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.
Can Hemorrhoids Be Prevented
You can help prevent hemorrhoids by
- Eating foods that are high in fiber
- Taking a stool softener or a fiber supplement
- Drinking enough fluids every day
- Not straining during bowel movements
- Not sitting on the toilet for long periods of time
NIH: National Institute of Diabetes and Digestive and Kidney Diseases
When Do Hemorrhoids Require Medical Intervention
Your hemorrhoids can be an embarrassing topic to discuss with anyone, even your doctor. But hemorrhoids are common and affect 5% of adults in the United States every year, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Its estimated, in fact, that as many as three in four adults will experience problems with hemorrhoids at some point in their lives.
Though you can find many treatments for hemorrhoids at your local pharmacy, home remedies dont help everyone. At Rivas Digestive Center, located in Hollywood, Florida, our expert gastroenterologist, Dr. John Rivas, wants you to know when its time to get medical help for your hemorrhoids.
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Alabama Colon & Rectal Institute Is Centered Around Treating Diseases Of The Colon Rectum And Anus
Alabama Colon & Rectal Institute has been in practice since 1990 as a free standing, private practice located in downtown Birmingham, Alabama. We are known for our efficiency and patient care, in a more relaxed office-based setting. Our doctors are known regionally for their expertise and are active in teaching surgical residents and other physicians. We are also a major sponsor of The Rumpshaker 5K, a race that promotes awareness about colorectal cancer. Check out our website for more information, or give us a call to make an appointment at 458-5000, or email us at .
Hemorrhoids By The Numbers
- Around 20 million people in the United States suffer from hemorrhoids .
- In 2004, the National Institutes of Health noted that the diagnosis of hemorrhoids was associated with 3.2 million ambulatory care visits, 306,000 hospitalizations and 2 million prescriptions in the United States.
- The peak incidence of hemorrhoids is between the ages of 4565. Development of hemorrhoids before the age of 20 is unusual.
- The risk of developing hemorrhoids is higher in white adults than in black adults, higher in women than in men and higher for women who are pregnant.
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When To Seek Help
If you have symptoms of a prolapsed hemorrhoid, see a doctor.
Sometimes the hemorrhoid may retreat away from the skin on its own and not cause any more symptoms.
But if pain, itching and bleeding persist, see a primary care physician, proctologist , or gastroenterologist .
If you feel a lump around your anus, even if there are no other symptoms, you should see a doctor. You want to make sure that lump is actually a hemorrhoid and not a tumor or other health concern.
How Long Does It Take To Recover
Having a bowel movement after any hemorrhoid procedure can be uncomfortable. This is especially true after surgery.
Your doctor will probably want you to have a bowel movement within 48 hours. You may be given a stool-softening medication to make it less painful.
It may take up to four weeks or longer before you can resume your usual activities after a hemorrhoidectomy. Recovering from the less-invasive procedures, such as sclerotherapy, coagulation, and rubber band litigation, may take just a few days. Sclerotherapy and coagulation may take a few sessions to be successful.
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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.
Be Patient When Treating Hemorrhoids
Most hemorrhoids will not interfere with normal daily living and resolve on their own after a few days.
There are conservative, at-home treatments to help with your symptoms like sitz baths, myrtus communis essential oil and stool softeners.
If hemorrhoids persist, more aggressive treatment options are available including prescription medications, rubber band ligation and surgical removal.
Remember that hemorrhoids are not life-threatening. Patience and following appropriate preventative tips are the best ways to manage them.
About Erin Peisach
Erin Peisach, RDN, CLT attended the University of Maryland, College Park for her Bachelorâs degree in Dietetics. She is now the owner of Nutrition by Erin, a San Diego-based virtual nutrition private practice specializing in gastrointestinal disorders.
Learn more about her on the About page.
Joe Leech, Dietitian
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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
Prolapsed Hemorrhoid Pain Relief Options
Prolapsed hemorrhoids are not generally accompanied by pain unless they become thrombosed or strangled. If you are experiencing pain from prolapsed hemorrhoids, there are many pain relief options available. These include:
- Warm sitz baths or soaks for fifteen minutes, three to four times a day
- Application of ice packs to relieve swelling and numb the pain
- Pain relievers such as acetaminophen and ibuprofen
- Rinsing off after a bowel movement or the use of moist wipes or medicated pads to avoid further irritation from wiping, such as Tucks
- Numbing ointments, pain relieving creams, or witch hazel
- Avoidance of heavy lifting and/or straining
- For severe cases, or flare-ups, staying off your feet and bed rest can greatly reduce swelling and pain associated with swelling
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Surgical Treatment For Hemorrhoids
Today, many minimally invasive surgical options are available to treat hemorrhoids. Your physician will refer you to a surgeon if conservative treatments dont address your symptoms or if you arent a candidate for in-office procedures.
