Hemorrhoids

Hemorrhoids are a common affliction caused by an increase in the size of spongy tissue, called anal cushions, present in the anal region. It afflicts millions of Americans.

The usual symptoms consist of rectal bleeding which is often bright red in color and accompanies a bowel movement. In addition protrusion at the anal opening and mucus discharge along with irritation may also be presenting features.

The hemorrhoids can be internal or external. Internal hemorrhoids usually present with bleeding. There may also be a mucus discharge and in some cases burning with irritation. A protrusion at the anal opening may sometimes be noted. External hemorrhoids are common especially in women after childbirth. They are usually asymptomatic unless they are large or are multiple. They may present with irritation due to trauma caused by excessive wiping.

Symptomatic hemorrhoids would need to be treated. There are several treatment options available, depending on the size and degree of protrusion of internal hemorrhoids. Treatment can vary from application of ointments, use of rectal suppositories, to rubber band treatment of the hemorrhoids. In some cases surgery may be necessary to control the symptoms. Newer techniques like the Procedure for Prolapse and Hemorrhoids PPH, also known as stapled hemorrhoidopexy, or Hemorrhoidal Artery Ligation (HAL) are also treatment options. External hemorrhoids would need to be removed surgically if they are large and symptomatic.

A thrombosed external hemorrhoid is caused by an external hemorrhoidal blood vessel rupturing and forming a clot in the tissue close to the anal opening. It is usually caused by excessive straining, either due to constipation or sometimes due to excessive physical activity. It is also known to occur in the later stages of pregnancy. It presents as a painful swelling and occasionally bleeds, especially when the skin overlying the hemorrhoid gives way and the underlying clot comes out. It may need to be surgically excised, usually done as an office procedure.

Keeping the bowel movements soft by staying on a high fiber diet and taking stool softeners, if needed, is recommended in all cases of symptomatic internal hemorrhoids.

Read more about hemorrhoids at the American Society of Colon & Rectal Surgeons website.