Hemorrhoids also are known as piles ( 1 ) are swollen, inflamed veins around the anus or lower rectum. They are under the skin around the anus or either inside the anus.
Hemorrhoids often result from
- straining to have a bowel movement
- aging and chronic constipation or diarrhea.
They are very common in both genders. About 1/2 of all people have hemorrhoids by age 50.
Type Of Hemorrhoids
The two types of hemorrhoids are
- External hemorrhoids, (under the skin around the anus)
- Internal hemorrhoids, ( lining of the anus and lower rectum)
Symptoms of hemorrhoids
The symptoms ( 2 ) depend on the type of hemorrhoids you have.
For external hemorrhoids Symptoms are
- Anal itching
- Hard, tender lumps near your anus
- Especially when sitting, anal ache or pain
Rubbing, cleaning around your anus, too much straining, make your symptoms worse. For many people, the symptoms of external hemorrhoids disappear within a few days.
For internal hemorrhoids
- bleeding from your rectum
- bright red blood on the stool,
- blood on toilet paper,
- After a bowel movement, blood in the toilet bowl
During your anal opening hemorrhoid that has fallen through your anal is known as prolapse
Internal hemorrhoids are not painful if that are not prolapsed. Prolapsed internal hemorrhoids cause pain and discomfort.
Causes of hemorrhoids
- Straining during the bowel movements
- Sitting on the toilet for a long time
- Diarrhea or chronic constipation
- Taking a low-fiber diet
- A weakness of the supporting tissues in your anus and rectum with aging
- lifting heavy weights
Diagnosis of Hemorrhoids
Doctor diagnoses ( 3 ) hemorrhoids based on your physical exam and medical history. Doctor diagnose external hemorrhoids by checking the area around the anus. The doctor will perform a digital rectal exam and may perform procedures to look inside your anus and rectum to diagnose internal hemorrhoids.
The doctor will ask you to describe your symptoms and provide your medical history. He will ask your eating habits, enema and laxative use, toilet habits, and current medical conditions.
In the physical exam, he will check the area around the anus for
- Swelling or lumps
- A blood clot in a vein
- leakage of stool
- skin irritation
- skin tags
- Anal fissure
Doctor performs a digital rectal exam to
- Check the strength of the muscles in your anus
- Check for tenderness, internal hemorrhoids, blood, and lumps or masses
Procedures to diagnose internal hemorrhoids
Anoscopy: Doctor uses an anoscope to view the lining of the anus and lower rectum. He will carefully examine the tissues lining your anus and lower rectum to look for bowel disease and signs of lower digestive tract problems.
Rigid proctosigmoidoscopy: It is similar to anoscopy, except that your doctor uses an instrument called a proctoscope to view the lower colon and lining of your rectum. The doctor will carefully examine the tissues lining your rectum & lower colon to look for signs of bowel disease and lower digestive tract problems.
Your doctor may diagnose internal hemorrhoids while performing procedures for other digestive tract problems or during a routine examination of your rectum and colon. These procedures include colonoscopy and flexible sigmoidoscopy.
Home Treatment of Hemorrhoids (4)
- Eat high fiber foods
- taking a fiber supplement such as psyllium (Metamucil) or methylcellulose (Citrucel) or a stool softener
- Drinking more water
- During bowel movements not straining
- Don’t sit on the toilet for long periods of time
- Sitting in a tub of warm water, several times a day to help relieve pain
- Applying over the counter hemorrhoid creams or ointments
- using suppositories (a medicine you insert into your rectum) may relieve mild pain, swelling, and itching of external hemorrhoids.
Doctors recommend using over the counter products for one week. You should concern with your doctor if the products of hemorrhoids do not relieve your symptoms in one week.
Side effects: dry skin around your anus or a rash
Most internal hemorrhoids go away with home treatment. However, many bleeding internal hemorrhoids may need medical treatment.
Medical Treatment Of Hemorrhoids
Rubber band ligation. This procedure is used to treat bleeding or prolapsing internal hemorrhoids. In this procedure, a special rubber band places around the base of hemorrhoid. The band cuts off the blood supply. Within a week the banded part of hemorrhoid shrivels and falls off. Scar tissue forms in the remaining part of hemorrhoid, often shrinking hemorrhoid.
Sclerotherapy. To form scar tissue doctor injects a solution into internal hemorrhoid. The scar tissue, cuts off the blood supply, shrinking hemorrhoid.
Infrared photocoagulation. This is a tool that directs infrared light at internal hemorrhoid. The heat created by the infrared light produces scar tissue, which cuts off the blood supply, shrinking hemorrhoid.
Electrocoagulation. This is a tool that sends an electric current into internal hemorrhoid. The electric current produces scar tissue, which cuts off the blood supply, shrinking hemorrhoid.
Hemorrhoidectomy. A surgeon may perform a hemorrhoidectomy to remove large external hemorrhoids and prolapsing internal hemorrhoids that do not respond to other treatments. Your doctor will give you anesthesia for this treatment.
Hemorrhoid stapling. A surgeon may use a special stapling tool to remove internal hemorrhoid tissue and pull a prolapsing internal hemorrhoid back into the anus. Your doctor will give you anesthesia for this treatment.
Diet, & Nutrition for Hemorrhoids
The doctor recommends high fiber foods to eat ( 5 ). Because high fiber foods can make stools softer and easier to pass and help treat and prevent hemorrhoids. Drinking water and other liquids, such as clear soups, fruit juices, can help the fiber in your diet work better.
The Dietary Guidelines for Americans recommends a dietary fiber intake of 14 grams per 1,000 calories consumed.
E.g, for a 2,000 calorie diet, the fiber is 28 grams per day.
Fiber Rich Food List
||Fiber In Grams
|⅓‒¾ cup high-fiber bran, ready-to-eat cereal
||9.1g to 14.3g
|1‒1¼ cups of shredded wheat, ready-to-eat cereal
||5g to 9g
|1½ cups whole-wheat spaghetti, cooked
|1 small oat bran muffin
|1 medium pear, with skin
|1 medium apple, with skin
|½ cup of raspberries
|½ cup of stewed prunes
|½ cup of green peas, cooked
||3.5g to 4.4g
|½ cup of mixed vegetables, cooked from frozen
|½ cup of collards, cooked
|1 medium sweet potato, baked in skin
|1 medium potato, baked, with skin
|½ cup of winter squash, cooked
|½ cup navy beans, cooked
|½ cup pinto beans, cooked
|½ cup kidney beans, cooked
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