Hemorrhoids Relief – Symptoms, pictures and treatment

Archive for the ‘Diagnosis and Treatments’ Category

There are the two kinds of anal canal nerves: visceral nerves, which are above the dentate line, and under where you would find somatic nerves. Visceral nerves never feel pain, they are like the nerves in the intestine, and only pressure is what they can feel. This makes internal hemorrhoid painless. The somatic nerves can feel pain just like nerves in the skin.

The anal canal swells when the anal cushion enlarges because of an internal hemorrhoid. Sometimes the rectal lining protrudes from the inside of the anus and loses its normal position. This refers to as prolapsing internal hemorrhoid. This can cause bleeding and pain particularly when using the toilet, and especially when the stool is in contact with the hemorrhoid. The lining that has protrude from the inside emits liquid that lubricates the anus and the skin surrounding it. The rectal lining that came out returns to the anal canal as time passes, but you can push it back to the inside using your finger. If this is done, there is no assurance that it won’t came back again, usually in your next bowel movement it will prolapse again.

A condition called incarceration of the hemorrhoid happens when the hemorrhoid that prolapses cannot be pushed back inside. Squeezing pressure of the anal sphincter can cut off the blood supply of incarcerated hemorrhoid. This requires immediate treatment.

Doctors use a grading system to determine how severe the hemorrhoid is.
•    First-degree Hemorrhoid – Bleeding but does not protrude
•    Second-degree Hemorrhoid – Prolapsing hemorrhoid but the rectal lining returns inside of the anus on its own
•    Third-degree Hemorrhoid -Hemorrhoid must be pushed by a finger to be able to bring it back inside the anus
•    Fourth-degree Hemorrhoid -Pushing the hemorrhoid back does not work.

The last degree may also include thrombosed hemorrhoid a condition wherein blood clots takes place or the rectal lining that was pulled out was too much.

The symptoms of external hemorrhoid are very different from the symptoms of internet hemorrhoid.
External hemorrhoid are lumps at the anus, the symptoms of internal hemorrhoid are rarely seen in this condition. A major problem of this type of hemorrhoid is blood clots inside the anus. This is called thrombosis. This causes an extreme pain on the anal lump. It may heal by scarring and leave a skin tagged outside the anus. Most often the tag skin is large which makes cleaning the anus difficult and sometimes can cause irritations.

Many anorectal problems are similar or have the same symptoms and are incorrectly referred to as hemorrhoids. These include fistulae, fissures, abscesses or itching and irritation. Hemorrhoids are not really dangerous, to the extent of having your life being compromised. In most instances, hemorrhoid symptoms will go away after a few days.

Below are some of the key symptoms of hemorrhoids:
- Traces of blood during bowel movements — this can be painless
- Anal region can be itchy or irritated
- Swollen anus
- There can be a lump near your anus that is painful
- Uncontrollable discharge of feces.

Symptoms of hemorrhoid vary depending on the location. These symptoms can guide you to determine what kind of hemorrhoid you have. If internal hemorrhoid which develops inside the rectum, you will not feel anything, but once they prolapse it may cause irritation. The most common symptom of internal hemorrhoids is having red blood in one’s stool. Bleeding can take place during bowel movements when the hemorrhoid is irritated by the passing stool.

Sometimes an internal hemorrhoid is pushed near the anal opening because of straining; this is what they call protruding or prolapses. In a few cases the sphincter muscle can experience spasm and trap the hemorrhoid that is outside the anus. The circulation of blood is then cut into the strangulated hemorrhoids. These are severe conditions of hemorrhoid that require immediate medical attention and treatment.

Small external hemorrhoids usually do not show any severe symptoms. Larger ones, however, can be painful and interfere with cleaning the anal area after a bowel movement. Sometimes blood clot may be formed in the external hemorrhoid (which is termed as thrombosed hemorrhoid) because of which the skin around the anus becomes inflamed and a very painful lump develops. On rare occasions the clot will begin to bleed after a few days and leave blood on the underwear. A thrombosed hemorrhoid will not cause an embolism.

External hemorrhoid however, lies under the skin around the anus. Small external hemorrhoids commonly have no symptoms to show. But the large ones can be very painful and having a hard time cleaning the anus after using the toilet can be a side effect of it. External hemorrhoid can bleed or itch if irritated. Clotting is also common with this condition and resulting in swelling, severe pain and irritation, this is called thrombosed hemorrhoid. Sometimes the clot can begin to bleed a few days after and traces of blood can be seen on the underwear. This is normally painful because the tissue around the anus is covered by nerve endings which are very sensitive.

