Internal Hemorrhoids Vs External Hemorrhoids
There are two main types of hemorrhoids:
Internal Hemorrhoids These hemorrhoids develop inside the lower rectum. Internal hemorrhoids usually don’t hurt, but they often bleed painlessly, resulting in bright red blood you might notice when you go to the bathroom and wipe.
Most of the time, internal hemorrhoids are not visible to the naked eye. But in some cases, internal hemorrhoids may protrude through the anus, which is known as becoming prolapsed. When this happens, they will usually shrink back inside the rectum on their own. Protruding hemorrhoids can become irritated and itchy, and patients may find it difficult to clean themselves after a bowel movement.
Internal hemorrhoids are categorized by how prolapsed they are, which helps determine how they should be treated.
Grade 1 hemorrhoids means there is no prolapse. A prolapse that goes back in by itself is categorized as grade 2. Prolapse that needs to be pushed back in by the patient is considered grade 3. Grade 4 is when the prolapse cant be pushed back in.
External Hemorrhoids These hemorrhoids develop under the skin around the outside of the anus. They can be itchy or painful, and may feel lumpy.
External hemorrhoids are called thrombosed hemorrhoids when a blood clot develops within the hemorrhoid. The increased pressure can be very painful, especially within the first 48 hours after it develops.
Seek An Experienced Specialist
While you want a specialist who works with the most cutting-edge treatments, you also want someone who has the experience to know what will work based on the details of your specific case. According to the American Board of Surgery, this is not a general practitioner. General practitioners may only see a few cases a year, and general surgeons may only see a few hemorrhoidectomies, fistulotomies, and other similar procedures each year. Without regularly handling these conditions, the rate of misdiagnosis or improper treatment is much higher.
This again highlights the benefits of choosing a specialist, and one who has extensive colorectal surgical experience such as that required to obtain board certification. This experience improves the outcome every step of the way, from routine screenings, to prescribing the right medical treatments, to performing surgery when necessary.
How Can I Treat My Hemorrhoids
You can most often treat your hemorrhoids at home by
- taking a stool softener or a fiber supplement such as psyllium or methylcellulose
- drinking water or other nonalcoholic liquids each day as recommended by your health care professional
- not straining during bowel movements
- not sitting on the toilet for long periods of time
- taking over-the-counter pain relievers such as acetaminophen, ibuprofen, naproxen, or aspirin
- sitting in a tub of warm water, called a sitz bath, several times a day to help relieve pain
Applying over-the-counter hemorrhoid creams or ointments or using suppositoriesa medicine you insert into your rectummay relieve mild pain, swelling, and itching of external hemorrhoids. Most often, doctors recommend using over-the-counter products for 1 week. You should follow up with your doctor if the products
- do not relieve your symptoms after 1 week
- cause side effects such dry skin around your anus or a rash
Most prolapsed internal hemorrhoids go away without at-home treatment. However, severely prolapsed or bleeding internal hemorrhoids may need medical treatment.
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What Can You Do At Home For A Hemorrhoid
Hemorrhoid home care. Over-the-counter ointments or creams that contain a mild steroid can help decrease itching or pain, and there are also prescription-strength creams and suppositories available. But one of the best treatments you can do at home is to soak the area in warm water several times a day.
Causes And Risk Factors Of Rectal Bleeding
Diverticulosis is the most common cause of rectal bleeding. It is the presence of tiny bulges, called diverticula, in the colon wall. Diverticula are common and typically do not cause problems, but can sometimes protrude through the walls of the bowels, leading to bleeding or infections.
Often called piles, hemorrhoids are swollen veins that appear at the bottom of the large intestine and outside the anus. They are caused by excessive straining, such as while making a bowel movement, sitting on the toilet too long, or, in women, pregnancy and giving birth. People who have persistent hemorrhoids are often constipated, overweight or obese, or eating a very low-fiber diet.
Hemorrhoids can be itchy, painful, and annoying, but they are rarely serious and often go away on their own. In certain cases, treatment may be needed.
Anal fissures, another cause of rectal bleeding, are tiny tears in the anus and anal canal commonly caused by straining with hard stools.
