Hemorrhoids

DEFINITION

Hemorrhoids (HEM-uh-roids), also called piles, are swollen and inflamed veins in your anus and lower rectum. Hemorrhoids may result from straining during bowel movements or from the increased pressure on these veins during pregnancy, among other causes. Hemorrhoids may be located inside the rectum (internal hemorrhoids), or they may develop under the skin around the anus (external hemorrhoids).

Hemorrhoids are common ailments. By age 50, about half of adults have had to deal with the itching, discomfort and bleeding that can signal the presence of hemorrhoids.

Fortunately, many effective options are available to treat hemorrhoids. Most people can get relief from symptoms by using home treatments and making lifestyle changes.

SYMPTOMS

Signs and symptoms of hemorrhoids may include:

Painless bleeding during bowel movements — you might notice small amounts of bright red blood on your toilet tissue or in the toilet bowlItching or irritation in your anal regionPain or discomfortSwelling around your anusA lump near your anus, which may be sensitive or painfulLeakage of feces

Hemorrhoid symptoms usually depend on the location. Internal hemorrhoids lie inside the rectum. You usually can’t see or feel these hemorrhoids, and they usually don’t cause discomfort.

But straining or irritation when passing stool can damage a hemorrhoid’s delicate surface and cause it to bleed. Occasionally, straining can push an internal hemorrhoid through the anal opening. This is known as a protruding or prolapsed hemorrhoid and can cause pain and irritation.

External hemorrhoids are under the skin around your anus. When irritated, external hemorrhoids can itch or bleed. Sometimes blood may pool in an external hemorrhoid and form a clot (thrombus), resulting in severe pain, swelling and inflammation.

CAUSES

The veins around your anus tend to stretch under pressure and may bulge or swell. Swollen veins (hemorrhoids) can develop from an increase in pressure in the lower rectum. Factors that might cause increased pressure include:

Straining during bowel movementsSitting for long periods of time on the toiletChronic diarrhea or constipationObesityPregnancyAnal intercourseLow-fiber diet

Hemorrhoids are more likely as you get older because the tissues that support the veins in your rectum and anus can weaken and stretch with aging.

COMPLICATIONS

Complications of hemorrhoids are rare but include:

Anemia. Chronic blood loss from hemorrhoids may cause anemia, in which you don’t have enough healthy red blood cells to carry oxygen to your cells. This may result in fatigue and weakness.Strangulated hemorrhoid. If blood supply to an internal hemorrhoid is cut off, the hemorrhoid may be “strangulated,” which can cause extreme pain and lead to tissue death (gangrene).

TESTS AND DIAGNOSIS

Your doctor may be able to see if you have external hemorrhoids simply by looking. Tests and procedures to diagnose internal hemorrhoids may include:

Examination of your anal canal and rectum for abnormalities. During a digital rectal exam, your doctor inserts a gloved, lubricated finger into your rectum. He or she feels for anything unusual, such as growths. The exam can give your doctor an indication of what further testing might be appropriate.Visual inspection of your anal canal and rectum. Because internal hemorrhoids are often too soft to be felt during a rectal examination, your doctor may also examine the lower portion of your colon and rectum with an anoscope, proctoscope or sigmoidoscope. These are scopes that allow your doctor to see into your anus and rectum.

Your doctor may want to do a more extensive examination of your entire colon using colonoscopy. This might be recommended if:

Your signs and symptoms suggest you might have another digestive system diseaseYou have risk factors for colorectal cancerYou’re older than age 50 and haven’t had a recent colonoscopy

TREATMENTS AND DRUGS

Most of the time, treatment for hemorrhoids involves steps that you can take on your own, such as lifestyle modifications. But sometimes medications or surgical procedures are necessary.

Surgical procedures

If other procedures haven’t been successful or you have large hemorrhoids, your doctor may recommend a surgical procedure. Surgery can be performed on an outpatient basis or you may need to stay in the hospital overnight.

Hemorrhoid removal. During a hemorrhoidectomy, your surgeon removes excessive tissue that causes bleeding. Various techniques may be used. The surgery may be done with a local anesthetic combined with sedation, a spinal anesthetic or a general anesthetic.

Hemorrhoidectomy is the most effective and complete way to treat severe or recurring hemorrhoids. Complications may include temporary difficulty emptying your bladder and urinary tract infections associated with this problem.

Most people experience some pain after the procedure. Medications can relieve your pain. Soaking in a warm bath also may help.

Hemorrhoid stapling. This procedure, called stapled hemorrhoidectomy or stapled hemorrhoidopexy, blocks blood flow to hemorrhoidal tissue. Stapling generally involves less pain than hemorrhoidectomy and allows an earlier return to regular activities.

Compared with hemorrhoidectomy, however, stapling has been associated with a greater risk of recurrence and rectal prolapse, in which part of the rectum protrudes from the anus. Talk with your doctor about what might be the best option for you.