Common surgical procedures to treat hemorrhoids include:
- Hemorrhoidectomy. Large external hemorrhoids or prolapsed hemorrhoids may need to be removed by a surgeon.
- Hemorrhoid stapling. A special stapling tool can remove internal hemorrhoids and pull prolapsed hemorrhoids back into the anus.
If you struggle with recurrent hemorrhoids, talk to your doctor about ways you can treat and prevent them, says Dr. Hackworth.
Need a doctor? Find a Riverside gastroenterology provider near you.
Three Types Of Prolapsed Hemorrhoids
If the prolapsed hemorrhoid retracts back into the anus on its own then its considered second degree. If the only way for the hemorrhoid to get back into the anus is with manual manipulation, then it falls into the third degree category.
And finally, if the hemorrhoid cant even be manually manipulated back into the anus, well then you have a third degree prolapsed hemorrhoid.
What Is Prolapsed Hemorrhoid
Presence of one or multiple lumps around the anus and the anal opening are indications of prolapsed hemorrhoid. It is visible as a protruding and bulging lump coming out of the anal opening.
The lump is generally dark blue in color as it has accumulated blood or blood clots with swollen, inflamed blood vessels.
Change In Bowel Habits
With a prolapsed internal hemorrhoid you may develop the sensation that you cant fully evacuate your bowels. You may also notice a mucous discharge or difficulty cleaning yourself following a bowel movement because of displaced toilet tissue.
These symptoms can be uncomfortable but easily treated with medical intervention.
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Peppermint Oil To Soothe Hemorrhoid Pain
Peppermint oil has a high menthol content that produces a cooling and refreshing sensation when applied to the hemorrhoids.
You can use a blend of peppermint oil and coconut oil to help get rid of hemorrhoid pain fast.
Consume More Fiber To Prevent Constipation And Straining
Its important to consume enough fiber to help get rid of hemorrhoids faster. Fiber helps relieve and prevent constipation which is a known cause of piles.
Research published in The Permanente Journal on treating hemorrhoids without surgery found that eating more fiber is essential. Scientists recommend to consume 30-35 grams of fiber a day to help treat hemorrhoids naturally. You can consume more fiber by increasing the amount of beans, vegetables, fruits, and whole grains in your diet.9
Along with increasing fiber intake to relieve hemorrhoid discomfort, you should drink enough water to reduce constipation.
You can also consume psyllium as it helps to prevent constipation and relieve the pain from enlarged hemorrhoids. Dr. Herman Villalba who has researched remedies for hemorrhoids, recommends using psyllium as a natural hemorrhoid reliever. The increased fiber in psyllium bulks up stool and softens them to prevent straining during a bowel movement.9
Fiber is a natural laxative
Fiber is also one of the best natural laxatives. A 2005 review of 7 randomized trials found that fiber has a laxative effects and it help treat painful hemorrhoids. Some studies suggest that fiber can help reduce, pain, itching and bleeding associated with hemorrhoids.17
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Hemorrhoids In Patients With Cirrhosis Or Portal Hypertension
A clinician must differentiate bleeding hemorrhoids form bleeding anorectal varices because the latter can be managed by suture ligation along the course of varices, transjugular intrahepatic portosystemic shunt, or pharmacological treatment of portal hypertension. Since a majority of bleeding hemorrhoids in such patients is not life threatening, conservative measure with the correction of any coagulopathy is a preferential initial approach. Of note, rubber band ligation is generally contraindicated in patients with advanced cirrhosis due to the risk of profound secondary bleeding following the procedure. Injection sclerotherapy is an effective and safe procedure for treating bleeding hemorrhoids in this situation. In a refractory case, suture ligation at the bleeder is advised. Hemorrhoidectomy is indicated when bleeding hemorrhoids are refractory to other approaches.
What Should I Eat If I Have Hemorrhoids Diet
Individuals with hemorrhoids should soften their stools by increasing the fiber in their diets.
Fiber is found in numerous foods, including
- fresh and dried fruits,
- whole grains, and
In general, 20 to 30 grams of fiber per day is recommended, whereas the average American diet contains less than 15 grams of fiber. Fiber supplements, like psyllium, methylcellulose, and calcium polycarbophil, also may be used to increase the intake of fiber.