Colitis is the inflammation of the lining of the tissues of the colon. This inflammation can lead to rectal bleeding. Ischemic colitis occurs when blood flow to the colon is reduced, typically as a result of narrowed or blocked arteries. With infectious colitis, the swelling of the colon is caused by bacteria, viruses, or parasites.
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How Do I Relieve Hemorrhoid Itching
For people who suffer from hemorrhoid itching, probably the best treatment plan is to find the underlying cause of the hemorrhoids to stop their occurrence. There are, however, a few treatments that may help minimize both hemorrhoid itching and pain until the actual cause has been determined. Topical ointments and suppositories that help reduce itching and swelling can be purchased at most pharmacies without a prescription. Keeping the rectal area very clean, especially following bowel movements, may also help lessen the severity of the symptoms.
The two most commonly used topical ointments designed to treat hemorrhoid itching and pain are ointments that contain either cortisone or lidocaine. Cortisone is an anti-inflammatory steroid that may help shrink hemorrhoids. As the hemorrhoids begin to shrink, very often the itching will also subside. Lidocaine is primarily targeted at relieving hemorrhoid pain, but also has some anti-inflammatory properties.
Easy Ways To Prevent Hemorrhoids
There are a number of easy, healthy ways to incorporate more fiber into your diet. Fiber-filled foods include fruits such as berries, avocados, and pears . Broccoli, artichokes, and Brussels sprouts are among the vegetables that can up your fiber intake. Whole grains, such as brown rice, quinoa, and oatmeal, are also an important source. Legumes, including lentils, various beans, and green peas, are a great way to get fiber. Nuts and seeds make for a great fiber-filled snack, too.
If you’re having trouble getting enough fiber in your regular diet, consider a fiber supplement.
If you experience chronic constipation and suspect that may be contributing to your hemorrhoids, avoid eating too many foods that contain little or no fiber, such as cheese and fast and processed foods.
Drink plenty of water and other fluids. Recommendations for daily water intake vary and depend on the individual, but the Institute of Medicine of the National Academies has set adequate intake levels at 2.7 liters for men and approximately 3.7 liters for women. This can come from beverages and food, but caffeinated beverages and alcohol can be dehydrating and should not be counted in reaching this intake goal.
Exercise regularly. Exercise, especially 20 to 30 minutes of moderate aerobic activity a day, can help keep bowel movements regular. And regular exercise may help you lose weight, which may be contributing to the formation of hemorrhoids.
Other tips for preventing hemorrhoids include:
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What Is The Best Doctor For Hemorrhoid Surgery
There are many reasons you may see a doctor for your hemorrhoids. But, some cases may require you seek treatment from a doctor who specializes in the treatment of conditions that affect the rectum or anus.
While a proctologist is commonly known as the specialist to handle these types of conditions, it is actually a gastroenterologist that treats hemorrhoids.
Gastroenterologists diagnose and treat conditions that affect the digestive tract. This can include the:
- Inflammatory bowel disease
- Bowel changes
Some gastroenterologists perform surgery under anesthesia. In more severe cases, your GI doctor may refer you to a proctologist, or colorectal surgeon.
Most patients who see a colorectal surgeon must see a GI doctor first for a referral.
What Do You Do If A Hemorrhoid Is Bleeding
If you experience any rectal bleeding, then it is time to inform your doctor. While there is a good chance that it is from your hemorrhoids, it can also be a sign of something else in your body.
If your doctor determines that the bleeding is in fact from hemorrhoids, then it will likely subside within days, but you may need to address your diet and toilet habits in the meantime.
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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.
Hemorrhoids are not arteries or veins, but instead are normal blood vessels called sinusoids that are located in the walls that surround the rectum and anus. When the venous pressure within these blood vessels increases, the hemorrhoids swell and dilate, because it is more difficult for blood to empty from them. This leads to the most common symptoms of bleeding and swelling.
Common situations that increase pressure within the hemorrhoidal blood vessels and lead to abnormalities include the following.
- Straining to have a bowel movement. This may be due to constipation or diarrhea.
