms, a physician can begin diagnosis on the basis of a careful examination of the anus and anal area. Although the physician should try his or her best to identify the hemorrhoids, it is perhaps more important to exclude other causes of hemorrhoid-like symptoms that require different treatment such as
- anal fissures,
This is true whether or not hemorrhoids are found during anoscopy.
How To Heal Hemorrhoids: Over
Products used to treat hemorrhoids are available as
- foams, and
When used around the anus, ointments, creams, and gels should be applied as a thin covering. When applied to the anal canal, these products should be inserted with a finger or a “pile pipe.” Pile pipes are most efficient when they have holes on the sides as well as at the end. Pile pipes should be lubricated with ointment prior to insertion. Suppositories or foams do not have advantages over ointments, creams, and gels.
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What Are The Symptoms Of Hemorrhoids Are They Painful
It depends on the type of hemorrhoids you have, Dr. Nelson says. If you have external hemorrhoids, youll probably have the following symptoms:
- anal itching
- one or more hard, tender lumps near your anus
- an anal ache or pain that you feel or gets worse when you sit
If you have internal hemorrhoids, youll likely have these symptoms:
- bleeding from your rectum
- a hemorrhoid that has fallen through your anus, which is called prolapse
Hemorrhoids, for the most part, do not cause pain when you have a bowel movement, says Rudolph Bedford, M.D., a gastroenterologist at Providence Saint Johns Health Center in Santa Monica, CA. However, if you have a prolapsed hemorrhoid, you can also experience swelling and pain if it doesnt go back inside your body, Dr. Nelson says.
Understanding The Difference Between External And Internal Hemorrhoids
Its true that the symptoms youre having help identify which type of hemorrhoid youre experiencing. The good news is that treatment exists for all types, and it may be easier than you believe to get rid of the pain and bleeding that often accompany this fairly common problem.
Betsy Clemens, MD, is a specialist who leads our team here at Midwest Hemorrhoid Treatment Center in Creve Coeur, Missouri. She shares insight about hemorrhoid types, their symptoms, and the therapy available to help resolve your discomfort.
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How Many Hemorrhoids Can A Person Have
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Signs You May Have Hemorrhoids
The symptoms of hemorrhoids typically depend on the location. Signs and symptoms may include:
- Bleeding during bowel movementsâyou might notice small amounts of bright red blood on your toilet tissue or in the toilet.
- Itching around your anus.
- Pain or discomfort around the anus.
- Swelling around your anus.
- A lump near your anus, which may be sensitive or painful.
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What Are The Signs And Symptoms Of An External Or Thrombosed Hemorrhoid
Thrombosed external hemorrhoids are a painful condition. These occurs when a blood clot develops in a hemorrhoidal blood vessel causing swelling and inflammation.
- When a blood clot occurs in a hemorrhoid, the hemorrhoid will become even more swollen. This swelling leads to increased pain.
- The pain is usually worse with bowel movements and may increase with sitting.
A thrombosed external hemorrhoid may resolve on its own however, this condition often needs medical care. Bleeding with a bowel movement is never normal and should prompt a visit to a health-care professional. While hemorrhoids are the most common cause of bleeding with a bowel movement, there may be other reasons for bleeding including inflammatory bowel disease, infection, and tumors.
Preventing And Treating Haemorrhoids
Haemorrhoid symptoms often settle down after a few days, without needing treatment. Haemorrhoids that occur during pregnancy often get better after giving birth.
However, making lifestyle changes to reduce the strain on the blood vessels in and around your anus is often recommended. These can include:
- gradually increasing the amount of fibre in your diet good sources of fibre include fruit, vegetables, wholegrain rice, wholewheat pasta and bread, pulses and beans, seeds, nuts and oats
- drinking plenty of fluid particularly water, but avoiding or cutting down on caffeine and alcohol
- not delaying going to the toilet ignoring the urge to empty your bowels can make your stools harder and drier, which can lead to straining when you do go to the toilet
- avoiding medication that causes constipation such as painkillers that contain codeine
- losing weight
- exercising regularly can help prevent constipation, reduce your blood pressure and help you lose weight
These measures can also reduce the risk of haemorrhoids returning, or even developing in the first place.
Medication that you apply directly to your back passage or tablets bought from a pharmacy or prescribed by your GP may ease your symptoms and make it easier for you to pass stools.
Surgery carried out under general anaesthetic is sometimes used to remove or shrink large or external haemorrhoids.
Read more about treating haemorrhoids and surgery for haemorrhoids.
