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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.”
If you know you have hemorrhoids and you have acute and severe anal pain, it could be a sign of thrombosed hemorrhoids.
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.
Roll Back The Intensity Of Your Workout
Look for non-vigorous exercises that tone and strengthen your muscles. Yoga is a popular choice, not only for the physical health benefits, but also for the mental relaxation associated with the practice. Because hemorrhoids can take a toll on your mental health as well as your physical health, its especially important to find an exercise routine that encourages a positive outlook on life.
What Causes External Hemorrhoids
External hemorrhoids are when one or more tender bumps form beneath the skin surrounding your anus. These are dilated blood vessels that have become so enlarged that they protrude.
Blood may clot, or thrombose, inside the protruding blood vessel. This can form a hard lump and cause considerable pain in some cases.
External and internal hemorrhoids are caused by many of the same factors. These include:
- Straining while pooping. The most common cause of external hemorrhoids is repeated straining while having a bowel movement. This is often caused by severe cases of constipation or diarrhea. Straining makes blood pool in the area.
- Sitting on the toilet for a long time. This can also put pressure on the tissues around your rectum and anus.
- Weakened support tissues. As you age, the tissues tend to weaken around the anus and rectum.
- Pregnancy.Pregnant people may also be at an increased risk of hemorrhoids because of the increased pressure of the abdomen on these veins.
- Obesity. Having excess weight has been associated with having hemorrhoids.
- Heavy lifting. You may have a higher risk of hemorrhoids if you frequently lift heavy objects.
- Not eating enough fiber. A low fiber diet may lead to constipation, which can cause hemorrhoids.
A range of symptoms can affect a person with external hemorrhoids. Symptoms vary depending on the severity. Some of the symptoms that you may have include:
Symptoms of external hemorrhoids may go away after a few days, according to the
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How Are Hemorrhoids Diagnosed
Your healthcare provider diagnoses hemorrhoids based on symptoms and a physical exam. You may also have:
- Digital rectal exam: Your provider inserts a gloved, lubricated finger into the rectum to feel for swollen veins.
- Anoscopy: Your provider uses an anoscope to view the lining of the anus and rectum.
- Sigmoidoscopy: Your provider uses a sigmoidoscope to view inside the lower part of the colon and rectum. Procedure types include flexible sigmoidoscopy and rigid sigmoidoscopy .
These tests may be uncomfortable but arent painful. They typically take place in a doctors office or outpatient center without anesthesia. You go home the same day.
Your provider may perform a colonoscopy to confirm findings from other tests or check for signs of colon cancer. This outpatient procedure requires anesthesia.
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
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Do I Need To See A Doctor
Its best to see a doctor if youre noticing blood. While it could be due to a hemorrhoid, it could also be a sign of something more serious, such as colorectal cancer.
A doctor will likely start by confirming that hemorrhoids are the source of the blood youve noticed. To do this, theyll either examine the area for external hemorrhoids or insert a gloved finger to check for internal hemorrhoids.
If its still not clear where the bloods coming from, they may recommend a colonoscopy, which involves inserting a small, lighted camera into your colon while you are sedated. This will help them check for any signs of other conditions that could be causing the bleeding.
Make sure to tell them if you have any of the following symptoms in addition to bleeding:
- changes in stool consistency or color
- changes in bowel movement habits
- weight loss
Can Hemorrhoids Be Prevented Or Avoided
Just about everyone has hemorrhoids at some time. But some things may make you more likely to get them. People whose parents had hemorrhoids may be more likely to get them. Pregnant women often get hemorrhoids because of the strain from carrying the baby and from giving birth. Being very overweight or standing or lifting too much can make hemorrhoids worse.
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Pay Attention To Pain
With any exercise you try, pay special attention to how your body feels and avoid activities that cause you pain. Some people with hemorrhoids struggle with sitting activities like spinning and rowing, as they increase pressure to an already sore area of the body. There are countless options to explore for burning calories and building muscle that wont leave you in pain.
Who Removes Hemorrhoids Treatment
Treating enlarged hemorrhoids is important, because they tend to get worse over time. Hemorrhoids are treated with a variety of measures including diet, over-the-counter medicine like
- anti-inflammatory pain killers,
and various treatment options are available, like
- sclerotherapy,
- surgery.