- Prolonged sitting, including on the toilet
- Lack of exercise
Signs Your Hemorrhoids Warrant A Doctor’s Visit
Your doctor may also check for blood in the stool, examine the muscle tone of your anus, and perform a rectal exam to diagnose internal hemorrhoids. This is done in the doctor’s office with a gloved, lubricated finger and an anoscope . Your doctor may also recommend additional tests to rule out other causes of bleeding, especially if you are over age 40.
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Which Illnesses Do Hemorrhoid Specialists Treat
There are two different types of hemorrhoids that can exist together, namely:
- internal hemorrhoids, which will be located in the lower rectum
- external hemorrhoids, which can occur under the skin immediately around the anus itself.
The most discomforting type are the external hemorrhoids because the overlying skin in this area, which is sensitive to pain and temperature, can soon become irritated and tends to wear away. If a blood clot should then form inside an external hemorrhoid, the pain is often sudden and can be severe. There may be a lump in the anal area, which can be felt or seen. The clot then typically dissolves, leaving a skin tag which may often itch or become irritated.
Unlike the external type, internal hemorrhoids are typically painless, even if they produce bleeding. Thus, you may notice bright red blood on the toilet paper, or else blood dripping into the toilet bowl. In addition, internally forming hemorrhoids can also prolapse, and thus extend beyond the anus. This can result in a number of potential problems because a protruding hemorrhoid may then collect microscopic stool particles and small amounts of mucus. This may then cause an irritation, which is called pruritus ani, and constantly wiping in an effort to relieve the itching may simply make the problem worse.
Based on the degree of prolapse, a standard medical classification recognises the following four grades of prolapsed hemorrhoid:
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How To Soar To Self
Different Types of Hemorrhoids
There are two types of hemorrhoids: external and internal. External hemorrhoids arise from the anal canal, while internal hemorrhoids arise from the rectum, immediately above the anal canal. According to Cuckoo Choudhary, MD, associate professor of gastroenterology at Thomas Jefferson University in Philadelphia, one type is not worse than the other, but both can cause problems. “It all depends on the size and degree of the hemorrhoid,” Dr. Choudhary says. “Untreated internal hemorrhoids can cause bleeding. External hemorrhoids can cause thrombosis , which gives way to severe pain from hemorrhoidal strangulation.”
Know When to See Your Doctor
Though the annoyance of hemorrhoids can be reason enough to call your doctor, use this checklist to know when a visit is a must:
- If you’re experiencing any type of rectal bleeding
- If the hemorrhoids are causing you pain or discomfort
- If the problems persist despite trying over-the-counter hemorrhoid creams or other remedies
- If you’re passing stools that look maroon in color or tarry in color, a sign of bleeding
If you experience a large amount of rectal bleeding that is accompanied by dizziness or faintness, be sure to seek emergency medical care immediately.
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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.
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.
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Are Bleeding Hemorrhoids Dangerous
For the most part, hemorrhoids are not dangerous. You may not even know you have them unless you see blood or feel a lump or stiffness around your anus.
However, do not take your hemorrhoids for granted, particularly if you have bleeding hemorrhoids. Not everything that causes blood in your stool is harmless, for example, colorectal cancer. You should see a hemorrhoid doctor or general practitioner as soon as possible.
Hemorrhoids do not cause cancer. However, cancer can cause many of the same symptoms as hemorrhoids, including bleeding.
Common Causes Of Hemorrhoids
Doctors are unable to pinpoint the exact cause of hemorrhoids, but numerous activities and risk factors can increase their presence in North Carolina patients. Common causes of hemorrhoids include:
- Straining during bowel movements
- Increased pressure due to obesity
- Sitting for long periods of time on the toilet
- Eating a low-fiber diet
As we age, hemorrhoids become more common. By age 50, half of older adults experience one or more common symptoms of hemorrhoids. While this condition is not usually dangerous, hemorrhoids can be a significant and painful intrusion in daily life.
December 22, 2017 by inx Medical
If you suffer from hemorrhoids, the good news is that lower grade hemorrhoids can resolve on their own with at-home treatments. But what if they get to the point where you need to see a doctor to treat them? How do you choose where to go and what doctor is right for you?
Heres what you should know about finding the right doctor for you:
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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.