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What Are Hemorrhoids? |
Hemorrhoids are swollen but
normally present blood vessels in and around the anus and lower
rectum that stretch under pressure, similar to varicose veins in
the legs. The increased pressure and swelling may result from straining to move the bowel. Other contributing factors include pregnancy, heredity, aging, and chronic constipation or diarrhea. Hemorrhoids are either inside the anus (internal) or under the skin around the anus (external). (See figure.) |
What Are the Symptoms of Hemorrhoids? |
Many anorectal problems, including fissures, fistulae,
abscesses, or irritation and itching (pruritus ani), have
similar symptoms and are incorrectly referred to as
hemorrhoids. Hemorrhoids usually are not dangerous or life threatening. In most cases, hemorrhoidal symptoms will go away within a few days. Although many people have hemorrhoids, not all experience symptoms. The most common symptom of internal hemorrhoids is bright red blood covering the stool, on toilet paper, or in the toilet bowl. However, an internal hemorrhoid may protrude through the anus outside the body, becoming irritated and painful. This is known as a protruding hemorrhoid. Symptoms of external hemorrhoids may include painful swelling or a hard lump around the anus that results when a blood clot forms. This condition is known as a thrombosed external hemorrhoid. In addition, excessive straining, rubbing, or cleaning around the anus may cause irritation with bleeding and/or itching, which may produce a vicious cycle of symptoms. Draining mucus may also cause itching. |
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How Common Are Hemorrhoids? |
Hemorrhoids are very common in men and women. About half of the
population have hemorrhoids by age 50. Hemorrhoids are also
common among pregnant women. The pressure of the fetus in the
abdomen, as well as hormonal changes, cause the hemorrhoidal
vessels to enlarge. These vessels are also placed under severe
pressure during childbirth. For most women, however, hemorrhoids
caused by pregnancy are a temporary problem. |
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How Are Hemorrhoids Diagnosed? |
A thorough evaluation and proper diagnosis by the doctor is
important any time bleeding from the rectum or blood in the
stool lasts more than a couple of days. Bleeding may also be a
symptom of other digestive diseases, including colorectal
cancer. The doctor will examine the anus and rectum to look for swollen blood vessels that indicate hemorrhoids and will also perform a digital rectal exam with a gloved, lubricated finger to feel for abnormalities. Closer evaluation of the rectum for hemorrhoids requires an exam with an anoscope, a hollow, lighted tube useful for viewing internal hemorrhoids, or a proctoscope, useful for more completely examining the entire rectum. To rule out other causes of gastrointestinal bleeding, the doctor may examine the rectum and lower colon (sigmoid) with sigmoidoscopy or the entire colon with colonoscopy. Sigmoidoscopy and colonoscopy are diagnostic procedures that also involve the use of lighted, flexible tubes inserted through the rectum. |
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What Is the Treatment? |
Medical treatment of hemorrhoids initially is aimed at
relieving symptoms. Measures to reduce symptoms include:
Good sources of fiber are fruits, vegetables, and whole grains. In addition, doctors may suggest a bulk stool softener or a fiber supplement such as psyllium (Metamucil) or methylcellulose (Citrucel). In some cases, hemorrhoids must be treated surgically. These methods are used to shrink and destroy the hemorrhoidal tissue and are performed under anesthesia. The doctor will preform the surgery during an office or hospital visit. A number of surgical methods may be used to remove or reduce the size of internal hemorrhoids. These techniques include:
Techniques used to treat both internal and external hemorrhoids include:
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How Are Hemorrhoids Prevented? |
The best way to prevent hemorrhoids is to keep stools soft so
they pass easily, thus decreasing pressure and straining, and to
empty bowels as soon as possible after the urge occurs.
Exercise, including walking, and increased fiber in the diet
help reduce constipation and straining by producing stools that
are softer and easier to pass. |
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National Digestive Diseases Information Clearinghouse2 Information Way The National Digestive Diseases Information Clearinghouse (NDDIC) is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK is part of the National Institutes of Health under the U.S. Department of Health and Human Services. Established in 1980, the clearinghouse provides information about digestive diseases to people with digestive disorders and to their families, health care professionals, and the public. NDDIC answers inquiries; develops, reviews, and distributes publications; and works closely with professional and patient organizations and Government agencies to coordinate resources about digestive diseases. Publications produced by the clearinghouse are reviewed carefully for scientific accuracy, content, and readability. This e-text is not copyrighted. The clearinghouse encourages users of this e-pub to duplicate and distribute as many copies as desired.
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NIH Publication No. 95-3021 May 1994 e-text updated: October 1999 |
