Hemorrhoids are a condition associated with dilated veins in the anorectal area, which can cause discomfort, pain, and bleeding. Hemorrhoids occur due to the weakening of vascular partitions and the expansion of veins in the rectum and around the anus. Hemorrhoids can be internal or external, depending on their location. Internal hemorrhoids are located inside the intestine and are usually less painful, as there are fewer nerve endings in the rectum. External hemorrhoids form on the outside of the rectum, under the skin, and can be very painful due to high sensitivity in this area.

What are the causes of hemorrhoids?

Hemorrhoids are a complex condition that arises due to various factors contributing to the dilation and inflammation of blood vessels, especially veins, in the rectum and around the anus. The causes of this condition are multifaceted and can include anatomical, physiological, lifestyle, and genetic factors.

  • Increased intra-abdominal pressure: This is one of the main causes of hemorrhoids. Increased pressure in the abdominal cavity can arise for various reasons, such as pregnancy, obesity, lifting heavy objects, or prolonged standing or sitting. This pressure causes the expansion of veins in the rectum, which can lead to the formation of hemorrhoids.
  • Constipation and diarrhea: Both constipation and prolonged diarrhea can cause hemorrhoids. Constipation creates increased pressure in the intestine, requiring stronger straining during defecation, which further increases the pressure in the rectal veins. Conversely, prolonged diarrhea can cause irritation and inflammation in the rectal area.
  • Genetic predisposition: Some people have a genetic predisposition to the formation of hemorrhoids. This can be related to weaker blood vessel walls or other characteristics of the circulatory system.
  • Physical inactivity: A sedentary lifestyle can contribute to hemorrhoids, as prolonged sitting increases pressure in the rectal veins.
  • Dietary factors: Improper diet, especially a diet low in fiber, can cause constipation, which in turn increases the risk of hemorrhoids. Fiber helps maintain normal bowel function and reduces pressure during defecation.
  • Aging: As the body ages, tissues lose their elasticity and strength. This also applies to veins. As veins weaken with age, this can lead to the formation of hemorrhoids.
  • Pregnancy: During pregnancy, blood volume increases, and pressure increases in the lower parts of the body, including the rectum. This can cause the expansion of veins and the formation of hemorrhoids. In addition, hormonal changes during pregnancy can also contribute to the dilation of veins.
  • Sexual activity: Some sexual acts, especially anal sex, can cause injuries or inflammation in the rectal veins, which can lead to the development of hemorrhoids.

Understanding these causes is important for properly treating and managing hemorrhoid symptoms. Additionally, paying attention to prevention and lifestyle changes can reduce the risk of hemorrhoid occurrence or exacerbation.

Symptoms

Hemorrhoids, a condition associated with dilated venous nodes in the rectum and around the anus, can present various symptoms depending on their location (internal or external) and severity. Understanding these symptoms is important not only for diagnosing hemorrhoids but also for planning appropriate treatment.

Bleeding

This is one of the most common symptoms of hemorrhoids. Bleeding is usually painless and occurs during defecation. The blood is typically bright red and may appear on toilet paper, in the stool, or simply drip into the toilet. Bleeding is more common with internal hemorrhoids but can also occur with external hemorrhoids.

Pain and discomfort

External hemorrhoids more often cause pain, as they are around the anus, where there are more pain receptors. The pain can be sharp or burning, especially when sitting, walking, or defecating. Internal hemorrhoids are usually less painful, but internal hemorrhoids can cause discomfort or a feeling of heaviness in the intestine.

Itching and burning

These symptoms are most commonly associated with external hemorrhoids and can be due to irritation or moisture in the anal area. Itching can be very uncomfortable and sometimes difficult to control.

Anal lump or swelling

Hemorrhoids can cause a palpable lump or swelling at the edge of the anus. This swelling can be sensitive to touch and sometimes visible with a mirror.

Prolapse

Internal hemorrhoids can sometimes protrude (prolapse) from the anus, especially during defecation. This can cause discomfort, pain, and difficulty after defecation.

Moisture around the anus

Hemorrhoids can cause a constant feeling of moisture around the anus, causing discomfort and possibly contributing to skin irritation or infection.

Blood clots

Sometimes external hemorrhoids can form blood clots (thrombosed hemorrhoids), causing severe pain, swelling, and redness around the anus.

It is important to emphasize that while these symptoms are often associated with hemorrhoids, similar symptoms can arise from other health problems, such as rectal cancer, anal fissures, infections, or inflammatory bowel diseases. Therefore, if these symptoms occur, especially if they are recurrent or severe, it is important to consult a healthcare professional for accurate diagnosis and appropriate treatment planning.


How are hemorrhoids treated?

