What are hemorrhoids?

Dr. Jeffrey Snow has more than 20 years of experience surgically treating hemorrhoids. In addition, you’ll have an experienced and caring team to help you through your journey. This article will review some of the basics of hemorrhoid symptoms, causes, and treatments.

What are hemorrhoids?

Hemorrhoids are a normal part of the anal canal that helps control bowel function. Hemorrhoids can be found in two locations. External hemorrhoids are located outside of the body where the skin has sensitive nerve endings. In contrast, internal hemorrhoids exist within the lining of the anal area and rectum and inside the body.

When hemorrhoids become inflamed, it can be excruciating, especially when they are located externally. Unfortunately, over 10 million people suffer from inflamed hemorrhoids each year.

Symptoms of hemorrhoids

The severity of symptoms of hemorrhoids varies based on which ones are causing the problem.

External hemorrhoids bring on sharp, excruciating pain. The cause of the pain is bleeding and a formed clot stretching the skin of the anal area.

Internal hemorrhoids are graded on a scale of 1-4. Where pain increases as the grade does. Although you can experience bleeding and burning, they’re rarely painful.

  • Grade 1.) painless rectal bleeding
  • Grade 2.) pain and discomfort from prolapsing or protruding the anal opening
  • Grade 3.) pain and discomfort from prolapsing or protruding the anal opening that requires being manually pushed back in
  • Grade 4.) pain and discomfort from hemorrhoids stuck in the prolapsed position, generally requiring surgery.

It’s crucial to note similar symptoms between hemorrhoids and other similar conditions, such as colon cancer. So if you are over 40 and experience rectal bleeding, talk to your doctor to rule out colon cancer.

Causes of hemorrhoids

  •  Lack of fiber- The United States Department of Agriculture (USDA) recommended women eat a minimum of 25 grams of fiber, and men consume over 30 grams of fiber every day. Many do not even get close.
  • Irregular bathroom habits- Even if you consume the proper fiber, it is possible to develop inflamed hemorrhoid. Regular constipation, straining, and irregular bowel habits are also common causes of hemorrhoids. As if they aren’t already suffering enough- pregnant women are also prone to the development of inflamed hemorrhoids.
  • Genetics- Unfortunately, if your parents suffer from inflamed hemorrhoids, there’s a higher probability of you developing them as well. Over 50% of patients with hemorrhoids in their families have a history of dealing with the same experiences. Individuals with Inflammatory Bowel Disease (IBD) may also have a higher risk of developing hemorrhoids.

Treatment of hemorrhoids

Over-the-counter medications like Preparation H can help relieve hemorrhoid discomfort, but you’ll need to modify your diet to keep them from coming back. You can increase your fiber intake by eating nuts, veggies, legumes, fruits, etc.

No one has died from a hemorrhoid, but the pain can be so bad at times you might wish you had. If your hemorrhoid is causing you severe pain, you’ll want to visit your doctor.

When dietary adjustments don’t work, your doctor will perform a painless procedure known as a “rubber band ligation,” where they place a small rubber band around the hemorrhoid to help it fall off. This technique is painless and very effective.

If neither a diet change nor band litigation provides relief, there are several surgical options:

Internal

  • Hemorrhoidectomy- After being given general anesthesia, incisions are made in the tissue surrounding your hemorrhoid. The swollen vein in the hemorrhoid is tied off to prevent bleeding, and the hemorrhoid is removed.
  • Stapled hemorrhoidopexy- Stapling the last section of the large bowel, reducing blood supply to the hemorrhoids causing them to shrink.
  • Hemorrhoid Artery Ligation- Using an ultrasound to detect which blood vessels supply blood to the hemorrhoids, your doctor will suture the arteries, so no blood accesses the hemorrhoid, causing it to shrink.

External

  • Hemorrhoidopexy- commonly referred to as “stapling,” this surgery is used to treat prolapsed hemorrhoids, where a surgical staple places a hemorrhoid back inside the rectum and cuts off the blood supply, causing the tissue to shrink and be reabsorbed.
  • Hemorrhoidectomy- *see above* Surgery is used for both external and internal hemorrhoid removal.

Prevention

Hemorrhoids can cause some of the worst pain you will experience in your life, so it is important to take a few preventative steps each day. The best way to prevent hemorrhoids is to keep your stools soft: a few ways to do that are:

  • Exercise
  • Staying active reduces pressure on veins and can help lose excess weight.
  • Increased fiber
  • Eating more fruits, vegetables, and whole grains will increase your fiber intake, but you may want to consider supplements.
  • Drinking plenty of liquids
  • Six to eight glasses of water each day keep stool soft and easy to pass
  • Not sitting on the toilet for extended periods
  • Sitting for too long, especially on the toilet, increases pressure on the veins in the anus, making it more susceptible to forming hemorrhoids.
  • Avoid straining and holding your breath when trying to pass a stool
  • This creates unnecessary pressure leading to an increased likelihood of hemorrhoids.
  • Going to the restroom as soon as you feel the urge, as it may dry up and be harder to pass.
  • You will want to go to the bathroom when the need arises, as letting it pass and it “going away” is the stool drying, leading to difficulty passing.

​​Dr. Jeffrey Snow has been a senior partner at Surgery Specialists of South Florida for 20 years and has spent his entire career practicing medicine in South Florida. Dr. Snow is a board-certified general and colorectal surgeon. He earned his medical degree from the Johns Hopkins School of Medicine in 1982 and completed his internship at the New England Deaconess Hospital in Boston in 1983. In addition, he completed residencies at Albany Medical Center and the Jewish Hospital of Cincinnati and a fellowship at St. Vincent’s Medical Center.

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