LIFESTYLE AND HOME REMEDIES

The best way to prevent hemorrhoids is to keep your stools soft, so they pass easily. To prevent hemorrhoids and reduce symptoms of hemorrhoids, follow these tips:

Eat high-fiber foods. Eat more fruits, vegetables and whole grains. Doing so softens the stool and increases its bulk, which will help you avoid the straining that can cause hemorrhoids or worsen symptoms from existing hemorrhoids. Add fiber to your diet slowly to avoid problems with gas.Drink plenty of fluids. Drink six to eight glasses of water and other liquids (not alcohol) each day to help keep stools soft.Consider fiber supplements. Most people don’t get enough of the recommended amount of fiber — 25 grams a day for women and 38 grams a day for men — in their diet. Studies have shown that over-the-counter fiber supplements, such as Metamucil and Citrucel, improve overall symptoms and bleeding from hemorrhoids. These products help keep stools soft and regular.

If you use fiber supplements, be sure to drink at least eight glasses of water or other fluids every day. Otherwise, the supplements can cause constipation or make constipation worse.

Don’t strain. Straining and holding your breath when trying to pass a stool creates greater pressure in the veins in the lower rectum.Go as soon as you feel the urge. If you wait to pass a bowel movement and the urge goes away, your stool could become dry and be harder to pass.Exercise. Stay active to help prevent constipation and to reduce pressure on veins, which can occur with long periods of standing or sitting. Exercise can also help you lose excess weight that may be contributing to your hemorrhoids.Avoid long periods of sitting.Sitting too long, particularly on the toilet, can increase the pressure on the veins in the anus.

Homoeopathic medicine:
HÆMORRHOIDS : Abrot., acet-ac., acon.,Aesc., aeth., Agar., agn., Aloe., alum., alumn., am-c., am-m., ambr., anac., anan., ang., ant-c., ant-t., apis., apoc., arg-n., arn.,ars-i., Ars., arum-t., aur-m., aur., bapt., bar-c., bell., berb., bor., bov., brom., bry., bufo.,cact., calc-p., calc-s., calc., cann-s., canth.,caps., carb-ac., Carb-an., carb-s., Carb-v.,card-m., carl., casc., Caust., cham., chel.,chim., chin-a., chin., chr-ac., cic., cimic.,cimx., clem., coca., cocc., coff., colch.,Coll., coloc., con., croc., crot-h., cycl., dios.,elaps., erig., eug., euphr., ferr-ar., ferr-m., ferr-p., ferr., fl-ac., gels., Graph., grat., Ham.,hell., hep., hydr., hyos., ign., iod., ip., Kali-ar.,kali-bi., Kali-c., kali-n., kali-p., Kali-s., kreos., Lach., lact., lept., lil-t., lob., Lyc.,mag-m., manc., med., Merc-i-r., merc.,mez., mill., mosch., Mur-ac., nat-m., nat-s.,Nit-ac., Nux-v., Paeon., petr., ph-ac., Phos., phys., phyt., plan., plat., plb., podo., psor.,Puls., rat., rhus-t., rhus-v., rumx., ruta.,sabin., sang., sec., Sep., sil., stann., staph.,stront., sul-ac., Sulph., sumb., syph., ter.,ther., thuj., tub., verat-v., verat., zinc., zing.

morning agg. : Aloe., Dios., mur-ac., sabin., sulph., sumb., thuj.

amel. : Alum., coll.

bed, in, agg. : Graph., rumx.

waking him : Aloe., kali-bi., petr., sulph.

night agg. : Aesc., aloe., alum., am-c., ant-c., ars., carb-an., carb-v., coll., euphr., ferr., graph., merc., phys., puls., rhus-t., Sulph.

alternating with palpitation : Coll.

with lumbago : Aloe.

beer agg. : Aloe., bry., ferr., nux-v., rhus-t.,Sulph.

as soon as the rheumatism is better :Abrot.

blind : Aesc., ant-c., ars., brom., calc-p.,caps., cham., coll., ferr., grat., ign., nit-ac.,nux-v., podo., puls., rhus-t., sulph., verat.
RECTUM p. 620

HÆMORRHOIDS, bluish

bluish : Aesc., aeth., ars., Carb-v., dios., ham.,Lach., lyc., manc., Mur-ac., phys., sulph.,verat-v.

children, in : Mur-ac.

chronic : Aesc., aloe., am-c., calc., carb-s.,carb-v., caust., Coll., dios., graph., lach., lyc.,Merc-i-r., nit-ac., Nux-v., petr., phos., phyt.,podo., Sulph., tub.

cold amel. : Aloe., brom.

