Hemorrhoids, also called piles, are swollen veins that lie just beneath the mucous membranes lining the lower rectum and anus. It is the swelling or displacement of the normal anal cushions. It is also one of the most common causes of rectal bleeding (1). The walls of these blood vessels stretch so thin that the veins bulge and get irritated, especially when you relieve your bowels. This is similar to varicose veins.
Hemorrhoids are quite common and almost every three out of four adults will have it at some point in their adult life. There are many causes, however, the specific cause is not always known. If the usual symptoms are not present, it may still cause discomfort, bleeding, and itching (2). It is luckily not a very dangerous occurrence, however, it can be recurrent and cause a lot of pain and discomfort.
What Causes Hemorrhoids?
It may be caused by increased pressure on the veins or a buildup of pressure in your lower rectum, which causes the rectum or anal veins to swell. This is usually due to (3):
- Straining during bowel movements
- Being overweight
- During pregnancy
- Standing or sitting for long periods of time
- Chronic diarrhea or constipation
- Eating a low-fiber diet
Take Home Note:
It is caused by pressure in the rectum and anal region which causes the veins to swell. This prevents blood from returning to the heart and it clots in this area.
Signs and Symptoms
It does not always cause symptoms, so you might not even know you have them. However, these are the most common known signs and symptoms recorded (4):
- Bleeding during bowel movements
- Irritation or itching in the anal region
- Discomfort or pain in the anal region
- Swelling around the anus
- A lump or moist, pink bumps situated near or around the edge of the anus
- Mucus discharge
- A sensation that the bowel is not really empty
Take Home Note:
The most common symptoms are bleeding from the anus and a swelling in this region. Itching and pain are also indications.
There Are Two Main Types
The symptoms normally depend on the location of the hemorrhoids. There are two main categories (5,6):
- Internal
This type is found inside the rectum, which is the last area of the large intestine. You will not see it or feel symptoms here as it is not covered by skin. This is because there are fewer pain-sensing nerves in the lower rectal area. When passing stool, for example, it adds pressure and strain on the hemorrhoid’s surface. This could damage the surface and cause it to bleed.
- External
These are found around the anus, which is the anal opening at the end of the digestive tract. These swollen veins are situated under the skin where many nerves are found. This causes a lot of pain, burning, and itching when irritated. Nonetheless, this type tends to bleed, and, if the situation becomes more serious, they can prolapse, or fall out of the anus. This may happen whilst passing a stool and can usually been seen and felt.
Take Home Note:
The two places where swelling can occur is internally, in the lower rectum and externally, in and around the anus. Pain occurs during bowel movements and can cause a prolapse.
Can Blood Clots Form?
In certain cases, blood clots can form within prolapsed external piles. This can cause a tremendously painful condition called a thrombosis (7). This can look rather alarming, especially because it turns a purple or blue color and because it could bleed. Strangely enough, this is still not a serious problem, although it can be very painful. If it does not resolve on its own within a couple of weeks, you can get a doctor to remove the blood clot from the thrombosed hemorrhoid.
Take Home Note:
Blood clots can form within prolapses which can cause a painful thrombosis. This is not dangerous and should disappear within a few weeks.
Diagnosis
A diagnosis can be performed by doing a physical exam and studying your medical history. An anoscope, which is a lighted tube, may be inserted in your anal region to view the lower area of the rectum. If there is evidence of bleeding or blood in the stool, a colonoscopy may be performed to confirm the cause (8).
Take Home Note:
A physical exam and medical history can be used to diagnose the condition. In cases where blood is found in the rectum or stool, a colonoscopy will be performed to confirm the cause.
What Treatments Are Available?
In most cases, hemorrhoid relief can be found by lifestyle changes, fiber supplements, creams, and medical treatment. Pregnant women should consult their doctor on the specific treatment they should use.
Here are a few examples of what you can do (9,10):
- Relieve the anal area
You can soothe the pain and itching by applying some petroleum jelly inside the anus to allow easier bowel movements. One can also use the “sitz baths” therapy by sitting in about 3 inches of warm water (not hot) for 15 minutes, for several days. This reduces the swelling and relaxes the muscles.
Creams and wipes which contain witch hazel can also be used for hemorrhoid relief. Placing an ice pack on the swollen area a few times a day may also reduce the pain and the swelling.
- Change your diet
The best diet in this case would be rich, high-fiber foods such as, vegetables, fruit, whole grains, and nuts combined with a healthy intake of water (seven to eight glasses a day). These foods will help prevent constipation. A fiber supplement may also be recommended to keep stool soft and regular.
- Medical treatments
If the condition does not improve, you will have to see your doctor for the removal of the swollen veins. This procedure can be done in the doctor’s office.
Take Home Note:
Hemorrhoid relief can be achieved by consuming high-fiber foods or using fiber supplements. This must be combined with the intake of enough water throughout the day. Sitting in a bath of warm water, using creams and wipes or using an ice pack can soothe the irritated and swollen area. Medical treatment can be considered if the symptoms persist.
Our Ultimate Take Home Message
Many factors may cause bleeding in the rectal area, so it’s crucial to get a doctor’s opinion if the condition does not improve. It is, however, important to know how to relieve the symptoms to prevent it from getting worse. This can be done by consuming a high-fiber diet or by using creams and wipes which contain witch hazel. You can comfort yourself in knowing that this is quite a common condition and that you are not alone.
