Hemorrhoids, which are also called piles, is a condition of weakened and swollen veins in the anus or lower rectum. They often go unnoticed and usually clear up after a few days, but can also cause long-lasting discomfort of the rectum such as pain, itching, and bleeding. Hemorrhoids can be divided into two types: Internal hemorrhoids lie inside the anus or lower rectum; external hemorrhoids lie outside the anal opening. Both can be present at the same time. Sometimes a blood clot forms in an external hemorrhoid and inflammation and a painful lump develops. This condition is called a thrombosed hemorrhoid.
Hemorrhoids are a very common medical complaint. More than 75% of Americans have hemorrhoids at some point in their lives, typically after age 30. Men are more likely than women to suffer from hemorrhoids that are serious enough to require professional treatment.
During a bowel movement, veins in the anus are protected from damage by expanding to drain blood away from the area. The veins are normally somewhat elastic, and they snap back to their regular size after defecation is finished. However, repeated straining due to constipation or hardened stools causes the veins to be swollen and stretched out of shape. The swelling also triggers nerves in the area, causing itchiness and a sensation of full bowels. In addition, straining may cause the rupture of blood vessels and bleeding at the anus.
Causes & symptoms
Aging, obesity, pregnancy, chronic constipation or chronic diarrhea, excessive use of enemas or laxatives, straining during bowel movements, and spending too much time on the toilet are all factors that can contribute to the development of hemorrhoids. In some people there is also a genetic tendency to have fragile veins that are prone to developing hemorrhoids and varicose veins .
The most common symptom of internal hemorrhoids is bright red blood in the toilet bowl or on one's feces or toilet paper. When hemorrhoids remain inside the anus they are almost never painful, but they can protrude outside the anus and become irritated and sore. Such hemorrhoids are called prolapsed hemorrhoids. These sometimes move back into the anal canal on their own or can be pushed back inside; however, they may remain permanently outside the anus until treated by a doctor. Small external hemorrhoids usually do not produce symptoms. Larger ones, however, can be painful and interfere with sitting, walking, defecating, and cleaning the anal area after a bowel movement.
Diagnosis of hemorrhoids begins with a visual examination of the anus, followed by an internal manual examination. The doctor may also insert an anoscope, a small tube with a light that can be used to view the anal canal. More serious problems may be ruled out using a sigmoidoscope or colonoscope to inspect the colon.