Hemorrhoids: causes, symptoms and treatment

Hemorrhoids and trips to the bathroom: a painful experience. Learn more about hemorrhoidal disease in more detail.

for those who have hemorrhoids, defecating can cause great discomfort and pain. These dilated and protruding veins can be internal or external and cause a lot of discomfort.

Internal hemorrhoids develop inside the anus and often cause bleeding during a bowel movement, usually without pain. What happens is that they tend to externalize (prolapse), when we go to the bathroom and, then, they start to hurt.

The external ones develop near the anus and are covered by very sensitive skin. As a rule, they also do not cause pain. However, if a clot forms, the external hemorrhoid quickly becomes bulging and painful.

Hemorrhoids: everything you need to know

In the face of symptoms such as bright red blood loss, prolapse and/or itching in the anal area during or after defecation, the first step is to consult a specialist doctor, in this case, a coloproctologist.

Anamnesis – a questionnaire given to the patient that allows obtaining information about the beginning and evolution of a disease – and a physical examination are part of the diagnosis of this problem.

according to a article published in the Portuguese Journal of Coloproctology“the anamnesis must obligatorily include the evaluation of bowel habits and the amount of ingestion of fiber foods in the diet, as well as the type of profession or other activities.”

As for the physical examination, experts recommend, in the document, performing an anal inspection, digital rectal examination, anoscopy and rectoscopy. These last exams allow you to see the inside of the anus and rectum, respectively.

Causes

This is a question for which there is still no exact answer. However, there are several causes that have been pointed out. Factors such as:

• age (they usually appear between 45 and 65 years old);
• constipation;
• straining to defecate;
• The pregnancy??
• prolonged time on the toilet;
• The diarrhea;
• sitting position for long periods.

Treatment for hemorrhoids

In the case of mild symptoms, follow the advice listed below.

• Drink water and eating fiber can reduce the bleeding and pain caused by hemorrhoids. For this, you should favor the consumption of fruits and vegetables; brown rice; whole grains; and nuts.
• avoid spending too much time sitting and to walk more can help ease the discomfort caused by hemorrhoids by lowering rectal pressure.
• Applying ice to hemorrhoids can help reduce swelling and relieve pain. Just sit on a bag of ice wrapped in a cloth for 20 minutes.
• Doing sitz baths in lukewarm water also relieves swelling in the veins as it increases blood flow.
• Maintain careful hygiene. Washing and drying yourself carefully and gently is even more important when you have hemorrhoids. Alcoholic or perfumed products should also be avoided.
• Lying down on a sofa with your legs up helps improve blood circulation and remove pressure from the inflamed area.
• Using plain toilet paper, free of perfumes or other chemicals that could irritate the most sensitive skin in the anal area, is also advisable.
• Applying vaseline to the painful area is another way to alleviate the discomfort felt.
• Do not postpone going to the bathroom, as this can cause increased abdominal pressure.

In the case of external hemorrhoidsit is recommended to carry out these same measures, accompanied by oral medication and the application of local topicals, in order to make the pain and swelling disappear in a few days.

When they are internal and are the target of greater concern, there are other types of treatments. See below.

• Sclerotherapy: an injection of solutions that will be beneficial to reduce hemorrhoids and stop bleeding.
• Hemorrhoidal ligation: it is a partial reduction of the hemorrhoidal tissue.
• Surgery: removal of these blood vessels.

This last treatment should only happen, according to experts, in the most serious cases, that is, in patients who have large hemorrhoidal components or in patients with external and internal hemorrhoids with significant prolapse.

In Portugal, it is estimated that about 20% of the population over 50 years old have hemorrhoids, and the number of surgeries exceeds 40,000 per year.

See too
Guide to a Healthy Gut

Hemorrhoids and pregnancy/postpartum

It’s not hard to understand why hemorrhoids in pregnancy are so common. As the baby grows, there is an increase in blood volume, greater dilation of the veins and a greater likelihood of constipation.

These factors, associated with an enlarged uterus, pelvic floor fatigue and the hormonal environment, favor the occurrence of hemorrhoidal disease.

However, hemorrhoidal disease is not only common in pregnancy, especially in the 3rd trimester, but is also quite common in the postpartum period. The effort and trauma associated with labor justify this situation.

Pmain symptoms

Although many pregnant women and new mothers have hemorrhoids, not everyone has symptoms. When symptoms are present, some of the most common are:

• bleeding: bright red bleeding that often occurs during or after a bowel movement;
• pain – occurs mainly when there is inflammation and obstruction of the hemorrhoid;
• anal burning – especially after eating spicy foods;
• prolapse – when hemorrhoids are external and outside the anus;
• mucus excretion – when there is mucus elimination through the anus;
• anal pruritus – an itchy sensation in the anal area.

How to treat hemorrhoids during pregnancy and postpartum?

Often, after giving birth, hemorrhoids mostly disappear by themselves. When this does not happen, dietary measures to control constipation are an important part of the treatment.

The treatment of hemorrhoids varies according to the degree of severity of the disease and, therefore, in the most serious cases, surgical treatment may be an option.

There are small lifestyle changes that can help prevent hemorrhoids from getting worse during pregnancy, including:

• eating fiber-rich foods and drinking plenty of fluids;
• avoid eating spicy foods;
• avoid making a lot of force when defecating;
• swimming and cycling can act preventively;
• prefer cotton underwear, which usually guarantee greater comfort.

Note: if, even after applying these measures, you experience severe pain, you should see your doctor. If you are pregnant, remember that under no circumstances should you start any medication without consulting your obstetrician.