When to see a doctor?
The most common sign of hemorrhoid is bleeding during bowel movements. But sometimes this may be caused by other diseases as well. Don’t conclude that this bleeding came from hemorrhoid without consulting your doctor. Tests can be done to confirm that you really are suffering from hemorrhoids. If you notice any hemorrhoid symptoms, change in your bowel movement or any excessive bleeding then do consult a doctor to avoid further complications.

Difficulty in bowel and straining to discharge it can become a major cause of hemorrhoids and the existing hemorrhoids can be triggered to severity by hard feces. Engaging more in fibrous diets is highly recommended to help soften a patient’s stool. A high-fiber diet includes fiber-rich edibles such as grains like wheat, cereals, fresh fruits as well as fresh vegetables. Approximately 20-30 grams of fiber is recommended to be consumed each day while the American diet prescribes less than 15 grams only.

Increased intake of fibers may also be achieved through supplemental fibers. You may also lessen the effect of hemorrhoids by using stool softeners and by increased consumption of water. Anti-motility medication also helps controlling diarrhea, a complication that contributes to hemorrhoid symptoms to aggravate more.

Hemorrhoid can be treated at home most of the time or without the need of medical attention. Changes in your life style can make a lot of difference. But still medical and surgical procedures can be done to treat hemorrhoids if needed.

Medications for hemorrhoids
If you have mild hemorrhoid, over-the-counter medicine can be prescribed by your doctor such as creams, ointment etc. These products may contain ‘witch hazel’ or ‘hydrocortisone’ which can relieve the pain and itch which comes along with hemorrhoids. Unless you are not directed by your doctor, do not use over-the-counter medications for more than a week, as it may cause inflammation, rashes etc.

Minimally invasive procedures for hemorrhoids
If there is any blood clotting in the external hemorrhoid, having a simple incision can be of immediate relief. If the bleeding or the hemorrhoid hurts, counter medications or procedures can be prescribed by your doctor that can be done inside the doctor’s clinic or other outpatient set-up.

Rubber band ligation: The hemorrhoid tissues are cut off by surrounding one or two rubber bands at the base of an internal hemorrhoid which causes it to subside. After a few days the hemorrhoid will disappear. This method is proven to be effective by many. However, one side effect of this method is that this can get a little uncomfortable and you may experience bleeding, which can be in effect for two to four days after the treatment.

*Injection (sclerotherapy): Compared to the other treatments this can be less effective and it involves little or no pain at all. In this procedure the doctor injects a chemical solution into the hemorrhoid tissue to make it smaller.

*Coagulation (infrared, laser or bipolar): This procedure is done using a laser or infrared light. With the use of this technique the internal hardened hemorrhoid is removed. Sometimes this can cause bleeding. But the chance of hemorrhoid to come back is high as compared to the rubber band method.

Surgical Procedures for hemorrhoids
If the above mentioned options fail to cure your problem, you can still take recourse to surgery. You can either be an outpatient or you can even stay in the hospital still the surgery process if completely over.

Hemorrhoidectomy: This procedure is said to be the most effective to remove hemorrhoids. An excessive tissue that causes bleeding is removed with this treatment. Although this method is claimed to be the most effective it is said to have the highest rate of complications. One of these complications is having UTI (Urinary Tract Infections) and difficulty to empty your bladder. Some even experience pain after the procedure, but you can take medicines to relieve the pain. Warm bath also helps to reduce the pain. This can be done under a local anesthetic with sedation, general anesthetic or spinal anesthetic.

Stapling: This treatment is also knows as Stapled hemorrhoidectomy. Through this method, the same excessive tissue is removed in a different way. However, this method causes little pain and helps in early recovery. Stapling has also a high rate of hemorrhoid recurrence and rectal prolapse.

Enlarged veins at the junction of the anus and rectum are termed medically as hemorrhoids. Rectal discomfort or having an itch near the anus can be experienced as a symptom, but hemorrhoid is not the usual cause of these symptoms. Anal related diseases can also be one of the causes.

Like the anal fissures, people who suffer from hemorrhoids also have it, most do not. Anal conditions and hemorrhoids have few identical symptoms or most of the time, they may even occur together. Diagnosis of hemorrhoids can be easily done though different methods. You can find it out through bloody stools because the inflamed veins tend to bleed through the anal canal. Discovering it may also happen by accidentally feeling a prolapsed hemorrhoid or a soft swelling.