Stool softeners and increased drinking of liquids also may be recommended, as well as bulk-forming laxatives. Nevertheless, the benefits of fiber, liquids, and stool softeners have not been well-tested with respect to hemorrhoidal control in scientific studies.
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Use These Tips To Prevent Hemorrhoids From Recurring In The Future
4 min read
Weve heard about how painful hemorrhoids can be, but few people are actually aware that hemorrhoidsveins in your anal canalare completely normal. Its only when they become swollen and inflamed that they become a problem.
When hemorrhoids are inflamed, they can cause significant discomfort, itching, and bleeding. But how they affect you depends entirely on the type of hemorrhoid you have.
There are two types of hemorrhoids: external and internal hemorrhoids. External hemorrhoids are located under the skin around the anus and can form a small, hard lump. When irritated, they can itch or bleed.
Internal hemorrhoids lie inside the rectum and cant be seen or felt. They also rarely cause discomfort. However, straining and irritation when passing stool can cause damage to the hemorrhoids surface. Sometimes straining can push an internal hemorrhoid through the anal opening, which is known as protruding or prolapsed hemorrhoids.
Although hemorrhoids are common, that doesnt necessarily make them any more comfortable to deal with. While they can be easy to treat, preventing them can save you from having to deal with treatments, pain, and embarrassment. But before you learn how to prevent hemorrhoids, first you must understand what causes them.
Risk Factors For Hemorrhoids
Several risk factors have been claimed to be the etiologies of hemorrhoid development including aging, obesity, abdominal obesity, depressive mood and pregnancy. Meanwhile, some conditions related to increased intraabdominal pressure, such as constipation and prolonged straining, are widely believed to cause hemorrhoids as a result of compromised venous drainage of hemorrhoid plexus. Some types of food and lifestyle, including low fiber diet, spicy foods and alcohol intake, was reported to link with the development of hemorrhoids and the aggravation of acute hemorrhoid symptoms.
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When To See A Doctor
Blood in the stool is never normal and should always be discussed with a physician, even when it is thought to be from a hemorrhoid.
Blood in the stool is most often the result of hemorrhoids bright red blood is characteristic. Stools that have darker red blood or that appear tarry might be related to another condition, particularly one associated with an area higher up in the digestive tract. In the event of these symptoms, it might be necessary to have testing to rule out other conditions.
Hemorrhoids Doctor Discussion Guide
Profuse rectal bleeding thats accompanied by feelings of faintness or dizziness is a reason to seek medical attention right away.
This type of bleeding is not typical for hemorrhoids and may be an indication that another problem is occurring. Similarly, mucus or pus from the rectum, fever, chills, nausea, or a rapid heartbeat arent common symptoms of a hemorrhoid and are also a reason to seek medical care right away.
Straining During Bowel Movements
Chronic constipation makes you strain while passing stool. This puts a lot of pressure on the hemorrhoids in your anus and rectum so they may be pushed out of the anus.
Chronic diarrhea also puts significant pressure on the blood vessels in the rectum and anus because stool passes more frequently. Therefore, the existing hemorrhoids may be pushed out because of this.
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What Are Prolapsed Hemorrhoids
A prolapsed hemorrhoid is an internal hemorrhoid that has begun protruding from the anus. When an internal hemorrhoid becomes prolapsed, chances are that symptoms will be similar to that of external hemorrhoids. The bulging, protruding tissue will gradually begin to cause itchiness, irritation, and bleeding from the anus. If large enough, you will be able to feel the prolapsed pile with your finger and push it back into the anus.
The classification of internal hemorrhoids are based on the severity of the prolapse. Grades are as follows:
Grade 1: No prolapse. The hemorrhoid tissue still remains inside the rectum.
Grade 2: Minor prolapse. The internal hemorrhoid will occasionally protrude outside the anus and then go back in on its own.
Grade 3: Increased prolapse. The protruding lump cannot retreat on its own and must be pushed in manually.
Grade 4: Severe prolapse. Hemorrhoid has become painful and cannot be pushed back in.
Prolapsed hemorrhoids and external hemorrhoids can have very similar symptoms, but certain symptoms point to a prolapsed internal hemorrhoid, including:
- Bright red blood after wiping
- Mucus discharge from the anus
- A feeling that you cant wipe away a stool
- An irritating mass you can usually push back into the anus
Heal Your Hemorrhoids