All You Should Know About Hemorrhoids

Written by: Dr. Ferrán Capell Ricart
Edited by: Top Doctors®

Hemorrhoids are a common occurrence that affect a large part of the population at some point in their life. Hemorrhoids are structures like pillows that are in the anal canal , in normal state. Usually they are three and coincide with the corresponding hemorrhoidal vein.

It is postulated that they have some help function in the anal continence. When these structures develop abnormally giving problems of hemorrhage, pain and itching, among others, it is when one speaks of a person suffering from hemorrhoids. Therefore , specialists in Coloproctology demystify the concept that many people have that hemorrhoids are like anal varicose veins.


Causes of Hemorrhoids


  • Constipation is the leading cause of hemorrhoids. Indeed, people suffering from constipation suffer from an increase in pressure in the anal region that leads to the dilation of hemorrhoidal veins that, over time, cause hemorrhoids. 
  • Another factor is pregnancy. Increased pressure in the pelvis conditions the increase in pressure in the hemorrhoidal veins. Although this situation is reversible, in most cases this is not the case. 
  • In recent times, there have been cases of hemorrhoids in people who practice anal sex. It is easy to understand that repeated trauma in the anal area can dilate these veins. 
  • Dietary factors do not cause hemorrhoids, but they can be triggers. Included here are spicy foods, alcoholic beverages, coffee or sweet foods. 


Types of Hemorrhoids

There are two types of hemorrhoids: internal hemorrhoids and external hemorrhoids.

Internal hemorrhoids are located inside the anal canal and are covered with mucosa, while the external hemorrhoids are around the anal opening and are covered with skin. This differentiation is not only anatomical, but there may be variations in its mode of presentation as will be seen later.

Symptoms of hemorrhoids

The main symptoms of hemorrhoids is bleeding. It is usually in variable quantity, red blood sparkling and coincident with deposition.

Pain is frequent, ranging from continuing discomfort to pain of varying intensity, which increases with deposition.

Sometimes called hemorrhoidal prolapse or hemorrhoidal tissue outflow through the anal opening during the deposition effort.

Another symptom, sometimes annoying, is anal pruritus and the presence of some secretions. Rectal tenesmus, which is the feeling of anal occupation with desire for exoneration, can occur in large hemorrhoids.

As a general rule, internal hemorrhoids cause bleeding and prolapse, while externals are more painful and pruritic.


Hemorrhoids: Treatment

The treatment of hemorrhoids depends on their degree and any discomfort they cause. When referring to degree of hemorrhoids, reference is made to the degree of prolapse during defecation: from minimal (grade I hemorrhoids) to permanent hemorrhoidal prolapse (hemorrhoids grade IV). In cases of grade I and II, normalization of dietary stools with fiber and / or laxatives is usually adequate.

In grade III hemorrhoids, apart from the above, ligation with elastic bands and / or coagulation with infrared is necessary .

The surgery is reserved for grade IV hemorrhoids or in those cases with lower grade but that present associated pathology: anal fissure, internal and external hemorrhoids or others.

The surgical intervention consists of the extirpation of hemorrhoids, associating the solution of associated pathologies, especially the anal fissure. This can be done by conventional surgery or by the CO2 laser technique. This laser technique is a high-intensity light energy that enables the dissection of hemorrhoids more precisely, with less damage to adjacent healthy tissues, resulting in less postoperative pain and faster recovery.

It has always been said of the extremely painful postoperative hemorrhoid intervention. At present, by careful technique, the use of laser and the prescription of potent analgesics the postoperative pain, but controlled. The worst moments are the immediate postoperative (first 24-48 hours) and the first bowel movement. After five or seven days, the discomfort is improving and patients can be discharged between the second and third postoperative weeks.

Post-operative complications such as bleeding, incontinence, or infection may occur. However, they are very rare.

*Translated with Google translator. We apologize for any imperfection

By Dr. Ferrán Capell Ricart
Colon & Rectal Surgery

Specialist in General Surgery at Vall d'Hebrón Hospital, Dr. Capell has completed his overseas training in Coloproctology at St. Mark's Hospital in London in 1987. He is an expert in the laser treatment of anal pathologies.

*Translated with Google translator. We apologize for any imperfection

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