Symptoms automatically give a physician a hint to suspect the presence of a hemorrhoid. Identifying the condition needs a wide knowledge and expertise in the field; hence it is always suggested to consult a doctor. However, do not ignore the hemorrhoid-like symptoms as they are also vital because it may need further special treatment. Basic anus and anal canal examinations can accurately diagnose other causes, like anal fissures and fistulae to name a few.
Thrombosed hemorrhoids, or tender lumps, and any other visible bumps should always be monitored because it might also lead to rare cancer of the perennial area. Bulging hemorrhoid that comes out from the anus makes it easier to diagnose internal hemorrhoids.

Feeling any abnormalities through close evaluation by using gloved finger may help uncover an internal hemorrhoid, it is also said that this kind of rectal examination is still helpful except for some rare cancers that usually develop in the junction of the anus and rectum.

The use of anoscope in which a medical tube that is light and hollowed usually 3“ long and with 1“ diameter helps medical examiners to evaluate internal hemorrhoids in detailed manner. To reach the rectum, a lubricated anoscope is inserted from the anus through the anal canal. Internal hemorrhoids will be more visually visible upon the withdrawal of anoscope.

For more effective result, indirect anoscopy can be conducted. To check the anus, a special mirror is used while the patient is sitting and strained on a toilet while undergoing this process. Indirect anoscopy helps a physician check the effects of straining on the anus.

Bleeding shouldn’t be ignored, even if hemorrhoids are diagnosed or not. Colon above the rectum should be automatically checked, so that other reason may also be identified to get the right treatment on time. Sigmoidoscopy and colonoscopy are flexible procedures that are done by the doctors to allow them to evaluate a patient’s colon for hemorrhoids or any other disease.

Hemorrhoids are swollen, twisted veins that take place in the end of our intestinal tract either in the anus or the rectum. The row at the upper end of the rectum is referred as the internal hemorrhoidal veins, and those enclosed by skin in the anus are referred as the external hemorrhoidal veins. Beneath these veins is a strong muscle whose function is to regulate stool passage.

Hemorrhoids are result of many years of damaging strain from constipation. Veins dilate as you put pressure on them while trying to pass stool with great effort. Once stretched beyond their normal conditions the rectum walls may protrude from the anal opening thus causing itch and bleeding. Occasionally hemorrhoids get swollen from a clot of blood that takes place inside the anus bringing great amount of pain with it. These blood clots form thrombosed hemorrhoids.

The accurate diagnosis can be made by inspecting the bleeding with the help of anoscope or sigmoidoscope. These tools help doctors make sure that bleeding and other complications are not result of polyps, cancer and diverticulosis.
Before any thorough investigation of the intestinal tract begins doctors need to determine root cause of the bleeding. They do that by placing a patient on a meat free diet for 4 days and then test the blood under microscope.

bleeding external hemorrhoid

Before any surgery or any other complicated treatment starts it is recommended you should try a conservative treatment of hemorrhoids. Try soaking in a warm bath for 15 mins 2 to 4 times daily. This procedure will attempt to clean and reduce inflammation of the affected tissues.

Usually nurses will clean and numb the hemorrhoid with the help of lidocaine and epi to reduce bleeding. After that a small incision is made to remove the blood clots. If the procedure is successful there should be little bleeding with complete relief of the pain. The minor surgery like this is fast and painless… It is also vital to consult a surgeon to get rid of the hemorrhoids completely.

Small and medium in size hemorrhoids can be treated with a well known medical treatment medically known as Infrared photo-coagulation or simply known as coagulation therapy. Throughout the procedure, the doctor utilizes a device that produces highly concentrated beam of infrared light. Heat from the infrared light is meant to mildly burn off the tissue, which in turn stops the blood supply to the hemorrhoids. The hemorrhoid goes away and a tissue scar takes place on the wall of the anal passage. The scar tissue binds surrounding veins in place so they don’t swell into the anal passage.

Just one hemorrhoid at a time will be treated while other hemorrhoids get treated at 10- to 14-day breaks. This medical practice can be carried out with other devices like electrical current or laser that also shuts off a hemorrhoid’s blood supply. Infrared photocoagulation for hemorrhoid can be performed in a doctor’s workplace. You may experience heat and some pain throughout the process. After that, you might experience feeling of fullness in the lower part of your abdomen or even feel as if you want to pass motion.

