Hemorrhoids: all you need to know


Hemorrhoids, also known as piles, are swollen veins located in the anus and lower rectum, similar to varicose veins. They can be categorized as internal or external depending on their location. This blog post aims to provide a comprehensive understanding of hemorrhoids, including their types, symptoms, and available treatment options.

Internal and external hemorrhoids

Types of Hemorrhoids and Their Symptoms

Symptoms of hemorrhoids depend upon type and the degree of hemorrhoid

A) Internal Hemorrhoids:

Internal hemorrhoids are situated inside the rectum, typically not visible or palpable. However, they can cause discomfort and symptoms such as:
  • Painless bleeding during bowel movements, with small amounts of bright red blood appearing on toilet tissue or in the toilet bowl.
  • Prolapse of internal hemorrhoids, where they extend beyond the anus, leading to pain and irritation.

B) External Hemorrhoids:

External hemorrhoids develop beneath the skin surrounding the anus. They may present the following signs and symptoms:
  • Itching or irritation in the anal region.
  • Pain or discomfort.
  • Swelling around the anus.
  • Bleeding during bowel movements.


C) Thrombosed Hemorrhoids:

Thrombosed hemorrhoids occur when blood pools in an external hemorrhoid and forms a clot. This can result in the following symptoms:
  • Severe pain.
  • Swelling.
  • Inflammation.
  • A hard lump near the anus.

Causes of Hemorrhoids

Several factors contribute to the development of hemorrhoids, including:
  • Pregnancy:Hormonal changes during pregnancy weaken rectal tissues, while increased abdominal pressure contributes to vein relaxation and swelling.
  • Aging:Hemorrhoids are most common in adults over 50, although they can affect individuals of all ages.
  • Diarrhea:Chronic diarrhea can irritate and strain the rectal area, potentially leading to hemorrhoids.
  • Chronic Constipation:Straining during bowel movements puts additional pressure on blood vessel walls, increasing the risk of hemorrhoids.
  • Prolonged Sitting:Spending excessive time in a seated position,
  • Diet:Consuming a low-fiber diet can contribute to constipation and increase the likelihood of hemorrhoids.
  • Heavy Lifting:Repeatedly lifting heavy objects can strain the rectal area and lead to hemorrhoids.
  • Anal Intercourse:Engaging in anal intercourse can cause new hemorrhoids to form or worsen existing ones.
  • Obesity:Excessive weight can put additional pressure on the veins in the rectal area, increasing the risk of hemorrhoids.
  • Genetics:Some individuals may inherit a predisposition to develop hemorrhoids.

Diagnosis of hemorrhoid 

Diagnosing hemorrhoids involves a thorough evaluation by a healthcare professional who will consider your symptoms and medical history. While physical examination often suffices for identifying hemorrhoids, additional tests may be recommended to rule out other potential causes and determine the appropriate treatment approach. Let’s explore the diagnostic methods commonly employed:

1)Visual Examination:

During a visual examination, the healthcare provider will visually inspect the anal area to identify any external hemorrhoids. They may use a gloved finger or a specialized instrument called an anoscope to examine the internal rectal area for internal hemorrhoids or any other abnormalities.

2)Digital Rectal Examination (DRE):

A digital rectal examination involves the insertion of a lubricated, gloved finger into the rectum to check for any internal hemorrhoids, assess their size and location, and evaluate the overall condition of the rectal area.

3)Anoscopic Examination:

An anoscope is a short, rigid tube that allows for a more detailed examination of the anal canal and lower rectum. It is inserted into the rectum to visualize and assess internal hemorrhoids, their severity, and any associated complications.


4)Additional Tests:

In some cases, additional tests may be necessary to confirm the diagnosis or rule out other conditions with similar symptoms. These tests may include:
  • Colonoscopy: This procedure involves the insertion of a flexible tube with a camera into the rectum and colon to examine the entire length of the large intestine. It is typically recommended if there is a suspicion of other gastrointestinal issues or to rule out more serious conditions.
  • Sigmoidoscopy:Similar to a colonoscopy, sigmoidoscopy involves the examination of the rectum and the lower part of the colon using a flexible tube with a camera. This procedure is useful for assessing the lower gastrointestinal tract.
These diagnostic tests help healthcare professionals accurately diagnose hemorrhoids, determine their type and severity, and rule out other potential causes of similar symptoms. Based on the findings, appropriate treatment options can be recommended to address the hemorrhoids effectively.
It is important to consult with a qualified healthcare professional for a proper diagnosis and individualized treatment plan tailored to your specific condition.

