Hemorrhoids are dilated and twisted veins of the rectum and are found inside the anus which occur when the veins in those area get enlarged. These varicose veins may eventually bleed, get inflamed or can develop a blood clot. Hemorrhoids are of two kinds, the external and internal. The inflamed veins between the rectum and the anus are the latter type and that develops around the opening of the anus is known as the external hemorrhoids. The external hemorrhoids may bleed and can also rupture.
This is a common health problem found among 50% of the population above 50 years of USA and though the reason for the disease cannot be considered as genetic it is also believed to be a contributing factor.
Q. What are the Causes of Hemorrhoids ?
Hemorrhoids are caused by the increased pressure in the abdomen at the time of defecation due to various reason such as strain in bowel movement due to frequent constipation, pressure of the fetus in pregnant women, obesity, etc, besides the common cause relating to the type of one's work that requires long hours of standing or sitting like the job of a traffic officer or waitress or sitting jobs like counter clerks and truck drivers etc. and also for people engaged in heavy lifting.
Hemorrhoids are also caused rarely on account of Cirrhosis of liver. However the exact reason for the development of the swelling of the veins is unknown while all or many of the above factors may cause a hemorrhoid condition.
It is also believed that the type of work is not the contributing factor for the condition though it can worsen existing hemorrhoids.
Q. What are the Symptoms of Hemorrhoids ?
While the common symptoms for the external Hemorrhoids are pain, itching, burning and swelling of in the anus area. Some times this may also cause bleeding. Internal hemorrhoids found inside the rectum are not painful and many may not know that they have them. However due to irritation or hard pressure like in constipated condition these veins may cause bleeding that is seen on the stool, toilet bowl or toilet paper.
In case the internal hemorrhoids are left untreated the internal hemorrhoids can protrud outside the anus opening leading to a state called prolapsed hemorrhoids that may eventually result in a strangulated hemorrhoid.
Q. How are they Diagnosed ?
As explained above many may not even know that they suffer from an internal hemorrhoid as no serious symptoms appear unless the internal veins are subject to pressure in conditions of constipation. The external hemorrhoids are protruded in later stages and become visible and problematic. Hemorrhoids are usually not dangerous to life and do not cause cancer.
Most of the conditions clear up after a few days. However the similarity in the external symptoms like anal bleeding that may also be due to diseases like colorectal cancer and certain other digestive system disorders one needs to get examined as soon the symptom appears to rule out the possibility of any such diseases and to get proper treatment early in such cases.
The disease is diagnosed by the visual examination by the doctor by inserting a gloved, lubricated finger into the anus. Alternately he may also use an anoscope to see the canal. In rare cases he may also examine using by a colon scope for the examination of the colon.
Because of the severity or hemorrhoids, or the lack of a suitable treatment from creams, prescriptions, or other remedies for curing hemorrhoids, surgery may be the only course of action for some people.
Here is a list of the 5 most common surgeries/treatments performed by a physician.
Three are used for external hemorrhoids and two for internal hemorrhoids : -
Hemorrhoidectomy
Laser coagulation
Infrared photocoagulation
Internal Hemorrhoid Surgery : -
Injection Sclerotherpy
Rubber Band Ligation
Hemorrhoidectomy
Surgical removal of hemorrhoids is recommended for third and fourth degree internal hemorrhoids when other treatments are unable to alleviate severe burning, itching, swelling, protrusion and overall pain. A general anesthesia for pain is administered prior to surgery.
Hemorrhoidectomy is appropriate when you have : -
Very large internal hemorrhoids.
Internal hemorrhoids that still cause symptoms after nonsurgical treatment.
Large external hemorrhoids that cause significant discomfort and make it difficult to keep the anal area clean.
Both internal and external hemorrhoids.
Had other treatments for hemorrhoids (such as rubber band ligation) that have failed.
Pros : -
May provide better long-term results
95% success rate of hemorrhoids reoccurring
When nothing else works
Cons : -
Surgery is more costly
Greater risk of complications
More painful than other procedures
Recovery may take longer 2-3 weeks
Laser Surgery for Treatment of Hemorrhoids
This is becoming the preferred laser surgery (versus Laser Coagulation). This process vaporizes or excises the hemorrhoid by a surgeon. The laser beam is infinitely small allowing for precision and accuracy. Generally results in a rapid healing.
Laser Coagulation involves an electric current applied to the hemorrhoid through an electrode probe. The hemorrhoid went through a chemical reaction to stop the flow of blood to the hemorrhoid thus resulting in the shrinking of the swollen tissue.
Pros : -
Less painful
Less invasive
Less expensive
Faster healing process
Usually no over night hospital stay - may be performed in doctor's office
Cons : -
Hemorrhoids may reoccur
Infrared photocoagulation (also called coagulation therapy)
This is procedure is used to treat small and medium sized hemorrhoids. Doctors recommend coagulation therapy in cases where small internal hemorrhoids continue to cause symptoms after home treatment.
It involves a device that creates an intense beam of infrared light. The heat created by the light causes scar tissue, which cuts cutting off the blood supply to the hemorrhoid. The hemorrhoid dies, and a scar forms on the wall of the anal canal. Only one hemorrhoid can be treated at a time. Infrared photocoagulation is done in a doctor's office.
Pros : -
Small internal hemorrhoids are often successfully treated with coagulation therapy (Large hemorrhoids are more likely to be treated with rubber band ligation)
Cons : -
Procedure is painful
Only one hemorrhoid can be treated at a time
Expensive
Rubber Band Ligation
One of the most common hemorrhoid surgeries is rubber band ligation. A tiny rubber band (diameter about 1/25 of an inch) is fitted onto a special gun-like device. When the trigger is pulled, the rubber band is forced onto the base of the hemorrhoid, thus cutting off the blood flow to the hemorrhoid. The hemorrhoid shrinks and within a week, falls off. The results are a scar in the place of the hemorrhoid. Rubber band ligation works best on first and second degree hemorrhoids.
The procedure is done in a doctor's office. Treatment is limited to 1 to 2 hemorrhoids at a time if done in the doctor's office. Several hemorrhoids may be treated at once if the person has general anesthesia.
Pros : -
Lease expensive of all surgical procedures
Repeat treatment for recurring symptoms is rarely needed
Performed in doctor's office
Quick Recovery
Most widely used treatment for internal hemorrhoids
Cons : -
Painful
Not all doctors have the experience or equipment to do rubber band ligation
Injectionc Sclerotherapy
In sclerotherapy, a chemical solution is injected around the blood vessel to shrink the hemorrhoid. This process is used to treat bleeding internal hemorrhoids where by a sclerosing or hardening solution is injected into the base of the hemorrhoids. Sclerotherapy is recommended for smaller hemorrhoids, such as first degree and early second degree hemorrhoids.
Doctors recommend injection sclerotherapy in cases where:
Small hemorrhoids do not improve with home treatment.
Internal hemorrhoids are too small to treat with rubber band ligation.
You have persistent bleeding from hemorrhoids.
You are older than age 70 or are in poor health and would not be a candidate for more invasive surgery.
Pros : -
Inexpensive
Multiple hemorrhoids can be treated at the same time
Fast procedure
Minor pain and discomfort
Performed in doctor's office
Cons : -
Sclerotherapy is not a cure for hemorrhoids
Hemorrhoids often recur after injection sclerotherapy
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