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| | Hemorrhoids
Hemorrhoids, or piles, are one of mankind's most common and nagging
disorders. By themselves, hemorrhoids are rarely serious, but they can be
extremely troublesome. In some instances, they may mask a more serious disorder,
such as colon or rectal cancer. Therefore, hemorrhoids require the proper
diagnosis and treatment by a physician.
 Hemorrhoids
are dilated (enlarged) veins which occur in and around the anus and rectum. They
may be external (outside the anus) or internal and slip to the outside. In both
of these instances, the hemorrhoids can be felt and seen as lumps or knots.
Hemorrhoids also may remain inside the rectum and so cannot be felt or seen.
These are called internal hemorrhoids.
What Causes Hemorrhoids?
A common cause of hemorrhoids is simply the standing position, in which all the
blood above the rectum exerts pressure on the rectal and anal areas. Other
conditions which contribute to hemorrhoids are: poor bowel habits, constipation,
diarrhea, pregnancy, obesity, and especially frequent straining when having a
bowel movement. However, some patients will have none of these conditions and
still develop hemorrhoids.
What Are the Complications?
Hemorrhoids can produce several uncomfortable, but non-serious problems.
Thrombosis and pain -- A blood clot in the hemorrhoid may cause severe
pain and usually demands immediate medical attention.
Bleeding -- Hemorrhoids can ooze fresh red blood, whether located
externally or internally. External hemorrhoids often cause dripping of blood
from the anus while sitting on the toilet. The blood might also be seen as
soiling of the underwear. Internal hemorrhoids that bleed may produce fresh
blood in the stool.
Itching and irritation -- External hemorrhoids can be itchy,
especially if the area is moist and irritated.
Do Hemorrhoids Cause Cancer?
Hemorrhoids do not develop into cancer. However, both hemorrhoids and cancer can
cause rectal bleeding. In fact, many disorders can be the cause of rectal
bleeding. When rectal bleeding occurs in persons over age 30, and especially in
those over age 50, it should be considered a serious problem until an exact
diagnosis is made. The physician who directly examines the rectal area can often
make the specific diagnosis.
Treatment
Treatment of hemorrhoids varies depending on where they are, what problems they
are causing, and how serious they are. Often, time and the normal process of
healing clear hemorrhoids with little or no specific treatment. When hemorrhoids
require treatment, the following general measures are recommended:
Conservative Treatment
- Keep the anal area clean, using a mild soap and gentle dabbing after a
bowel movement. Avoid vigorous rubbing of the area.
- Keep the anus and hemorrhoids as dry as possible, using talcum powder and
a pad of soft tissue to absorb moisture.
- Eat a diet high in fiber (bran) and roughage. Fiber and bran retain water
in the stool, producing soft, bulky stools which are easier to pass and
reduce the tendency to develop hemorrhoids. Bulking agents, such as
Metamucil, Konsyl, Citrucel, and Fibercon, are available in drug stores.
These also come in less expensive generic versions.
- Avoid straining when having a bowel movement.
- When thrombosis, pain, and tenderness occur, a 10 to 20 minute hot tub
bath two to four times daily brings heat to the area, provides relief from
the pain, and promotes healing. This is called a hot Sitz bath.
Ligation
A common method of treating internal hemorrhoids is to use a small rubber band
to tie off the base of the swollen vein. The blood circulation stops and the
hemorrhoid then falls off. Repeat treatments are sometimes necessary.
Infrared Photocoagulation
An infrared light source can be used to coagulate internal hemorrhoidal veins.
Often, more than one treatment is necessary.
Lasers
A laser directs a high-intensity light beam at tissue and so produces heat,
thereby coagulating or cauterizing the hemorrhoid. This technique is still in
the research phase, but may have application in the future.
Surgery
 | Surgery is sometimes recommended in treating hemorrhoids. It usually is
reserved for:
| Acute, painful clot (thrombosis) of hemorrhoids
| Profusely or continuously bleeding hemorrhoids
| Longstanding, irreversible, and large hemorrhoids
| When other treatment is unsuccessful |
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The physician evaluates each patient's case to determine the appropriate
treatment.
To Prevent Hemorrhoids...
| Eat plenty of fiber, bran, or roughage, or use a bulking agent to maintain
regular, soft bowel movements.
| Do not delay or try to prevent a bowel movement when the urge is present.
| Exercise, especially aerobic, may help produce more regular bowel
movements.
| Drink plenty of liquids and eat regularly scheduled meals.
| Keep the area around the anus clean and dry. |
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Summary
Hemorrhoids are an especially common disorder and often clear up by
themselves or with minimal treatment. Treatment typically is simple and
effective, although surgery occasionally is necessary. Hemorrhoids can mask a
more serious disorder and, therefore, must be evaluated and diagnosed properly
by a physician. People with hemorrhoids who work closely with their physician
are usually assured a good outcome and relief from this common disorder.
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