By the age of 50, most adults will already be dealing with hemorrhoids. This unpleasant condition, also known as piles, is caused by swollen veins in the lower rectum and anus. It leads to bleeding, itching and peri-anal discomfort. Here’s what you need to know about them.
Most hemorrhoids come from strained bowel movements, which can either be the result of chronic diarrhea or constipation. Sitting on the toilet for long stretches of time can also be a factor. Pregnant women and individuals who are overweight or obese are also more likely to get them. Finally, anal intercourse, especially if frequent and without the use of proper lubrication, can result in hemorrhoids.
Generally, no. Over time, significant blood loss from hemorrhoids can lead to anemia. In rare cases, the blood supply to a hemorrhoid can be cut off, which can lead to a serious pain condition called thrombosis (blood clot within the external hemorrhoids).
Fortunately, hemorrhoids can be treated in a variety of ways. Over-the-counter hemorrhoid creams or pads containing a numbing agent can provide fast relief. It’s important to keep the area around your anus clean, so make a point of showering or bathing (better) on a daily basis. Do not use soap on your anus as it can further aggravate the problem. When going to the bathroom, avoid using dry toilet paper, as this can cause irritation. Instead, use a moist towelette or damp toilet paper. Stay away from any products that contain perfumes or scents. If possible, try to soak your anal region in warm water for 10 to 15 minutes three times a day (during a flare up). This might seem impractical, but is actually quite manageable. A sitz bath can be purchased in large drugstores and fits conveniently over a toilet, making it possible to get in a quick soak even when you are away from your home.
Your doctor’s approach to hemorrhoids will depend on the severity of your condition. In mild cases, they may suggest sticking to over-the-counter creams or medications. For more severe cases, your doctor may recommend one of three minimally invasive procedures. Rubber band ligation involves placing tiny rubber bands on an internal hemorrhoid to cut off circulation, causing the hemorrhoid to shrivel up and drop off within a week. The insertion process can be painful, but rarely leads to serious bleeding. Sclerotherapy involves injecting a chemical solution into the hemorrhoid. It is relatively painless, but sometimes less effective than other methods. Coagulation involves the use of lasers or infrared heat or light.
In the most serious cases, your doctor may recommend surgically removing the hemorrhoid. This procedure, called a hemorrhoidectomy, is highly effective, but can be painful and sometimes results in urinary tract infections. Another alternative is a stapled hemorrhoidectomy, which usually allows a patient to return to their normal life more quickly.
Certificate in Advanced Endoscopy Siriraj Hospital . Faculty of Medicine Siriraj Hospital, Mahidol University , 2011