Who Removes Hemorrhoids?
Most hemorrhoid complaints begin with a trip to a family doctor. Your doctor will then refer you to a specialist: either a gastroenterologist or a proctologist . Proctologists specialize in surgical treatments, while gastroenterologists are experts in digestive diseases.
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What Do Hemorrhoids Feel Like
Do hemorrhoids itch? Do hemorrhoids hurt?
These are some of the first questions that people will ask when they are trying to determine the cause of their discomfort. By far, the biggest complaint regarding hemorrhoids is the itching. The feeling of blood pulsing through a swollen and twisted vein in such a sensitive region of your body is going to cause you to feel itchy.
The worst part about itching hemorrhoids is that you cant simply itch them, which typically causes the sensation to grow more severe. Sitting for a prolonged period of time will typically worsen the itching.
To alleviate itching caused by hemorrhoids you can try using cold compresses, take a warm sitz bath, or try using an over the counter ointment.
These solutions will help to reduce itching, as well as lessen the severity of other symptoms that commonly develop with hemorrhoids. Whether they are internal or external, all hemorrhoids produce the same symptoms at different levels of severity.
Common symptoms of hemorrhoids include:
- Itching
- Light bleeding
- Pain during bowel movements
Bleeding causing by hemorrhoids is not typically severe. Bleeding occurs typically during a bowel movement, when the process of pushing causes the bulbous vein to tear or scratch. When this happens, the blood will show clearly on the tissue in a streak of bright red.
What Not To Eat
Foods with little fiber can cause or make constipation worse, so it’s best to limit how much you eat of them.
- White bread and bagels
- Milk, cheese, and other dairy
- Meat
- Processed foods such as frozen meals and fast food
Watch the amount of salt you eat. It can lead to your body hanging on to water, which puts more pressure on your blood vessels. That includes the veins in your bottom that cause hemorrhoids.
Iron supplements can cause constipation and other digestive problems, so talk to your doctor before you take them.
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How Do You Treat External Hemorrhoids Diagnosis
External hemorrhoids appear as bumps and/or dark areas surrounding the anus. If the lump is tender, it suggests that the hemorrhoid is thrombosed. Any lump needs to be carefully followed, however, and should not be assumed to be a hemorrhoid since there are rare cancers of the anal area that may masquerade as hemorrhoids.
What Is A Hemorrhoid
A hemorrhoid is essentially an engorged or swollen blood vessel, says Sameet Shah, D.O., a gastroenterologist at Mountainside Medical Group.
Hemorrhoids can be inside or outside your body. With external hemorrhoids, you can see them and they tend to hurt. With internal hemorrhoids, you dont see or feel them, but a symptom might be bleeding during a bowel movement.
The most common cause of hemorrhoids is due to constipation or straining while using the toilet. Women are prone to hemorrhoids during pregnancy and after giving birth because of the increased pressure on the pelvic floor and hormonal changes that can lead to constipation. Children and adolescents can also get hemorrhoids.
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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
- cereals.
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.
Dont Overlook Diet And Hydration
Dont forget your water bottle when you head to the gym. Water is crucial for preventing constipation, which can then lead to hemorrhoids or can worsen existing symptoms. The diet you eat between workouts is also key in keeping your body in its best shape. Eating plenty of fresh fruits and vegetables can also work to prevent constipation. Talk with your doctor for more advice on how to find and maintain a healthy diet and exercise routine that fits your symptoms and fitness goals. Dont Ignore Your Doctors Advice.
If your doctors advice is to take it slow for a few days, such as after stop exercising after hemorrhoid surgery, it is important you follow their advice. Your proctologist or colorectal surgeon is the expert on your case, because they understand your condition better than anyone else.
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Getting Restful Sleep Without Triggering Hemorrhoid Pain
Depending on your preferred sleeping position, your hemorrhoid pain can make it difficult for you to get a good nights rest. In addition to clean cotton underwear and loose-fitting pajamas, we recommend you sleep on your stomach to reduce anal pain and place a pillow under your hips to prevent yourself from rolling over onto your back.
A full-body sitz bath right before bed may also ease discomfort, help you feel more relaxed, and make it easier for you to fall asleep. In addition, reading or listening to soothing music may take your mind off your hemorrhoids and your discomfort, which may help you get to sleep faster.