Treatment of hemorrhoids

Treatment of hemorrhoid broadly divide into two part, surgical and non surgical

A) Non-Surgical Treatment:Finding Relief for Hemorrhoids at Home

When it comes to managing hemorrhoids, there are non-surgical options that can provide significant relief. These simple home remedies can help alleviate symptoms and promote healing without the need for invasive procedures. Let’s explore these self-care measures:
Embrace a Fiber-Rich Diet:
Including more fiber in your daily meals can work wonders for your hemorrhoids. Foods like broccoli, beans, whole grains, wheat and oat bran, and fresh fruits are excellent sources of fiber. The added fiber softens your stools and makes them easier to pass, reducing the pressure on your hemorrhoids. If needed, you can also consider fiber supplements like Metamucil, Citrucel, or Fiber Con to boost your fiber intake.
Hydrate, Hydrate, Hydrate:

Drinking an adequate amount of water is crucial for maintaining good bowel health. Staying hydrated helps prevent constipation and keeps your stools soft, making them easier to pass without straining. Aim to drink enough water throughout the day to promote smooth bowel movements and reduce the risk of irritating your hemorrhoids.

Soothe with Sitz Baths:
A sitz bath is a relaxing and therapeutic option for soothing hemorrhoid discomfort. You can find small plastic tubs that fit over your toilet seat or use a regular bathtub with a few inches of warm water. The warm water helps relieve itching, irritation, and spasms of the sphincter muscle. Most experts recommend taking a 20-minute sitz bath after each bowel movement and two or three times a day. Afterward, make sure to gently pat the anal area dry to avoid any further irritation.
Sitz bath
Get Moving with Exercise:
Engaging in moderate aerobic exercise, such as brisk walking for 20-30 minutes each day, can have a positive impact on your bowel function. Exercise helps stimulate your digestive system, promoting regular bowel movements. By staying active, you reduce the likelihood of constipation and the associated strain on your hemorrhoids.
Over-the-Counter Hemorrhoid Treatments:
Several over-the-counter options can provide relief from hemorrhoid symptoms:
  • Steroid cream (hydrocortisone) helps reduce inflammation and relieve discomfort.
  • Local anesthetic cream (lidocaine/lignocaine), when combined with steroids or other anti-inflammatory agents, can effectively reduce pain, inflammation, and other symptoms.
  • Zinc oxide is known for its anti-inflammatory properties and can help alleviate swelling and irritation.
  • Witch hazel, available in various forms, has a soothing effect on hemorrhoids.
  • Simple analgesics, such as pain relievers, can provide temporary relief from hemorrhoid-related discomfort.
Remember, these non-surgical options can bring significant relief for most hemorrhoid symptoms. However, if your symptoms persist or worsen, it is essential to consult with a healthcare professional for further evaluation and personalized treatment recommendations.

B) Surgical Treatment: Advanced Solutions for Hemorrhoid Relief

When non-surgical measures aren’t sufficient to address your hemorrhoid concerns, surgical options can provide advanced solutions for effective treatment. These procedures are typically recommended for severe cases or when non-surgical interventions have been unsuccessful. Let’s explore the surgical treatment options for hemorrhoids:

1)Minimally Invasive Procedures:

  • Rubber Band Ligation:This is the most commonly used hemorrhoid treatment. During this procedure, a small elastic band is placed around the base of the hemorrhoid, cutting off its blood supply. With reduced blood flow, the hemorrhoid shrinks and eventually falls off, providing relief.
  • Sclerotherapy: In this procedure, a chemical solution is injected into the hemorrhoid, causing it to shrink and harden. The hardened hemorrhoid no longer causes discomfort and eventually withers away.
  • Laser or Infrared Coagulation: Heat-based techniques, such as laser or infrared coagulation, can be used to shrink internal hemorrhoids. These methods promote the formation of scar tissue, which cuts off the blood supply to the hemorrhoid, leading to its resolution.

2)Traditional Hemorrhoidectomy:

In cases of large protruding hemorrhoids, persistently symptomatic external hemorrhoids, or internal hemorrhoids that do not respond to rubber band ligation, a traditional hemorrhoidectomy may be necessary. This surgical procedure involves the complete removal of the hemorrhoids using various techniques, including excision, suturing, and wound closure.

3)Stapled Hemorrhoidopexy:

also known as procedure for prolapse and hemorrhoids (PPH), offers an alternative to traditional hemorrhoidectomy for treating bleeding or prolapsed internal hemorrhoids. During this procedure, a circular stapling device is used to reposition and secure the hemorrhoidal tissue back into its normal position, reducing symptoms and preventing future prolapse.
It is important to note that surgical options for hemorrhoids should be discussed and evaluated by a qualified healthcare professional. They will consider the severity of your condition, medical history, and individual factors to determine the most appropriate surgical intervention for you.
Following any surgical procedure, it is essential to adhere to post-operative care instructions provided by your healthcare provider. This includes proper wound care, pain management, and maintaining regular follow-up appointments to ensure optimal healing and monitor your progress.

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