What to Expect after Infrared photocoagulation
Most common side effects:
Your anus may bleed for 7 to 10 days after the treatment once the hemorrhoid drops off. Bleeding is usually mild and should stop on its own. You may be prescribed pain killers and coupled with sitz bath(resting in a tub of warm water for 15 minutes to get rid of discomfort).
To stop bleeding, you are advised not to take aspirin and other nonsteroidal anti-inflammatory medications for four to five days both before and after the infrared coagulation procedure.
Health specialists advise that you should consume stool softeners that have fiber to promote smooth bowel movement. However you must avoid straining during while passing motion as it can bring hemorrhoids back.

When Infrared photocoagulation is necessary?
Doctors suggest coagulation therapy in situations when small internal hemorrhoids persist causing symptoms even after home procedures.

Does Infrared photocoagulation work?
The success of Infrared photocoagulation in curing hemorrhoids depends on many factors that include what type of treatment is applied and whether causal factors like constipation can be treated first.
For example: small internal hemorrhoids are easier to treat using Infrared photo-coagulation or coagulation therapy. Bigger sized hemorrhoids are harder to be treated when there’s rubber band ligation involved.

Risks of coagulation therapy:
Significant pain throughout the procedure.
The anus bleeding.
Possible infection in the anal passage.
Momentary incapacity to urinate.

Cost of coagulation therapy is high, but definitely cheaper than having a surgery that may require a hospital stay and lost hours of productivity while being away from your workplace. Not every doctor has the necessary experience or the right kind of equipment to perform coagulation therapy. Always ask your doctor what treatment he or she has performed the most in the past, how many times he or she has performed the procedure, and how happy people have been with the results. Lasers are not necessarily proven to be more successful than other types of treatment. You must take a great care when going for laser based treatment which costs more and present possible damages to the treated tissue causing more scars.

For most hemorrhoids can be managed with easy changes to diet and bowel routines and do not need surgery or other invasive treatments provided the hemorrhoids are not very bulky and painful. Fixative procedures don’t require surgical involvement and can treat hemorrhoids. It does so by decreasing the blood flow to the hemorrhoid so it reduces in size and slowly disappears.

One of the well known fixative procedures is called rubber band ligation and it involves binding off the hemorrhoids with a rubber band. Other ways consist of coagulation therapy that leaves a scar tissue, involving lasers, heat or electric current.

Surgical way to treat hemorrhoids is known as hemorrhoidectomy and it is used to treat large internal hemorrhoids, when a number of little hemorrhoids are present, or when other treatment methods couldn’t manage bleeding. Occasionally a combination of a fixative procedure and a hemorrhoidectomy treatment can be one of the most promising ways to treat hemorrhoids.

Typically fixative procedures are the first to be recommended and try to avoid surgery if hemorrhoids are still manageable and come out of the anus throughout a bowel movement but go back to their normal position once it’s over, this is known as second-degree hemorrhoids.

Hemorrhoidectomy at times provide greater long-term end results compared to fixative procedures. But it can be more expensive and require longer recovery time. It’s also more painful, and carries a greater risk leading to more complications.
Fixative procedures are recommended for individuals older than 70 yrs old and those with weak health.

Medications
If hemorrhoids cause minor discomfort, the doctor might recommend over-the-counter ointments, creams or pads. These medications contain elements, such as witch hazel, hydrocortisone that are known to stop pain and itching. They are known to be temporary relievers.

However if you happen to use an over-the-counter cream or some other product, it shouldn’t exceed a week unless your doctor has directed you. Otherwise you may be exposed to various side effects like skin rash, skin thinning and inflammation.

Other invasive procedures
Stapling is medically known as stapled hemorrhoidopexy or stapled hemorrhoidectomy and cuts off blood supply to hemorrhoidal tissue. Stapling causes less pain than hemorrhoidectomy and lets you get back to normal life sooner. However in relation to hemorrhoidectomy, stapling is known to present a greater risk of rectal prolapse and recurrence which means a portion of your rectum sticks outs from the anus.

Read and understand why sometimes laser treatment for hemorrhoids also medically known as laser hemorrhoidectomy is one of the best procedures you can have to get rid of severe hemorrhoids.
This works just the way a common hemorrhoid surgery does however instead of using a scalpel surgeons use intense laser beam that acts like a cutting tool. It’s so fine and precise that there’s less room for errors as it can target exact areas of affected tissue which in this case swollen veins in a patient’s anal passage.There are quite a few advantages of having  hemorrhoids laser treatment instead of old traditional method:
-    It is a non-intrusive practice so it does not cause open wounds and stitches
-    It doesn’t obstruct the doctor’s view throughout the surgery
-    laser “burns off” the blood vessels it cuts, so there’s less bleeding
-    Less damage to nearby tissue that gets cut by the laser, hence reducing  the chance of complication from necrosis or tissue death

Compared to other surgical practices where after surgery pain and discomfort are obvious, hemorrhoid laser treatment minimizes all that discomfort providing faster recovery time. You may even get discharged from the hospital sooner than you expect and can be back to your normal life after hemorrhoids laser treatment.

