Hemorrhoids FAQs

Hemorrhoids are swollen, inflamed veins in the anal canal (internal hemorrhoids) or under the skin around the anus (external hemorrhoids). In their normal state, these veins provide cushioning during bowel movements. They can, however, swell from lifting, straining, being constipated, passing hard stools and having diarrhea, or from pregnancy. Hemorrhoids are not usually serious, but they can be painful and interfere with quality of life. If swelling persists, the veins may become permanently stretched (prolapsed). Hemorrhoids are a very common complaint, particularly in people older than 50. Fortunately, there are many treatment options available.

What are the symptoms of hemorrhoids?

Hemorrhoid symptoms vary in type and severity depending on factors such as a person's age and anatomy; heredity; and the duration of the problem. Symptoms of hemorrhoids include rectal bleeding with a bowel movement, anal itching, burning or discomfort, and a feeling of fullness, or having a mass, in or on the anus. A patient with hemorrhoids may have a lump at the anus that is tender or painful, and may leak small amounts of stool.

What is a protruding hemorrhoid?

When straining during a bowel movement pushes an internal hemorrhoid out through the anus, it is called a protruding (prolapsed) hemorrhoid.

What is a thrombus?

A thrombus is a clot that forms when blood pools in an external hemorrhoid. A thrombus can cause severe inflammation and pain.

Is rectal bleeding serious?

Although rectal bleeding is the most common symptom of hemorrhoids, it can also be an indicator of life-threatening diseases, such as colorectal or anal cancer. If bowel habits change, or dark stools or blood clots are passed, it may be an indication of bleeding in other parts of the intestine. When rectal bleeding is intense, and the patient feels dizzy or faint, the situation is an emergency. The cause of rectal bleeding should always be diagnosed by a doctor.

How are hemorrhoids diagnosed?

Hemorrhoids are diagnosed by rectal examination. The doctor inserts a gloved, lubricated finger into the anus to feel for abnormalities. At times, depending on what the doctor detects upon digital examination, the patient may also have to undergo a sigmoidoscopy.

How are hemorrhoids graded?

Hemorrhoids are graded from I to IV. Grades I and II can be treated nonsurgically, but grades III and IV can require surgical intervention.

What are home remedies for hemorrhoids?

In many cases, hemorrhoids can be treated with simple remedies, including making lifestyle changes (to diet, fluid intake, exercise and toilet habits) to avoid constipation or diarrhea. Some patients find relief using over-the-counter hemorrhoid preparations, or ointments, creams, pads or suppositories containing hydrocortisone, witch hazel or Vaseline.

What are the medical treatments for hemorrhoids?

If hemorrhoids are not helped by home remedies, one or more of the following techniques may be used: rubber-band ligation (RBL), infrared photocoagulation (IPC), electrocoagulation, or injection sclerotherapy. All of these treatments are minimally invasive and take place in a doctor's office.

What are the surgical treatments for hemorrhoids?

There are two primary surgeries performed to treat hemorrhoids: surgical hemorrhoidectomy and stapled hemorrhoidectomy. In a surgical hemorrhoidectomy, excessive tissue is excised. In a stapled hemorrhoidectomy, blood flow to the hemorrhoidal tissue is blocked. Although the latter is somewhat less painful and has a shorter recovery period, it carries a greater risk that hemorrhoids will reoccur, and of rectal prolapse.

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