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What Causes Internal And External Hemorrhoids And Simple Ways To Treat Them
Hemorrhoids are usually caused by increased pressure due to pregnancy, being overweight, or straining during bowel movements. By midlife, hemorrhoids often become an ongoing complaint. By age 50, about half the population has experienced one or more of the classic symptoms, which include rectal pain, itching, bleeding, and possibly prolapse . Although hemorrhoids are rarely dangerous, they can be a recurrent and painful intrusion. Fortunately, there’s a lot we can do about hemorrhoids.
Classification Of Internal Hemorrhoids:
- Grade 1 – A hemorrhoid is present but only visualized by a doctor with ansocopy or colonoscopy. The hemorrhoid does not extend out the anus.
- Grade 2 – The hemorrhoid extends out of the anus with a bowel movement or with straining. After your BM, the hemorrhoid goes back inside on its own.
- Grade 3 – The hemorrhoid extends out of the anus with a bowel movement or with straining. You have to manually push the hemorrhoid back inside the anus. If you have this, you should seek medical attention, but it is not urgent.
- Grade 4 – A hemorrhoid extends outside the anus and are not able to be manually pushed back inside. If you have this seek medical attention immediately. There are significant potential complications.
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What Is Rectal Cancer
The rectum is the lower part of the colon that connects the large bowel to the anus. The rectum’s primary function is to store formed stool in preparation for evacuation. Like the colon, the three layers of the rectal wall are as follows:
- Mucosa: This layer of the rectal wall lines the inner surface. The mucosa is composed of glands that secrete mucus to help the passage of stool.
- Muscularis propria: This middle layer of the rectal wall is composed of muscles that help the rectum keep its shape and contract in a coordinated fashion to expel stool.
- Mesorectum: This fatty tissue surrounds the rectum.
In addition to these three layers, another important component of the rectum is the surrounding lymph nodes . Lymph nodes are part of the immune system and assist in conducting surveillance for harmful materials that may be threatening the body. Lymph nodes surround every organ in the body, including the rectum.
The American Cancer Society estimates about 95,520 new cases of colon cancer, and 39,910 new cases of rectal cancer will occur in 2017. Males are more likely than females to develop rectal cancer . The most common type of rectal cancer is adenocarcinoma , which is a cancer arising from the mucosa. Cancer cells can also spread from the rectum to the lymph nodes on their way to other parts of the body.
When Is It Time To See Your Doctor
While most people think of hemorrhoids as a minor problem, they can be very painful, explains Dr. Buzas. Knowing when to treat conditions such as hemorrhoids on your own and when its better to seek help can help you avoid unnecessary complications.If youre experiencing any of the following situations related to your hemorrhoids, make an appointment to see your doctor:
- You experience rectal bleeding or see bright red blood on your toilet paper.
- You have pain and discomfort in your rectum or anus.
- Youve tried over-the-counter remedies for more than one week without relieving your symptoms.
- You have bowel movements that are maroon or dark like tar in color, which can be a sign of bleeding.
If your rectal bleeding wont stop and you feel dizzy or faint, you should consider it a medical emergency that warrants a trip to the emergency room.When you see your doctor for hemorrhoids, youll first discuss your symptoms. Be sure to answer any questions directly and honestly, to get the best diagnosis. Your doctor will then examine you for external hemorrhoids, internal hemorrhoids and other potential issues.
Getting your hemorrhoids checked out is no different than and as important as getting a routine colonoscopy, Pap test, mammogram or prostate exam, Dr. Buzas notes. Theres no reason to be reluctant or delay your care.
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What Is The Treatment For Rectal Cancer
Surgery is likely to be the only necessary step in treatment if stage I rectal cancer is diagnosed.
The risk of the cancer coming back after surgery is low, and therefore, chemotherapy is not usually offered. Sometimes, after the removal of a tumor, the doctor discovers that the tumor penetrated into the mesorectum or that the lymph nodes contained cancer cells . In these individuals, chemotherapy and radiation therapy are offered after recovery from the surgery to reduce the chance of the cancer returning. Chemotherapy and radiation therapy given after surgery is called adjuvant therapy.
If the initial exams and tests show a person to have stage II or III rectal cancer, then chemotherapy and radiation therapy should be considered before surgery. Chemotherapy and radiation given before surgery is called neoadjuvant therapy. This therapy lasts approximately six weeks. Neoadjuvant therapy is performed to shrink the tumor so it can be more completely removed by surgery. In addition, a person is likely to tolerate the side effects of combined chemotherapy and radiation therapy better if this therapy is administered before surgery rather than afterward.
The following chemotherapy drugs may be used at various points during therapy:
Medications are available to alleviate the side effects of chemotherapy and antibody treatments. If side effects occur, an oncologist should be notified so that they can be addressed promptly.