Hemorrhoids Causes, Symptoms & Home Remedies
Changes in food habits have affected the health of our digestive system to a certain extent. People are consuming more food items that do not match with the requirements of the system. Junk foods contain loads of gluten that is the main cause of constipation. People prefer more spicy foods rather than the simple diet we used to follow earlier. The various additives in processed food items are also harmful to health. One of the most painful conditions caused due to these habits is hemorrhoids. It is estimated that roughly 1 in every 20 people in the USA suffers from hemorrhoids.
What are hemorrhoids?
Most commonly known as ‘Piles’, a hemorrhoid is a kind of lump that is formed either inside or around the anus. In many cases, the condition is resolved within a few days and might not require medical treatment. However, in severe cases, this medical condition requires proper and continuous treatment.
In many cases, people do not recognize their presence until the condition worsens and causes severe pain. Proper adherence to medications along with changes in diet plan can help to manage hemorrhoids (1).
Types of hemorrhoids
The differentiation of hemorrhoids based on location is the best way to study them. Accordingly, there are 4 main types of piles.
- External hemorrhoids – these piles are under the skin around the anal region. They feel like hard lumps.
- Internal hemorrhoids – these are inside the rectum and you can not see it like external ones. They do not cause much discomfort to the patient. They tend to bleed when excess pressure or strain is applied.
- Thrombosed hemorrhoids – these are formed as a result of blood inside external hemorrhoids. Further, clots are formed within.
- Prolapsed hemorrhoids – this is a severe type of piles that is highly painful. They consist of veins that are pushed through the anus and are hanging out of the body especially after going to the toilet. In certain cases, the anal sphincter can strangulate the hanging veins (2).
hemorrhoids can also be classified according to their size as
- 1st degree- these remain in the rectal area.
- 2nd degree- they appear during defecation but reduce soon afterward.
- 3rd degree- these appear during defecation and might require digital reduction to cure.
- 4th degree- these remain persistently prolapsed.
Causes of hemorrhoid
Hemorrhoids are swollen blood vessels mostly found in the anal region. The veins might stretch under excess pressure resulting in swelling or bulging. Medical research has not yet discovered the clear cause of this condition. There are certain factors attached to piles and could be the reasons for its formation.
- Constipation- a condition where it gets difficult to push the stool from the anus.
- Exerting or pushing too hard while excreting or defecating.
- Heavy lifting exercises or routine that puts extra pressure on the anal region.
- Pregnancy- the relaxation of veins in the anal region causes piles during pregnancy.
- Sometimes obese patients might have higher chances of getting piles.
- Anal intercourse.
- Colon cancer can also lead to piles.
- Spinal cord injury and improper sitting posture that creates strain in the anal region.
- Eating a low-fiber diet for prolonged periods.
- Sitting for a long time on the toilet will also create excess pressure on the anus.
Age is an important risk factor for hemorrhoids. Veins in rectum and anus will weaken and stretch with increasing age. This will make them more prone to piles (3).
Symptoms of hemorrhoids
There are certain initial symptoms of hemorrhoids and these are to be taken seriously by people prone to piles (4).
- Frequent and extreme itching around the anal region.
- Pain around the anus especially while defecating.
- You can see the blood on the surface of the stool.
- Formation of painful lump or swelling near the anus which might be itchy.
- Certain patients might also experience leaking of fecal matter.
- Bowel movements will become painful and difficult.
- Bright red blood after a bowel movement.
- Presence of slimy mucus in underwear or toilet paper on wiping the bottom.
- General pain and discomfort in the anal region.
Diagnosis of hemorrhoids
When the patient visits the doctor with one or more of the above symptoms, the doctor would go for several diagnostic tests that will confirm the presence of hemorrhoids (5).
- Medical history – the doctor would examine the previous medical conditions of the patient. Based on factors like eating habits, toilet habits, use of laxatives and enema, etc., the doctor would make an initial diagnosis.
- Physical examination – physical exams diagnose the different types of hemorrhoids. The doctor would generally check for lumps or swelling around the anus, prolapses, skin tags, anal fissures, etc.
- Digital rectal examination – This examination checks for anal muscle tone, tenderness, presence of blood or internal masses/lumps/hemorrhoids. Here, the doctor inserts a gloved and lubricated finger into the rectum of the patient and then feels for unusual growths.
- Anoscopy – an anoscope views the inner lining of the anus and lower rectum.
