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What causes Hemorrhoids?

Hemorrhoids are an abnormal swelling in the rectum or anal area, which is caused by enlarged or dilated veins. Internal hemorrhoids usually appear along the wall of the anus. Most people

with internal hemorrhoids are unaware that they are even there. External hemorrhoids are usually visible or palpable as small, soft pads around the outside of the anal opening and are the same color as the skin. When a clot forms in the internal hemorrhoid, it can thromboses turn blue in color and is generally associated with pain, swelling and itching. External hemorrhoids also can cause blood to appear on the surface of the stool.

 
Three out of four people at some point in their life will develop hemorrhoids. More than 10 million people visit a physician each year in the United States with symptoms related to hemorrhoids.

The causes of hemorrhoids are variable. Individuals who either sit or stand for prolonged periods of time are at risk for developing hemorrhoids due to pooling of blood in the rectal region. Other individuals at risk are those with poor bowel habits or those who frequently strain to have a bowel movement. In addition, obesity, pregnancy, or continued constipation or diarrhea can lead to the development of hemorrhoids.

Hemorrhoidal swelling also often occurs during difficult elimination when the individual strains to pass the stool. Straining causes swelling of the hemorrhoid and as hard stool passes over the swollen hemorrhoid; it tends to scrape off the surface causing surface irritation, bleeding and discomfort. Hard stool with straining is a frequent cause of hemorrhoidal inflammation.

Prevention of Hemorrhoids

Practicing good bowel habits is the initial step in trying to prevent or decrease flare of the hemorrhoids.

1. Straining at the stool to have a "good bowel movement" every day is a misconception. It is not important that people have a bowel movement every day. In fact, oftentimes people will not have a bowel movement more than 1 to 2 times weekly. Don't strain in an attempt to stay on a schedule.

2. Respond to the urge to have a bowel movement immediately. Delay in having a bowel movement may decrease the urge and allow stool in the rectum to become harder and more difficult to pass later.

3. Do not spend more time than necessary sifting on the toilet. Avoid reading, as sitting on the toilet straining for too long will lead to hemorrhoidal swelling.

4. Use only soft, white, un-perfumed tissue to cleanse the rectal area. Pre-moistened toilet wipes such as Kleenex Wipes can be very beneficial.

5. The addition of fiber to the diet is important in the treatment of hemorrhoidal disease.

Checklist of Hemorrhoidal symptoms

1. Rectal itching, burning and pain

2. Palpable swelling with blue or red anal tissue pads appearing around the anus

3. Blood on the toilet tissue or on the surface of the stool

Treatment

1. Warm baths

2. Cotton pads with astringent

3. Over the counter preparations for the treatment of hemorrhoids

4. Prescription medications for treatment of hemorrhoids.

5. Surgical procedures to eliminate hemorrhoids

Prevention

1. Good Bowel habits

2. High fiber diet

3. Regular exercise

Initially when rectal bleeding or pain occurs, a full evaluation should be performed to exclude an alternative cause for the symptoms, even when hemorrhoids are present.

Excellent medical and surgical treatments are available for hemorrhoids; however, a thorough evaluation is always appropriate to ensure that the symptom is solely due to hemorrhoids.

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