Hemorrhoids

Hemorrhoids (piles) is a condition when the veins around the anus or lower rectum are dilated, swollen, and inflamed. This condition is very common, especially during pregnancy and after childbirth.

Hemorrhoids arise from a plexus of dilated arteriovenous channels and connective tissue with the veins. The piles are located in the submucosal layer in the lower rectum.

Hemorrhoids result from increased pressure in the veins of the anus. The pressure causes the veins to bulge and expand, making them painful, particularly when you are sitting. The most common cause is straining during bowel movements. Hemorrhoids may result from constipation, diarrhea, and sitting for long periods of time. Piles are estimated to occur in up to one-half of the population by age 50.

There are two forms of hemorrhoids: external and internal, depending on their location. Hemorrhoids that form above the dentate line between the rectum and anus are called internal hemorrhoids. Those that form below the anorectal junction are called external hemorrhoids. Both internal and external hemorrhoids may remain in the anus or protrude outside the anus.

Symptoms

Many people believe they have hemorrhoids. However, the similar anorectal discomfort may be a symptom of a more serious condition, such as a fissure, or a simply an anal irritation following a bowel movement. On the other hand, not everyone who has hemorrhoids experiences symptoms.

Symptoms of hemorrhoids include:

Hard tender lumps near the rectum
Grape-like piles protruding from the anus
Bleeding during bowel movements, often painless
Blood in stool
Anal itching, irritation, ache, or pain
Painful bowel movements

What can help with hemorrhoids?

Self-Care at home

If the symptoms are mild you can relieve pain, irritation and itching with the application of hemorrhoidal creams or suppositories. Several products containing local anesthetic (benzocaine, dibucaine, or pramoxine) or hydrocortisone are used to reduce pain, itching and burning.

Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can help to relieve pain and inflammation.

The prevention of constipation (hard or infrequent stools) and diarrhea is the priority for avoiding exacerbation of hemorrhoids:

Eat high fiber diet. Good sources of dietary fiber are fresh fruits, leafy vegetables, and whole-grain breads and cereals. Avoid starchy foods and refined grains.
Drink plenty of fluids. Water helps to prevent constipation by facilitating the flow of food though the intestines. Even mild dehydration can be a contributing factor to constipation.
Taking stool softners or a bulking laxative may relieve straining with bowel movements. However, avoid excessive use of laxatives.
Never ignore the urge to go to the toilet. When you feel the need to have a bowel movement, don't wait too long.

Relieving the pain and irritation:

Effective and simple way to lessen the swelling and the pain is to take warm sitz baths. Sit in a tub or pan of plain warm water, 3 or 4 times a day, for 15 to 20 minutes each time. The water will keep the area clean, and calm the inflammation and discomfort.
Clean your anus after each bowel movement by patting gently with moistened pads such as baby wipes or a cotton cloth soaked in warm water.
Apply cold compress or icepack on the anus area to relieve swelling.

Fixative (non-surgical) procedures

In serious cases of hemorrhoids (e.g. prolapsed internal piles), medical intervention may be necessary. Several non-surgical techniques are used to treat internal and external hemorrhoids:

Rubber band ligation. A rubber band is placed around the base of the hemorrhoid inside the rectum to cut off circulation to the piles. The hemorrhoid then gradually shrinks and withers away within a few days. The band is usually applied to one hemorrhoid at a time at intervals of 2 weeks or longer.
Sclerotherapy. A chemical solution is injected around the blood vessel to shrink the hemorrhoid.
Electrical or laser coagulation or infrared photo coagulation. These techniques that use special devices to burn hemorrhoidal tissue.

Surgery (hemorrhoidectomy)

Hemorrhoidectomy is a surgical procedure which permanently removes the hemorrhoids. Surgery may be used if other measures fail. However, hemorrhoid surgery may result in severe pain.