- Rigid proctosigmoidoscopy – here, a proctoscope examines the inner lining of the rectum and lower colon.
- The doctors might also use colonoscopy and flexible sigmoidoscopy to check for signs of hemorrhoids.
Home remedies for hemorrhoids
Since the initial signs and symptoms of hemorrhoids would go away in a few weeks, the patient can treat the condition using home remedies for hemorrhoids. One has to keep in mind to consult a doctor when the symptoms become more painful or unmanageable.
1. Aloe vera
This plant possesses anti-inflammatory properties which makes them useful in treating hemorrhoids. It is safe for topical use in the form of a gel. Apply the pure aloe vera gel from inside the aloe leaves to the hemorrhoids.
Check for allergy towards aloe vera by applying the gel on the forearm and waiting for 24-48 hours for any reaction (6).
2. Epsom salt bath
The effectiveness of Epsom salt in soothing the irritation of hemorrhoids makes them an easy remedy for piles. You can use warm baths in the form of a sitz bath. Sitz bath consists of a plastic tub that fits over a toilet seat. Take a warm bath for 20 minutes after every bowel movement. Add Epsom salt to the bath before using it.
3. Stool softeners
Since constipation is a major cause of hemorrhoids, it is important to soften the stools for better bowel movements. Fiber supplements in the form of powder, tablets, capsules or syrups can be taken 3 times a day for better results (7). You can try home remedies for constipation like fiber foods, oil, etc, that might help in providing some comfort.
4. Witch hazel
This is an effective remedy against the itching, swelling, and pain caused by piles. Apply the witch hazel in liquid form directly over the hemorrhoids for the best results.
5. Yoga Asanas for Hemorrhoids
Yoga asanas for hemorrhoids are effective in reducing the pain and provide some comfort. Do try yoga poses like malasana which helps in getting rid of piles.
Medical treatments of hemorrhoids
Initially, patients try to get better from the effects of piles with home remedies. When these do not show promising results, consult a medical practitioner. The doctors then decide the best treatment plan based on factors like severity of the condition, general health condition of the patient, age, allergic reactions to medications and medical history. There are two kinds of treatment for hemorrhoids.
A. Non-surgical techniques
These treatment methods do not require hospitalization in most occasions. Doctors anesthetize only the affected area leaving the patient awake and conscious. They can leave the hospital on the same day if there are no complications (11).
- Rubber band ligation- using endoscopic techniques, doctors place a rubber band around the piles and tied tightly. This will make the piles drop off (7) (8).
- Electrotherapy- to shrink the size of the piles, an electric current is applied to them (9).
- Sclerotherapy- the size of the piles reduced to maximum levels by injecting liquid into the piles (10).
- Coagulation- similar to the above two methods, the size of the piles is reduced here. There is an application of infrared light or laser on the piles to cut the blood supply to these tissues which eventually results in shrinking.
B. Surgical techniques
When the non-surgical methods do not show the required results, doctors might then choose surgical options. The patient will be under general anesthesia for these methods and might need to be hospitalized for a day or two (12).
- Haemorrhoidectomy- in this surgery, the piles are cut off from the anal region (13) (14).
- Haemorrhoidal artery ligation- to shrink the piles, stitches are made on the affected area and cut the blood supply (15) (16).
- Stapled haemorrhoidopexy- the piles are stapled back into the anal region to prevent further worsening of the condition (17) (18).
Ways prevent hemorrhoids
Prevention is better than cure and can be best applied in the case of hemorrhoids. There are certain simple ways by which you can prevent this painful medical condition to an extent.
- Use the toilet whenever there is an urge for defecation. Otherwise, you might face constipation.
- Do not strain or apply pressure during bowel movements. This might weaken your anal muscles and lead to piles.
- Include loads of dietary fiber in your daily diet. This can reduce the chances of constipation and further prevent the formation of hemorrhoids. Certain food items like whole wheat, oatmeal, pear, carrots, brown rice, etc. are rich in dietary fiber.
- Drink plenty of water to prevent the hardening of stools. This will ease the bowel movements.
- Moderate physical exercises can help in proper bowel and digestive movements. This will avoid constipation and hence the chances of piles. Walking, cycling, yoga, running, etc. are some simple ways to keep the body active.
- Avoid food items that can irritate the bowels. Spicy foods are the main culprits and avoid them completely. Also, avoid gluten-containing food items as they cause constipation.