Hemorrhoids, also known as piles are result of swollen and inflamed veins in the anus and rectum. More than three-quarters of the US population are affected by hemorrhoids at some point of time in their lives. Those who fall into 45 to 65 years old age range seem to be at a higher risk.

Hemorrhoids or Anal Fissures

When people notice blood on the toilet tissue paper and experience pain during bowel movements, the first thing that comes to their minds is hemorrhoids when the actual problem could be a tiny but quite painful wound known as an anal fissure.

Anal fissures are often result of constipation and as stools get dry and hard the anal sphincter is pressured to stretch wider than usual causing a tear called anal fissure. There are often marks of bright red blood on tissue paper.

Anal fissures come with a stinging, sharp and often acute pain each time you pass motion while hemorrhoids often produce bleeding with no pain.

Natural remedies for Hemorrhoids Relief

Here are well known natural remedies that can bring hemorrhoids relief.

1) Eat lots of fiber

Fiber always demonstrated benefits in relieving hemorrhoid discomfort and one of the easiest home remedies to avoid bleeding. Fiber softens stool and increases its bulk which in turn aids in reducing pressure on your sphincter. It has been proven in many trials where fiber proved positive by preventing itching, discomfort, and pain due to hard stools.

There are many ways to obtain fiber. You can begin with eating whole grains and vegetables. You can opt for ready made powdered fiber supplement called Psyllium, it’s affordable and widely available. A recommended amount of psyllium is a teaspoon of the husks in your favorite drink followed by a glass of water.

Another natural remedy is ground flaxseeds

2) Bioflavonoids

Bioflavonoids are special compounds found in plants; they act as stabilizers and fortify blood vessel walls while at the same time reducing inflammation. Bioflavonoids are well known to lessen anal discomfort and pain including discharge throughout severe hemorrhoid attacks. Side effects seem to be rare and mild, making them attractive treatment for hemorrhoids especially for pregnant women (however the flavonoid tangeretin must not be taken by people who were prescribed tamoxifen to treat breast cancer).

So the flavonoids we are talking about are derived from diosmin, citrus fruits, herperidin, and oxerutins. One ready made product called Daflon, that contains citrus bioflavonoids appear to ease symptoms in pregnant women on the 4th day after taking it. It’s also found to reduce symptoms of heaviness, pain, itching, bleeding, and discharge.

3) Witch Hazel Cream

This medication which can be found in many drug stores is prepared from the leaves and bark of a plant scientifically known as Hamamelis virginiana. It is not for oral usage and used topically to the affected area around anus. The cream comes in the type of witch hazel purified ointment, liquid or medicated pads.

Witch hazel acts as an astringent and known to reduce the bleeding of hemorrhoids. It also relieves itching, pain and swelling related with hemorrhoids.

4) Knee Holly or Butcher’s Broom

The plant called Ruscus aculeatus is popularly known as sweet broom, box holly, knee holly and it was used by European butchers to wash their chopping blocks. Butcher’s broom had been a long history of traditional use for hemorrhoids and varicose veins. It is often used when there is underlying poor circulation in the veins.

So what exactly does butcher’s broom do? There are no confirmed researches that say about the effectiveness of butcher’s broom for hemorrhoids, however butcher’s broom are said to contain vein-constricting and anti-inflammatory properties. That active element is called ruscogen.

People who are prescribed alpha blocker or MAO inhibitor drugs and those with high blood pressure should avoid Butcher’s broom always consult your doctor before starting treatment.

5) Horse Chestnut

Horse chestnut is a herb much like Butchers broom and recommended to improve poor circulation of blood or those with chronic venous insufficiency. As a natural remedy, it is well known to relieve inflammation and swelling while at the same time strengthens blood vessel walls. The active element is known as aescin.

6) Additional Natural Remedies

Triphala is said to act a bowel tonic which is gentle on stomach and can relieve constipation.

Calendula and chamomile in the form of topical cream can be applied as ointment.

How to prevent Hemorrhoids?

These are the basic steps to reduce hemorrhoids:

At least six glasses of water intake daily
Sufficient fiber in the diet
Physical exercise