Haemorrhoids caused by the normal veins around the anal area become abnormally dilated or enlarged. Haemorrhoids can be called internal or external depending on wheather they develop in the inner or outer part skin of the anal cavity. A person can have both internal and external haemorrhoids at the same time
External haemorrhoids develop below the line and are generally not painful. They will only require medical treatment, if a vein rupture, bleed under the skin and a painful lump forms – this is called thrombosed haemorrhoid.
Internal haemorrhoids develop above the dentate line and very painful. For treatment purposes, internal haemorrhoids are graded according to their size for treatment purposes: Grade I: The vein expands during bowel movements. Grade II: The vein comes out of the anal orif during bowel movements and goes back by itself. Grade III: The vein comes out of the anus during bowel movements, but it has to be put back by hand. Grade IV: The vein bulges out all the time and cannot be replaced back.
Cause Laxatives abuse – which causes straining of the veins. Obese and pregnancy, which leads to straining to pass stools. Prolonged standing or sitting. Chronic heart and liver disease, which causes blood to pool in the abdomen and pelvic area and increase pressure to all abdominal veins. Can be Genetic.
Symptoms External haemorrhoids: Slight swelling around the anal area. Pressure in the anus that makes it hard to keep the area clean. Skin irritation, itching and burning. If a vein is large, it may cause discomfort, during bowel movements. A thrombosed haemorrhoid can be very painful and prevent you from sitting or walk. The lump may break and cause pain or bleeding.
Internal haemorrhoids – Painless rectal bleeding. (After having a bowel movement you may notice trace of blood on the tissue). If you strain to pass stools, blood may spray the sides of the toilet bowl. Due to the bulging of the haemorrhoid in the anal canal you may have an uncomfortable feeling of blottiness after passing stools. Mild skin irritation and itching can be caused by secreted mucus from grade III and IV haemorrhoids. Good hygiene can keep this from becoming a problem. The larger they get, the more painful and uncomfortable, they can swell and as they are squeezed by the anal sphincters (muscles that control the opening and closing of the anus). Large internal haemorrhoids will stick out of the anus all the time and stay outside.
Visit a doctor when – Rectal bleeding occurs for no apparent reason and is not associated with trying to pass stools. Rectal bleeding continues for more than one week. A lump near the anus gets bigger and more painful. Moderate pain lasts longer than one week after home treatment. Rectal bleeding becomes heavy dark red colour. If stools change in colour (bloody).
Treatment – The following techniques can be used to treat most small internal haemorrhoids:
A ring cushion can ease the pressure and make sitting more bearable. Eat more roughage to loosen the stool, not too loose but soft. Unlike the laxatives. Apply hydrocortisone this may help decrease inflammation and speed the healing. Scratching haemorrhoids will increase irritation on the inflamed veins more. Use non-prescription haemorrhoid creams may help for the itching and irritating pain. Be gentle when wiping yourself, damp rough toilet paper or use non-alcoholic baby wipes. Gently keep your anal area clean by bathing regularly and avoid scrubbing with soap as it will increase the irritation.
External haemorrhoids – External haemorrhoids usually do not need treatment, unless an enlarged vein near the anus rupture, external haemorrhoids does not need treatment. If the pain and bleeding is not too severe, stool softeners can be used to relieve the pressure, topical pain-relieving creams. Sitting in a bathtub of warm water and salt (Sitz baths) for few minutes several times a day may be help in relieving the pain and swelling. Surgical treatment may be required only if pain is severe.
Internal haemorrhoids that continue to bleed after a trial of home treatment require professional treatment.
Prevention – Eating high-fibre foods such as fruits, vegetables, whole wheat breads, beans, and legumes may prevent constipation. Avoid refined and “junk” food. Drink a lot of liquids such as water, fruit juice and less caffeine. Limit alcohol consumption to one drink per day especially wine. This can lead to constipation. Exercise to help keeping your weight down, it will decrease constipation and enhancing smooth bowel movements. Doesn’t strain to pass stools let nature take its cause? Take frequent short walks during lunch breaks instead of sitting at the dinning room until lunch is over.