About Dr David Heiman
Dr. David R. Heiman is Endoscopy Medical Director and a gastroenterologist at Florida Medical Clinics North Tampa location. He specializes in treating patients with conditions like hemorrhoids, IBS, GERD, and hepatitis, as well as performing endoscopies and colon cancer screenings. Dr. Heiman is dedicated to helping patients find treatment plans that work best for them and that address all of their medical concerns.
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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.
Symptoms Of Prolapsed Internal Hemorrhoids
Hemorrhoids prolapse when their blood vessels swell and extend from their location in the rectum through the anus. In the anal canal, the hemorrhoid is exposed to the trauma of passing stool, particularly hard stools associated with constipation. The trauma can cause bleeding and sometimes pain when stool passes.
The presence of
- inflammation, and
- constant moisture
can lead to anal itchiness , and occasionally the constant feeling of needing to have a bowel movement. The prolapsing hemorrhoid usually returns into the anal canal or rectum on its own or can be pushed back inside with a finger, but falls out again with the next bowel movement.
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Is It Internal Or External Hemorrhoids
If your symptoms include internal itching, anal bleeding anda bulge that comes and goes with bowel movements, an internal hemorrhoid is thelikely culprit.
However, some people are more bothered by externalhemorrhoids, which can cause swelling, itching and bleeding, and be unsightly.Visible bumps and tags are common with external hemorrhoids.
Hemorrhoid Treatment In A Doctors Office With Or Without Surgery
Medical procedures may be needed for hemorrhoids that dont go away with home treatments.
Painful external hemorrhoids can be excised during an office visit following a shot of local anesthetic to numb the area.
For internal hemorrhoids, a few office procedures may be considered. In rubber band ligation, the most common hemorrhoid procedure performed in the United States, the doctor places a small rubber band around the base of the hemorrhoid, cutting off the hemorrhoidâs blood supply. The hemorrhoid typically shrinks and falls off within about a week, though several quick follow-up visits may be required to completely get rid of the hemorrhoid.
Other procedures include sclerotherapy, in which a chemical injected into the hemorrhoid causes scar tissue to form, shrinking the hemorrhoid and infrared coagulation, in which an intense beam of infrared light causes the scar tissue to form, cutting off the blood supply and shrinking the hemorrhoid.
If you have a large external hemorrhoid, both internal and external hemorrhoids, or an internal hemorrhoid thats prolapsed , a surgical operation called a hemorrhoidectomy may be necessary, though few patients require this procedure.
Another option that aims to reduce postoperative pain is a stapled hemorrhoidopexy, in which a device pulls the hemorrhoidal tissue upward and to its normal position, stapling it in place.
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Get Back To The Gym With Or Without Your Hemorrhoid Symptoms
If you do not already have a regular exercise routine, you should visit a doctor to prepare for a program that best fits your age and activity level. Or maybe you exercise regularly but want to modify your current exercise program to prevent irritating a current hemorrhoid or reduce the risk of developing hemorrhoids again.
In Los Angeles, our team of proctologists can help you ensure you are healthy enough for vigorous exercise and offer advice about the types of exercise that might be right for you based on your current health and any medical concerns. Call us today at 273-2310 to make an appointment and get started.
When Do I Need To See A Health Care Provider For Hemorrhoids
You should see your health care provider if you:
- Still have symptoms after 1 week of at-home treatment
- Have bleeding from your rectum. Hemorrhoids are a common cause of bleeding, but other conditions can also cause bleeding. They include Crohn’s disease, ulcerative colitis, colorectal cancer, and anal cancer. So it’s important to see your provider to find the cause of the bleeding.
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Does Alcohol Or Caffeine Cause Hemorrhoids
Some of you may also want to know does alcohol or caffeine cause hemorrhoids? If you’re anything like me, when it comes to having an ice cold soda on a hot day, there’s nothing better.
However if you’re having a flare-up of hemorrhoids, you might want to give it a miss.
Caffeine and alcohol will both dehydrate you. If you’re right there on the edge of being dehydrated to begin with, they can push your system over the edge and start causing stiffer bowel movements.
Stiffer bowel movements can trigger a hemorrhoid attack.