Hemorrhoids is the name for a condition in which the veins around the anus or the lower rectum become swollen and inflamed. This inflammation may be caused by straining to move stool, pregnancy, aging, chronic constipation, diarrhea or anal intercourse. This condition is very common in both men and women. About half of the population has hemorrhoids by age 50. They also are very common among pregnant women, although the condition is usually temporary.
Hemorrhoids can be either inside the anus (internal) or under the skin around the anus (external).
Although many people have hemorrhoids, not everyone experiences symptoms. The most common symptom of internal hemorrhoids is bright red blood covering the stool or visible on toilet paper or in the toilet bowel. Sometimes, an internal hemorrhoid may protrude through the anus outside of the body, becoming irritated and painful. Symptoms of external hemorrhoids may include painful swelling or a hard lump around the anus that occurs when a blood clot forms; this also is called a thrombosed external hemorrhoid.
Hemorrhoids usually are not dangerous or life-threatening, and in most cases, any symptoms go away within a few days. However, patients should be aware that many anorectal problems – such as fissures, fistulae, abscesses or irritation and itching – have similar symptoms and can be confused with hemorrhoids. This is why it’s important to have a proper examination by a doctor any time bleeding from the rectum or blood in the stool occurs.
The doctor will examine the anus and rectum to look for swollen blood vessels that might indicate hemorrhoids. The doctor also will perform a digital rectal exam with a gloved, lubricated finger to feel for any abnormalities.
The physician also may use an anoscope – a hollow, lighted tube useful for looking at internal hemorrhoids – or a proctoscope to examine the entire rectum. Depending on the symptoms, the doctor also may order a sigmoidoscopy or colonoscopy to view further into the colon.
Before any surgery, most doctors use medical means to relieve the symptoms. These may include several warm tub baths per day or application of a hemorrhoidal cream or suppository for a period of time. To prevent recurrence, physicians also will recommend fiber and fluids to reduce constipation and straining. Drinking six to eight glasses of fluid (not alcohol) results in softer stools, which makes emptying the bowel easier and helps you avoid straining.
In some cases, hemorrhoids must be treated surgically to destroy the hemorrhoidal tissue. This may be done in the office or in the hospital.
One of the surgical techniques is rubber band ligation. A rubber band is placed around the base of the hemorrhoid inside the rectum. The band cuts off circulation, and the hemorrhoid dries up within a few days.
A hemorrhoidectomy is used occasionally when severe internal or external hemorrhoids exist.
Your doctor will determine which approach is best based on your specific condition.
To make an appointment with a Washington University colorectal surgeon, please call (314) 454-7177.