congested : Acon., agar., aloe., alum., apoc., arg-n., ars., bell., carb-v., caust., cham., hep.,Kali-c., kali-n., merc., mur-ac., Nux-v., Paeon., podo., puls., rhus-t., sil., sulph., verat-v., zing.

drunkards, in : Ars., carb-v., Nux-v., sul-ac.

excitement : Arg-n., gels., hyos., nat-c., nux-v., sumb.

external : Abrot., Aesc., all-c., Aloe., alum.,am-c., anac., ang., ant-c., apis., apoc., arn., ars-i., ars., aur., bar-c., bar-m., berb., brom.,bry., cact., calc-p., calc-s., calc., caps., carb-ac., carb-an., carb-s., carb-v., caust., coll.,coloc., dios., ferr-ar., ferr-i., ferr-p., ferr., fl-ac.,gran., graph., grat., Ham., hep., iod., kali-ar., kali-c., kali-n., kali-p., kali-s., Lach., lyc., med.,merc., Mur-ac., nat-m., nit-ac., nux-v., paeon.,ph-ac., phos., phys., plat., podo., puls., Rat.,rhus-t., rumx., sep., sil., sul-ac., Sulph., ter.,thuj., tub., verat., zinc.

flatus, protrude when passing : Bar-c., phos.

hard : Ail., alum., ambr., Caust., lach., lyc.,phys., sep.

inflamed (See Congested)

internal : Aesc., alum., ant-c., arn., Ars., bor.,Brom., calc., caps., caust., Cham., cimic.,Coloc., hep., Ign., kali-ar., kali-c., kali-p., kali-s., lach., lyc., Nux-v., petr., ph-ac., phos., plan.,Podo., Puls., rhus-t., sep., stront., Sulph., ter.,verat.

itching (See Itching)

large : Aesc., agar., Aloe., alum., ang., arn., ars., bry., cact., calc., caps., Carb-an., carb-s.,carb-v., Caust., clem., coloc., cycl., dios.,euphr., ferr-ar., ferr., gall-ac., graph., Ham., kali-ar., Kali-c., kali-n., kali-s., lach., lyc., manc., merc., mur-ac., nat-m., Nit-ac., Nux-v.,podo., puls., sep., sul-ac., Sulph., thuj., tub.

menses, before : Cocc., phos., puls.

during, agg. : Aloe., am-c., calc., carb-s., carb-v., cocc., coll., graph., ign., lach., lyss., phos.,puls., sulph.

after, agg. : Cocc.

suppressed, during : Phos., sulph.

mental exertion : Caust., nat-c.

mercury, after abuse of : Hep., sul-ac.

milk agg. : Sep.

motion agg. : Apis., carb-an., euphr., merc.,mur-ac., nat-m., puls.

offensive (fetid) : Carb-v., manc., med.

parturition agg. : Ign., Kali-c., lil-t., mur-ac.,podo., puls., sep., sulph.

pendulous : Nit-ac.

pregnancy, during : Aesc., am-m., ant-c.,caps., coll., lach., lyc., nat-m., nux-v., sep.,sulph.

purgations, after : Aloe., nux-v.

rheumatism abates, after : Abrot.

riding amel. : Kali-c.

standing agg. : Aesc., am-c., caust., sulph.

stool, preventing : Aesc., caust., lach., paeon.,sul-ac., thuj.

protrude during : Alumn., am-c., bar-c., Calc-p., calc., fl-ac., kali-bi., kali-c., lach., mur-ac.,nit-ac., ph-ac., phos., plat., Rat., rhus-t., sil.

strangulated : Aesc., Aloe., ars., bell., ign.,Lach., nux-v., Paeon., sil., sulph.

suppressed : Ars., calc., caps., carb-v., euphr.,Nux-v., phos., puls., Sulph.

suppurating : Anan., carb-v., hep., ign., merc.,Sil.

thinking of them agg. : Caust.

touch agg. : Abrot., Bell., berb., calc., carb-an., carb-s., Caust., graph., hep., kali-c., lil-t., lyc., merc., Mur-ac., nit-ac., nux-v., phos.,Rat., sep., sil., sul-ac., Sulph., syph., Thuj.
ulcerating : Cham., hep., ign., kali-c., lach., nit-ac., paeon., phos., Sil., staph., syph.

urination, protrude during : Aloe., Bar-c., bar-m., canth., kali-c., merc., mur-ac., nit-ac.

after agg. : Merc.

walking agg. : Aesc., agn., alum., ars., Brom., calc., Carb-an., Caust., cycl., kali-ar., kali-c.,Mur-ac., nit-ac., phos., phys., rumx., sep., sil.,Sulph., sumb., ther., thuj.

amel. : Ign.

warmth, external, amel. : Ars., mur-ac.

warm weather agg. : Nit-ac.

amel. : Aesc.

wiping after stool agg. : Aesc., Graph., Mur-ac., Paeon., puls., sulph.

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