What Are Hemorrhoids?
Hemorrhoids, also called plies, are a common condition. They are swollen veins located around the anus or in the lower rectum. Hemorrhoids can occur at any age. However, as people age, the incidence increases. Hemorrhoids are mainly caused by enlarged varicose veins in the rectum. In China, there is an old saying that “9 out of 10 people will get hemorrhoids”. As you can see, the incidence is way too high. You should keep a good diet and healthy habits in your daily life so as to reduce the risk of piles.
Causes
Hemorrhoids seem to be a common problem. However, people has not yet figured out the cause of them. The formation of piles is affected by many factors. The common ones of them include unhealthy eating habits, bad bowel habits, occupational factors and so on.
⚫ Unhealthy eating habits
Most of the occurrence of hemorrhoids is related to people’s diet. With the rapid development of society, a variety of foods appear in people’s daily life. Thus, people have more choices in diet than before. Many people prefer to eat some spicy and irritating foods. They also love to smoke and drink over a long period of time. However, they rarely eat fruits and vegetables. These bad eating habits will increase the risk of piles.
⚫ Bad bowel habits
Many patients with hemorrhoids also suffer from constipation. Constipation can cause those painful swellings. This is because dry stools stay in the intestines, which can cause gastrointestinal obstruction. At the same time, dry stools will also scratch the anus during defecation, causing piles. Some people like to look at their mobile phones and read books when they defecate. As a result, they will sit on the toilet for a long time. These bad bowel habits can also induce and aggravate hemorrhoids.
⚫ Occupational factors
This is also an important reason for the occurrence of piles at present. People in many occupations need to stand or sit for a long time and maintain the same posture for a long time. Such bad habits can easily lead to poor blood circulation in the body and cause hemorrhoids.
Symptoms
There are five common symptoms of hemorrhoids, which are as follows:
⚫ Blood in the stool: mainly bright red blood on toilet paper or in the stool, blood dripping or spraying;
⚫ Prolapse: Some people can easily push them back by hand if they feel prolapse after defecation. But others’ hemorrhoids cannot be pushed back after prolapse, which is more serious;
⚫ Itching: If the prolapse exists for a long time, it will cause local muscle relaxation. Such a condition causes the mucus from the rectum to flow. If the anus always remains wet, itching will occur;
⚫ Pain: Many people are afraid of hemorrhoids. Moreover, the main reason for fear of related surgeries is because of pain. The pain is obvious due to the very rich distribution of nerve endings around the anus. The anus is very sensitive, so even a small lump can cause pain;
⚫ Constipation: First of all, dry stool will cause hemorrhoids to prolapse, which will cause pain. If you do not have a normal bowel movement for a long time, it will lead to constipation. Obviously, this is a vicious circle.
Types of Hemorrhoids
There are three types of hemorrhoids, including internal hemorrhoids, external hemorrhoids, and mixed hemorrhoids.
Internal hemorrhoids can be divided into four stages according to their severity:
⚫ Grade I: blood in the stool without prolapse of lump.
⚫ Grade II: blood in the stool with prolapse of lump, which can be retracted on its own.
⚫ Grade III: blood in the stool with prolapse of lump, which needs to be pushed back by hand.
⚫ Grade IV: blood in the stool with prolapse of lump, which cannot be retracted on its own.
External hemorrhoids occur outside the anus. Doctors can also directly see them from the outside. External hemorrhoids are mainly oval or round lumps. They often appear at the anal verge. The lumps are not very large, but there are many lumps. Some lumps are hard while some are soft. If there are more lumps, it means that the external hemorrhoids are more serious.
When internal hemorrhoids and external hemorrhoids merge into one, it is called mixed hemorrhoids.
Who is at risk for hemorrhoids?
The occurrence of hemorrhoids is mainly related to people’s bad living habits. If people have the following bad living habits, they will be more likely to deal with the tricky problem.
⚫ People usually stand or sit for a long time. It will easily aggravate the congestion of the anus, causing the occurrence of piles.
⚫People like to eat spicy food and drink a lot of alcohol. This group of people are more likely to develop piles. Alcohol and spicy food are easy to form damp heat. In this case, it is easy to get piles.
⚫ People tend to squat for a long time in the toilet. This kind of people are easily to have hemorrhoids. Due to the long squatting time, the abdomen puts a huge pressure on the anus. If this pressure persists, it will lead to poor blood circulation around the anus. In this situation, it is prone to cause piles.
⚫ For people with dry stools, they will spend more time on defecation. Furthermore, the dry stools will stimulate the vicinity of the anus and cause hemorrhoids.
In addition, women’s hemorrhoids are related to fertility. It is easy to cause and exacerbate piles during pregnancy and childbirth.
How Are Hemorrhoids Diagnosed?
The most common ways to diagnose hemorrhoids are as follows:
⚫ Digital rectal examination(DRE): An examination in which a doctor inserts a lubricated, gloved finger into the rectum to feel for abnormalities[1]. It is the simplest and most effective method in the examination of anorectal disorders.
⚫ Inspection of the anus: A doctor uses both hands to retract the anus to both sides. Except for the Grade I internal hemorrhoids, Grade I~IV internal hemorrhoids can also be seen under the anus inspection. It is more meaningful to diagnose prolapse.
⚫ Through observation of symptoms of hemorrhoids:
- Bleeding, dripping, or blood or pus in the stool when you defecate, mostly caused by piles;
- Blood from an anal fissure is bright red with severe pain in the anus;
- Stool with blood in dark red or dark stool, which is caused by gastrointestinal bleeding;
- There is a mass protruding from the anus during defecation, accompanied by anal dampness or mucus. It may be prolapse from internal hemorrhoids or rectal mucosa;
- If there is a lump in the anus, the pain is intense, and the surface of the lump is dark and round, it may be a thrombosed external hemorrhoid.
