Hemorrhoids

Definition: Dilated or enlarged veins in the lower portion of the rectum or anus. Hemorrhoids are commonly known as piles which is nothing but lump in the rectal area. They are painful causing inflammation of veins present in the lower portion of the rectum. This condition is quite common during pregnancy and shortly after childbirth. Piles can occur either inside the body called as internal hemorrhoids present in the anus or starting point of the rectum. Sometimes it is present externally at the anal opening or it might hang out of the anus.
Alternative Names

• Rectal Lump
• Piles
• Lump in the Rectum

Two Types:

• Internal- Under the skin
• External- Around the anus

Grades:
I- Hemorrhoids only bleed
II- Prolapse and reduce spontaneously
III- Require replacement
IV- Permanently Prolapsed
Symptoms

• Rectal Bleeding
• Bright red blood in stool
• Pain during bowel movements
• Anal Itching
• Rectal Prolapse
• Thrombus

Causes

• Pressure
• Constipation
• Diarrhea
• Sitting or standing for long periods of time
• Obesity
• Heavy Lifting
• Pregnancy

Signs and Tests

• Rectal Examination
• Visual
• Digital

Tests

• Stool Guaiac (FOBT)
• Sigmoidoscopy
• Anaoscopy
• Proctoscopy

Complications

• The blood in the enlarged veins may form clots and the tissue surrounding the hemorrhoids can die (Necrosis)
• This causes painful lumps in the anal area.
• Severe bleeding can occur causing iron deficiency anemia.

MANAGEMENT: Mild cases are controlled by:

• Preventing constipation
• Drinking Fluids
• High-fiber diet
• Use of Fiber supplements
• Stool softeners
• Apply and OTC cream or suppository containing hydrocortisone
• Keep anal area clean
• Soak in a warm bath
• Apply ice packs or compresses x 10min
• If prolapses, gently  push back into anal canal
• Use a sitz bath with warm water
• Use moist towelettes or wet toilet paper instead of dry toilet paper.

Prevention

• Eat high fiber diet
• Drink Plenty of Liquids
• Fiber Supplements
• Exercise
• Avoid long periods of standing or sitting
• Don’t Strain
• Go as soon as you feel the urge