How to deal with hemorrhoids, a common disorder

Written by: Dr. Antoni Oliva Soler
Edited by: Top Doctors®

Hemorrhoids are a dilation of veins with the tissue that covers them. They are found in the anal area or the lower part of the rectum.

It is a more common disorder than is believed. In fact, between 50 and 80% of the population comes to present this pathology at some point in their life .


Causes of Hemorrhoids

Hemorrhoids are mainly caused by an increase in pressure in this area. This effect causes the veins to dilate and swell. The most frequent causes that cause this increase of pressure are: great effort during the depositions, constipation, pregnancy and childbirth.

However, there are also other causes that can cause hemorrhoids, such as prolonged sitting (especially in the toilet), exertion and weight lifting, episodes of diarrhea, and certain diseases such as cirrhosis of the liver.

There are two types of hemorrhoids, external and internal: 

  • External anal hemorrhoids may be palpated as small lumps around the anus, which may sometimes be itchy or stinging in the area. Occasionally, when inflamed or thrombosed, intense pain appears in the area, as it is highly innervated and sensitive. If left untreated, ulcers and bleeding may occur. 
  • Rectal internal hemorrhoids do not cause pain and, mainly, bleeding and prolapse. 

How to diagnose hemorrhoids

The diagnosis of hemorrhoids is done with the clinical history and an anal examination, and a rectal examination if necessary. In some cases of bleeding the specialist will recommend doing a colonoscopy to rule out other major causes.

Usually hemorrhoids appear episodic and, often, spontaneously or with local treatments. If these episodes occur more frequently, they end up establishing themselves permanently. Untreated hemorrhoids tend to grow in size and present major complications: pain, pruritus, bleeding, and even difficulty in properly cleaning the area after defecation.


Medical treatment of hemorrhoids

Hemorrhoids can be treated by:


  • Corticosteroid or anesthetic anti-inflammatory ointments 
  • Oral anti-inflammatory / analgesic medication 
  • Drugs that improve venous circulation 

Surgical treatment of hemorrhoids and postoperative

When the previous treatments do not work, there are some simpler techniques for hemorrhoids of degree I and II, which are done on an outpatient basis and even in the office: sclerosing injections, photocoagulation, cryocoagulation, placement of elastic bands , etc.

In hemorrhoids of grade III and IV, the treatment of choice is hemorrhoidectomy , consisting of the excision of the hemorrhoids. It is a surgery performed by the specialist in General Surgery in the operating room and under anesthesia. Hemorrhoid dissection can be done with scissors, electric scalpel or laser.

The advantage of the laser in front of the electric knife is that it allows a greater precision in the cut or coagulation and a smaller propagation of the heat. In this way a "burn" of lower depth occurs in the area that the patient thanks in the postoperative.

During the postoperative period it is normal to have slight bleeding when going to the toilet, especially with the effort of the bowel movements. Sometimes postoperative small hemorrhoids may be more painful than those of larger ones but, in any case, after bowel movements, it usually lasts between 4 and 10 days. In order to obtain the greatest possible comfort, analgesics and anti-inflammatory drugs are used to relieve it.


How to Prevent Hemorrhoids

There are a number of guidelines that can help us to prevent the appearance of hemorrhoids: 

  • To prevent constipation it is advisable to carry out a diet rich in fiber, an abundant intake of fluids and fiber supplements. 
  • It is also necessary to avoid feeding on irritating nutrients , such as spices or spices, as well as moderate consumption of alcohol, coffee and tobacco. 
  • Another way to prevent hemorrhoids is to perform sports activities to avoid becoming overweight or obese. 
  • Go to the bathroom when you feel the need. 
  • Be time right on the toilet.
*Translated with Google translator. We apologize for any imperfection

By Dr. Antoni Oliva Soler

*Translated with Google translator. We apologize for any imperfection

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