Hemorrhoids – symptoms
Symptoms of hemorrhoids
Hemorrhoids form as an enlargement of the submucosal venous plexus in the rectum and the anal canal, they may occur for several reasons. It is a very common disease that affects about 70% of people over the age of thirty years and more often affects men. The hemorrhoids can be found also in younger people. People usually visit a doctor only when the problems are unbearable, or fear of a more serious disease such as colon cancer.
Causes of hemorrhoids
Hemorrhoids are formed because the lining is not firmly fixed to submucosa and such lining sticks outwards. On this layer, blood vessels change and they enlarge. Here blood accumulates and therefore the so-called hemorrhoids are formed. A relatively common cause are liver diseases, associated with increased pressure in the capillary bed, which removes venous blood from some organs of the gastrointestinal tract, especially from the intestines to the liver. In a damaged liver the blood flow is restricted, and the blood is therefore looking for other options how to get into large veins and into the heart. One of the possible routes are the veins of the rectum. Hemorrhoids also form if you have constipation, a sedentary lifestyle and lack of exercise.
Types and symptoms of hemorrhoids
Hemorrhoids are a very common disease that affects both old and young people. Depending on the type further therapy is determined. In principle, we distinguish two main types of hemorrhoids, internal and external hemorrhoids. Individual types of hemorrhoids have some common but also different symptoms.
Internal hemorrhoids are formed by the enlargement of veins under the mucous membrane in the walls of the rectum, usually due to increased intra-abdominal pressure. This happens for example during pregnancy, obesity, while pushing the stool or coughing. If the intra-abdominal pressure is increased the venous plexus swells and may subsequently lead to bleeding or it prolapses before the anus. These hemorrhoids are often accompanied with bleeding during or after defecation. It is usually accompanied with relief. Usually after defecation the surface of the stool is covered by rich red blood. The blood from hemorrhoids can also absorb. In this case an empty pouch of skin can remain there, which may again be filled with blood and a new hemorrhoid may appear. Bleeding should not be underestimated; sometimes it does not have to be a symptom of hemorrhoids, but colon cancer. Therefore it is necessary to always try to determine the cause of the bleeding. Prolonged bleeding from hemorrhoids can lead to anemia.
External hemorrhoids are located on the outer surface of the anus. They have the form of a pouch-like enlarged vessel; they are soft, painless and visible to the naked eye. Usually they do not bleed. Problems occur when the flow of accumulated blood is blocked, most often during excessive pushing of the stool. In this case, the accumulated blood coagulates, the hemorrhoid begins to interfere in this area and it is painful. In most cases these hemorrhoids must be surgically removed.
Diagnosis of hemorrhoids
Diagnosis of hemorrhoids starts with an anamnesis where we are searching for the presence of blood in the stool. This is followed by a finger rectal examination where the doctor confirms the presence of blood. Hemorrhoids themselves are not palpable during this examination. They are palpable only if the accumulated blood has coagulated and a thrombus has formed. For the diagnosis of hemorrhoids rectoscopy is further performed, using an optical instrument, which is introduced into the rectum and thus confirming the presence of hemorrhoids. Given that the blood in the stool may have other causes, the examination performed is called colonoscopy. It is an examination where a tube-like device with a camera is introduced into the rectum and the colon, which visualizes the state of the mucous membranes of the rectum and colon.
Treatment of hemorrhoids
Hemorrhoids are not life-threatening, but may significantly decrease the quality of life. Therefore, it is recommended to see a doctor as soon as possible. In principle, we can choose between conservative and surgical treatment.
Conservative treatment of hemorrhoids
Conservative treatment is suitable for patients with less advanced stages of hemorrhoids. It is mainly a change of lifestyle. The treatment is based on care for regular bowel movement. This can be achieved by an increased amount of vegetables and fiber in your diet. Also, fruits are convenient since they support the softening of stool. The conservative treatment of course includes increased hygiene of the rectal area. Also the use of suppositories or ointments is recommended.
Surgical treatment of hemorrhoids
Surgical treatment is indicated for patients with advanced stages of hemorrhoids. Possibilities are outpatient procedures or operations.
- Outpatient procedures are beneficial for both younger and older patients. They are painless; the patient is not burdened with anesthesia, and inability to work. Outpatient surgery is not time-consuming; the entire procedure takes about 20 seconds. Outpatient interventions are successful to 95%.
- Surgical treatment is a bigger procedure, since the patient must be put to sleep. It is performed in more advanced stages of hemorrhoids, when the treatment can not be solved on an outpatient basis.