Hemorrhoids are dilated, twisted (varicose) veins located in the wall of the rectum and anus. Hemorrhoids occur when the veins in the rectum or anus become enlarged, they may eventually bleed. Hemorrhoids that form above the boundary 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.

This condition is very common, especially during pregnancy and after childbirth. 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, sitting for long periods of time, and anal infections.

Symptoms.

Symptoms of hemorrhoids include:

Anal itching
Anal ache or pain
Bright red blood on toilet tissue, stool, or in the toilet bowl
Pain during bowel movements
One or more hard tender lumps near the anus

Treatment

Usually, hemorrhoids do not require treatment unless they cause symptoms. Taking stool softners or a bulking type of laxative may relieve straining with bowel movements. Symptoms can sometimes be relieved by soaking the anus in warm water in what is known as sitz bath. The soaking is accomplished by squatting in a partially filled tub or using a container filled with warm water placed on the toilet bowl or commode.

Bleeding hemorrhoids can be treated with an injection of a substance that causes the hemorrhoids to become obliterated with scar tissue. This procedure is called injection sclerotherapy.

Large internal hemorrhoids and those that do not respond to injection sclerotherapy cab be tied off with rubber bands. This procedure is called rubber band ligation. The band causes the hemorrhoid to wither and drop off painlessly. The treatment is usually applied to one hemorrhoid at a time at intervals of 2 weeks or longer.

Interlan hemorrhoids may also be destroyed with laser, an infrared light, or an electrical current.

Surgery to remove the hemorrhoids may be used if other treatments fail. However, hemorrhoid surgery may result in severe pain. New, less painful techniques are being investigated, including Dropper-guided hemorrhoid artery ligation, in which hemorrhoid arteries are identified and tied off.

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