⚫Anoscopy: An anoscopy is a procedure that uses a small tube called an anoscope to view the lining of your anus and rectum[2].
Hemorrhoids Treatments
At-Home Treatments
Changes in lifestyle, diet and bowel habits are very important for people with piles. People need to develop a healthy lifestyle, don’t sit and stand for a long time. They should exercise more, and do some levator ani muscle contraction exercises. All mentioned above can relieve the condition.
In terms of diet, patients should not eat spicy, greasy and irritating food. They should rather eat more fresh vegetables and fruits. Quitting smoking and alcohol is also very important. Patients with hemorrhoids should also pay attention to developing good bowel habits. The defecation time should not be too long. Don’t look at your phone or read a book while you’re having a bowel movement.
During the acute attack of hemorrhoids, you can choose a warm water sitz bath, 2 to 3 times a day. By doing so, it can reduce inflammation and edema, and relieve perianal discomfort and itching. The water temperature should not be too hot to avoid burns.
Medical Treatment
Due to the huge individual differences, there is no absolutely best, fastest, and most effective drug use. Except for commonly used non-prescription drugs, patients must take the most suitable drug fully based on personal circumstances under the guidance of a doctor.
At present, taking topical medications is the main way to treat hemorrhoids. The doctor would like to advice patients to take some anti-inflammatory drugs to relieve the condition.
Surgical Treatment
⚫ Sclerotherapy
This method is to inject sclerosing agent to produce aseptic inflammatory reaction around hemorrhoids and hemorrhoids, and submucosal tissue fibrosis, so as to shrink hemorrhoids.
⚫ Rubber band ligation
This method is to use a special rubber ring to tie the root of the internal hemorrhoids, and use the elasticity of the rubber ring to block the blood supply of the hemorrhoids, so that the hemorrhoids are ischemia and necrosis, and then fall off and heal.
Rubber band ligation is not suitable for external hemorrhoids because this method can cause severe pain in external hemorrhoids.
⚫ Infrared coagulation (IRC)
IRC therapy uses infrared light as a heat source to cut off blood supply to internal hemorrhoids so as to make the blood coagulate and shrink piles. Similar to sclerotherapy, infrared light can make the internal hemorrhoids hardened or shrunk.
⚫Hemorrhoidectomy
It is the most effective method for the treatment of severe hemorrhoids. Usually, doctors would consider surgical treatment only when outpatient treatment is not effective or there are some special circumstances.
Postoperative care
People must pay attention to nursing after hemorrhoid surgery. Postoperative wound bleeding is one of the most serious postoperative complications, so in nursing, you need to focus on the following aspects:
⚫ About 7-10 days after the operation, try to stay in bed as much as possible. Try not to get out of bed as much as possible. Here is the reason: too much movement or getting out of bed too early will cause the bulge of anus. There are many blood vessels around the anus. Doctors will cut them off during the operation. Therefore, the wound around the anus may bleed. If getting out of bed too early, it is very prone to bleeding from the surgical wound. If the patient has a relatively large amount of bleeding, he will need reoperation, so try to rest in bed after the operation.
⚫ Try to eat more liquid foods and foods with high fiber, prevent dry stool or diarrhea, and develop good bowel habits. After hemorrhoid surgery, there may be anal bulge, obstruction of anal reflux. You may also have a feeling of unclean stool, but don’t worry, because it is a normal situation.
⚫ Patients after operation need sitz bath, physical therapy, and some suppositories or ointments that promote wound healing, hemostasis and anti-inflammatory effects on the anal wound.
⚫ Patients after surgery should also pay attention to the diet. Try to avoid spicy, irritating foods, because those foods are not conducive to the recovery of resistance and the healing of wounds.
Complications of Hemorrhoids
The First is blood in the stool. Many patients with hemorrhoids will have blood in the stool, repeated bleeding. It is easy to lose a lot of iron in the body, causing iron deficiency anemia.
The second is perianal eczema. In the middle and late stages of hemorrhoids, due to prolapse of piles, relaxation of anal sphincter and outflow of mucus, the surrounding anus remains wet and unclean. It is easy to cause skin itching or perianal eczema.
Third, it is easy to cause gynecological inflammation. Bleeding or inflammation of hemorrhoids will lead to the proliferation of bacteria, causing vaginitis, urethritis, cystitis and other gynecological inflammation.
Fourth, complications of hemorrhoids will reduce the quality of life of patients. The above symptoms caused by piles bleeding, as well as prolapse, perianal damp pain, anal itching, etc. will affect the work or life of patients to varying degrees.
Prevention of Hemorrhoids
⚫ Try to eat more foods rich in vitamins and cellulose, such as whole grains, vegetables and fruits, soy products, drink more water, keep the stool smooth, and eat less spicy and irritating food;
⚫ Exercise more, avoid stand or sitting for a long time. Physical exercises can promote gastrointestinal motility, improve blood circulation, and prevent the occurrence of hemorrhoids;
⚫ Develop a good bowel habit, and the defecation time is generally no more than five minutes;
⚫ Prevent constipation, because constipation is an important cause of piles;
⚫ Once there is discomfort around the anus, pain and itching, blood in the stool, etc., it should be noted in time and treated early.
⚫For pregnant women, the pressure in the abdominal cavity during pregnancy is high, which will affect venous return and easily induce hemorrhoids.