The treatment of hemorrhoids is complex and depends on the severity of symptoms, the type of hemorrhoids (internal or external), and the patient's overall health condition. The goal of treatment is to reduce symptoms, improve blood circulation in the rectum, and prevent recurrence of the condition. Hemorrhoid treatment methods include both conservative measures and invasive procedures.

The main method of treating and preventing hemorrhoids is lifestyle adjustment. This includes adequate fluid intake, enriching the diet with fiber (fruits, vegetables, whole grain products), regular physical activity, and weight control. These changes help to prevent constipation, which is one of the main factors in the development of hemorrhoids.

Local preparations, such as ointments, creams, or suppositories, are often prescribed, which reduce swelling, itching, and pain. They may contain anti-inflammatory components, anesthetics, or substances that improve venous tone. Stool softeners may also be prescribed to avoid constipation.

Warm sitz baths can help reduce inflammation and pain. They are often recommended after defecation or several times a day.

For moderate to severe hemorrhoids, minimally invasive procedures may be applied. This includes rubber band ligation, during which a ring is placed on the hemorrhoidal node to reduce blood supply and shrink the node. Another procedure is sclerotherapy, where a substance is injected into the hemorrhoids, causing the walls of the veins to contract and reducing the nodes.

In severe cases, when conservative treatment is ineffective, surgical operation - hemorrhoidectomy - may be performed. This is a procedure to remove hemorrhoid nodes, which is performed under local or general anesthesia. Although it is an effective way to remove hemorrhoids, postoperative pain and a longer recovery period may occur.

Laser therapy and infrared coagulation are used to reduce or remove hemorrhoid nodes. They are less invasive and can be performed on an outpatient basis.

Some patients also seek alternative treatments, such as natural remedies (e.g., arnica, calendula), acupuncture, or other alternative therapies, to alleviate symptoms.

When treating hemorrhoids, it is important to pay attention to the individual needs of the patient and the characteristics of the condition. It is also important to have regular check-ups with a doctor and follow his recommendations to avoid complications and recurrence. Hemorrhoid treatment may require patience and consistent adherence to a lifestyle and treatment plan.

What prevention methods can help avoid the occurrence of hemorrhoids?

Prevention of hemorrhoids is an important aspect to avoid the onset or worsening of this unpleasant and often recurring condition. The basis of hemorrhoid prevention is the adjustment of lifestyle and dietary habits, as well as proper personal hygiene maintenance. These preventive measures help reduce the pressure on the rectal veins and improve bowel function.

Enriching the diet with fiber is one of the main ways to prevent hemorrhoids. Fiber helps ensure regular and soft bowel movements, reducing constipation, which is one of the main causes of hemorrhoids. It is recommended to consume plenty of fruits, vegetables, whole grain products, and other fiber-rich foods. In addition, adequate water intake is necessary to ensure that stools are soft and easily passable.

Regular physical activity is another important part of prevention. Movement helps improve blood circulation, reduces pressure in the rectal veins, and helps prevent constipation. Even simple walking or light exercise can have a positive effect.

Being overweight or obese increases pressure in the abdominal cavity and rectal veins, so weight loss can help reduce the risk of hemorrhoids.

Proper hygiene of the anal area is important to avoid infections and irritation. After defecation, it is recommended to use warm water or wet wipes to avoid excessive friction caused by dry toilet paper. It is also important to maintain a dry and clean environment around the anus.

Prolonged sitting, especially on the toilet, can increase pressure in the rectal veins. It is recommended to break up sedentary work, stand up and move regularly, and avoid prolonged sitting on the toilet.

It is important to avoid excessive straining during defecation, as this can increase pressure in the rectal veins. If there are difficulties with defecation, it is worth considering the use of stool softeners or laxatives.

Stress management is also important, as tension can have a negative effect on the digestive system and cause constipation.

Regular check-ups with a doctor are especially important if there are risk factors for hemorrhoids, such as family history or existing digestive system disorders.

These preventive measures can help reduce the likelihood of developing hemorrhoids or prevent the worsening of an existing condition.

Although hemorrhoids are a common condition, proper treatment and prevention can help reduce symptoms and improve quality of life.


Information sources

  1. American Society of Colon and Rectal Surgeons: Hemorrhoids Overview
  2. British Society of Gastroenterology: Hemorrhoids Management Guidelines
  3. Journal of Gastroenterology and Hepatology: Hemorrhoids - Diagnosis and Treatment Options
  4. Clinical Gastroenterology and Hepatology: Advances in the Management of Hemorrhoids
  5. The Lancet: Hemorrhoids - Pathophysiology and Clinical Management
  6. New England Journal of Medicine: Current Strategies in the Treatment of Hemorrhoids

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