Causes and risk factors
The exact cause of hemorrhoids is not known expect in case of pregnancy. It occurs due to the pressure on the lower rectum. Certain predisposing fact ors which lead to the pressure rise are obesity, pregnancy, straining of stools, hard stools, anal intercourse and prolonged diarrhea. Chronic cough, sedentary lifestyle like smoking , excess alcohol intake, irregular bowel patterns, bad food haibts and weakness of the muscles of the lower abdomen or pelvis can also be some of the contributing factors. If bleeding from hemorrhoids is prolonged it can cause anemia. Hemorrhoids can lead to cut off of the internal blood supply leading to strangulation. In such cases death of surrounding tissue can occur.
Clinical presentation:
The presentations commonly seen are pain and discomfort in the anal region, itching, difficulty in passing stools. In cases of external hemorrhoids a lump can be felt and seen at the anus. This lump can cause difficulty in sitting posture. In cases of internal hemorrhoids straining can cause bleeding also. The blood is bright red colour. It is occurs after of during passage of stools. Mucous discharge can be another symptom. Many people can face an embarrassed feeling. At times straining can also cause protrusion of the internal hemorrhoids. External hemorrhoids can lead to complication like formation of a thrombus or localized infection. Hemorrhoids are associated with anal fissures and narrowing of the anal passages. This may be the primary cause of pain. Sometimes external hemorrhoids can protrude and hand outside like a tag. It is known as ‘Sentinel Pile’.
Investigations:
Diagnosis is done on the basis of symptoms narrated by the patient and the physical examination conducted by the doctor. For visualization of the internal hemorrhoids a proctoscopy can be done. In severe cases of per rectal bleeding colonoscopy can be suggested to differentiate hemorrhoids with other serious disorders of rectum and intestine.
Treatment:
The first line of treatment for hemorrhoids is to correct the dietary errors and lifestyle changes. High dietary fibrous food and adequate quantity of water should be implemented. Regular exercises and a well balanced diet should be motivated. Weight reduction in obese people should be recommended. Constipation may be treated for soft stools. Conservative method remains the hallmark of hemorrhoids. Hardly 30% of patients require surgical intervention. Sitez bath, rest, and use of topical ointments and gels are encouraged. Medication like non steroidal anti inflammatory drugs can be prescribed. Severe cases may be considered for surgical intervention. A number of procedures can be performed like cauterization, sclerotherapy or rubber band ligation. In advanced cases stapling or removal of hemorrhoids can be done.
Other Modes of treatment:
Certain other modes of treatment can also be helpful in coping up Hemorrhoids. Taking into consideration the symptoms in holistic way, homoeopathy can offer a good aid for the relief of the symptoms. The Ayurvedic system of medicine uses herbal and certain synthetic derivates. These can also be effective to combat the symptoms. However surgery is mandatory in cases of prolapse of hemorrhoids certain yoga exercises have also found to be effective to relief constipation.
Recent updates:
A publication given by Trilok on medindia suggested that the natural extract from the bark of French pine tree could relief symptoms of acute hemorrhoids and even prevent new attacks.
