HEMORRHOIDS (PART 1)

HEMORRHOIDS (Treatment and Prevention).

Hemorrhoids also commonly known as piles or “jedi-jedi” in Yoruba, “basir” in Hausa and “Avara” in Igbo are painful, swollen veins in the lower portion of the rectum or anus.

This condition is very common especially in women during pregnancy and after childbirth. It is also quite common in men.  By age 50 about half of all adults will have experienced the itching, discomfort and bleeding that can signal the presence of hemorrhoids.

Causes of Hemorrhoids

Hemorrhoids result from increased pressure in the veins of the anus. The pressure causes the veins to bulge and expand, making them painful particularly when someone is sitting.

The most common cause is straining during bowel movements. Hemorrhoids may therefore result from constipation, sitting for long periods of time, and anal infections.

Some cases may be caused by other diseases such as liver cirrhosis (chronic failure).

Types of Hemorrhoids

• Internal hemorrhoids occur just inside the anus, at the beginning of the rectum. Internal hemorrhoids usually do not hurt but they may bleed painlessly.
• External hemorrhoids occur at the anal opening and may hang outside the anus. They can be itchy or painful and can sometimes crack and bleed.
• Prolapsed hemorrhoids may stretch down until they bulge outside your anus. A prolapsed hemorrhoid may go back inside your rectum by itself, or you can gently push it back inside.

Symptoms of Hemorrhoids

1.   Bleeding

The most common symptom and sign from hemorrhoids is painless bleeding. There may be bright red blood on the outside of the stools, on the toilet paper, or dripping into the toilet. The bleeding usually is self-limiting.

Bleeding with a bowel movement is never normal and should prompt a visit to a health care practitioner. While hemorrhoids are the most common cause of bleeding with a bowel movement, there may be other reasons to have bleeding including inflammatory diseases of the bowel, infection, and tumors.

2. Prolapsed Internal Hemorrhoids

Prolapse or protrusion of an internal hemorrhoid occurs when the internal hemorrhoids swell and extend from their location in the rectum through the anus. A prolapsed internal hemorrhoid:

·         can be felt as a lump outside the anus;

·         can be gently pushed back through the anus, this may resolve the problem of prolapse but does not fix the hemorrhoid itself;

·         may enlarge and swell even more if they cannot be pushed back;

·         may become entrapped, which requires urgent medical attention.

Hemorrhoids may also cause itching around the anus, and a constant feeling of needing to have a bowel movement.

3. Thrombosed External Hemorrhoids

Thrombosed external hemorrhoids are a painful condition. These occur when a blood clot develops in the hemorrhoid causing swelling and inflammation. When a blood clot occurs in a hemorrhoid, the hemorrhoid will become even more swollen. This swelling leads to increased pain. The pain is usually worse with bowel movements and may increase with sitting. Thrombosed external hemorrhoids often need medical care and treatment.

When to Seek Urgent Medical Care

·     Bleeding from the rectum or anus is never normal and although hemorrhoids are the most common reason to have blood in the stool, it should be discussed with your physician as soon as possible. Other causes of rectal bleeding exist and can be serious. Inflammatory bowel disease and colon cancers can present with rectal bleeding.

·       Individuals who have associated symptoms such as lightheadedness and weakness may have significant blood loss and may require more urgent care.

·    Hemorrhoids do not cause abdominal pain; should this be present with bleeding, medical care should be accessed immediately.

·         Prolapsed hemorrhoids that cannot be pushed back through the anus require medical care.

·         Thrombosed external hemorrhoids may cause significant pain and medical care may need to be sought.

Dr. Olukayode Williams