Hemorrhoid
Hemorrhoids are veins within the rectum that become irritated and swollen for a number of reasons. Internal hemorrhoids will sometimes get so large that they protrude from the anus, they are now considered external. They are similar to varicose veins of the legs, or anywhere else in the body, for that matter. They are often worsened by increased pressure within the rectum, such as from pregnancy or straining. Many people do not even know they have hemorrhoids, until they are so large that they have changed from internal hemorrhoids, to external. In general, although you may experience discomfort, most hemorrhoids will not harm you. It is important to talk to your doctor about your symptoms to be sure that you do not have something more serious, like colorectal cancer.
Signs and Symptoms of Internal Hemorrhoids
Bright red blood after a bowel movement, especially if constipated; the blood may be on the toilet paper, on the surface of the stool, or inside the toilet bowl. This is often the only symptom of internal hemorrhoids as there are few nerve endings within the rectum that will sense the discomfort of the hemorrhoid.
Some people experience anal itching and irritation, this is often due to leaking mucous from the hemorrhoid within the anal canal. It often leaks out and irritates the external skin of the anus. Another source of itching and irritation is leaking stool and the inability to clean the area well, or over-cleaning the area causing local skin irritation.
If the hemorrhoid gets large and becomes external, symptoms often worsen and pain develops. If the hemorrhoid thromboses, or clots, the pain may become severe. This is often when a person will seek medical attention.
Who is At Risk for Internal Hemorrhoids:
Internal hemorrhoids are created when there is an increase of pressure within the veins of the rectum or anus. The veins become engorged with blood. This may happen for a number of reasons, including: pregnancy, obesity, sitting or standing for long periods of time, straining with bowel movements or heavy lifting.
Poor dietary habits may also put you at risk for internal hemorrhoids. These habits include low fiber, high fat diet, and decreased fluid intake. This may lead to constipation and therefore straining to have a bowel movement.
There are also some risk factors that are unable to be modified to decrease your risk; these include age, sex, family history and cirrhosis of the liver.
How are Internal Hemorrhoids Diagnosed:
It is extremely important to be evaluated by a medical professional if you are having rectal bleeding of any sort, even if you are not experiencing any pain. A doctor will perform a history and physical exam. He will discuss your symptoms, dietary habits, behavioral habits, as well as your family history. In addition, a physical examination of your anus and internal examination of your rectal vault will be done to check for the presence of hemorrhoids, as well as something more concerning, such as a mass or tumor.
Possible Treatment Options for Internal Hemorrhoids:
Because many people don’t have the same symptoms with internal hemorrhoids as they do with external hemorrhoids, many of the topical creams and ointments are not necessary. Treatment often includes decreasing risk factors and diet modification. The goal for patients with internal hemorrhoids is to reduce their size, stop the bleeding, and prevent them from becoming large and prolapsed, or external hemorrhoids.
The itching caused by seeping mucous may be resolved with topical treatments such as Preparation H. There are patients that may need hydrocortisone in suppository form, that will treat the internal symptoms, including pain, itching and inflammation.
If they do become large and painful, there are several surgical treatments that you can discuss with your doctor if other topical or oral medications haven’t been helpful. These surgical procedures can be as simple as removing a clot from within the hemorrhoid at the doctor’s office with local anesthesia, to having large hemorrhoids banded or removed in the operating room.
It is important to try to control your hemorrhoid situation with less invasive ways. It is not always necessary to have surgery if you can modify your behaviors. Unfortunately, some patients simply have bad luck and need more aggressive treatment than others.
