Hemorrhoid disease is very wide-spread, with very unpleasant symptoms which, thanks to current methods can be efficiently managed with very little pain involved.

What are hemorrhoids?

It’s an abnormal development of the hemorrhoid veins which can appear in some patients. These veins are part of a structure that ensure rectal continence, in order words, the mechanism that allows the rectum to empty through the anal canal at the moment of defecation.

Lesions

Often, a hypertrophy of the normal hemorrhoid veins can be seen, similar to that of the veins in the lower limbs. During the examination of the anal canal, with the help of an “anoscope”, small purple growths can be observed. In the area where the mucosa is normal, it will appear pink and smooth.

Causes of the disease

There are several factors that can cause an imbalance in this mechanism:

  • Constipation and congestion of the basin are the main causes for the illness;
  • The patient’s lifestyle plays a very important role in triggering hemorrhoid episodes. Long trips by car, the period before a woman’s menstrual cycle and lack of physical exercise are important factors that promote the development of hemorrhoids;
  • Stress is probably the most prevalent cause, most often triggered by financial, personal or professional problems, as well as, the persistence of this issues can provide an explanation as to why treatment fails in some cases and recurrences can appear. In this contexts, relaxation techniques can help the patient deal with stress, while playing sports on a regular basis is very effective in eliminating it;
  • The hereditary factor is also present in a large number of cases.

There are two types of hemorrhoids: internal and external.

External Hemorrhoids consist of a layer of skin, which protrudes outside the hemorrhoidal mucosa and are always located outside the anus, meaning they are irritated by rubbing against the patient’s underwear. In women, this type of hemorrhoids often appear after giving birth due to the effort made during labour.

Internal Hemorrhoids are located deeper and can easily bleed. During an episode they can exit the anus. This can occur during intense physical exertion or after defecation. When the disease persists for a long period of time, both internal and external hemorrhoids can appear.

The preventive treatment of hemorrhoids without complications

This treatment’s purpose is to reduce the frequency of painful episodes by eliminating their triggers. In this case the patient’s lifestyle has to incorporate:

  • An adequate diet, without spices, mustard, excessive alcohol, as well as, fighting constipation by adopting a vegetable fiber-rich diet, in sufficient quantities. Often, it’s best that one’s breakfast contains foods rich in fibers so bowel movements can be regulated without medication;
  • Physical exercise on a regular basis, such as walking, jogging, swimming, gymnastics;
  • Drug treatments, usually based on plant extracts, which have to be followed for several months;
  • Local treatments, ointments and suppositories, which are useful especially during episodes of severe pain;
  • Treatments against constipation. Eliminating constipation involves reverting to a normal and complete digestive process, without any difficulties, and is necessary for the identification of the disease’s potential causes and for prescribing the correct diet and drug regime for each patient.

The complications generated by untreated hemorrhoids can arise in time

They can appear both in the case of small and large hemorrhoids. Thrombosis is the most frequent postoperative complication – with blood stalling in the hemorrhoid varics and forming a clot (thrombus), the hemorrhoid then becomes externalized as a result of the inflammatory reaction of the body, causing the surrounding area to become very painful. This thrombosed hemorrhoid presents as a small, purple node, hard to touch. The treatment is simple: an incision with a scalpel, under local anesthesia, for the removal of the clot and pain relief. Afterwards, the hemorrhoid itself requires treatment in order to avoid the recurrence of such thrombosis. If this clot is not surgically removed, it will become a small fibrous mass which will constantly protrude through the anus. It doesn’t cause much pain and doesn’t require surgical intervention. Should it cause discomfort, it can be dealt with through sclerosis by mean of the steam method, under local anesthesia and without requiring hospital admission.

A gastroenterologist’s opinion is often required. Laxatives taken without medical supervision can cause complications and have proven to be ineffective on the long run.

Anal fissures represent another frequent complication and consist of the tearing of the mucosa, often caused by constipation and the effort of defecation. It doesn’t heal spontaneously, due to the dilation provoked by defecation. It’s very painful, with pain onset at the moment of defecation and can last for hours. The treatment of recent or of those which are not spread over a large area can be performed through a simple puncture: the injection of a small amount of medicine in the fissure, which doesn’t require hospitalization nor anesthesia. However, the lesion is often old and requires surgical treatment, repairing the fissure with hospital admission for 48 hours. The surgical treatment is performed with steam, in order to lessen the postoperative pain.

The fistula can occur in patients who don’t suffer from hemorrhoids, but often, there’s a combination between the fistula and an anal fissure. The fistula corresponds to an abscess of the rectal wall, the path of which opens outside the anus. Depending on the relationship between the fistulous path and the anal sphincter, there are two types of fistulae. The illness presents with recurrent and persistent, often festering drainage. Surgical treatment is the only solution. The fistulous paths are opened at the skin-level in order to allow for sufficient drainage, which represents the basis of a permanent treatment solution. Sometimes, an elastic thread is inserted in the fistula, which is then gradually pulled out over a period of 10-15 days. This procedure makes the later intervention much easier, decreasing the depth of the incisions required. It requires 3 to 4 days in hospital and discontinuing normal activities for two weeks.

Conclusion

Treating hemorrhoids is a lot less painful when the surgeon can step in before complications arise or the hemorrhoids grow to very large dimensions. Current methods considerably reduce the pain and postoperative inconveniences involved, and allow a much better approach to this frequently occurring and just as frequently neglected illness.