Did You Know?

Hemorrhoidal disease is one of the most common medical conditions. More than half of the population will develop hemorrhoids, typically after the age of 30. Many patients live with the condition for a long time before seeking medical attention. Millions of people worldwide suffer from hemorrhoidal disease. Fortunately, modern surgical techniquesprovide painless solutions for treatment.

What Are Hemorrhoids?

Hemorrhoids are vascular cushions located around the anal area. They become swollen and noticeable when the veins enlarge.

Types of Hemorrhoids

Hemorrhoids are classified into internal and external types.

• Internal hemorrhoids are located inside the rectum. You may only notice them when they prolapse, bleed, or produce mucus discharge. Painless bleeding and the presence of a lump during or after defecation are the most common symptoms. A doctor’s examination can confirm the presence of internal hemorrhoids.

• External hemorrhoids are small bumps at the anal opening. They are usually painless, but if a blood clot forms, they turn bluish and cause severe pain. Otherwise, they maintain normal skin color. External hemorrhoids may lead to swelling, burning, itching, or discomfort in the anal area.

What Causes Hemorrhoids?

The exact cause of hemorrhoids is unknown, but standing for long periods increases pressure in the anal veins, leading to hemorrhoid enlargement.

Other contributing factors include:

• Age

• Chronic constipation or diarrhea

• Pregnancy

• Genetic predisposition

• Obesity

• Straining during bowel movements

• Frequent use of laxatives or enemas

• Spending excessive time (over 5 minutes) on the toilet

Regardless of the cause, the vascular cushions in the anal region stretch, leading to enlarged, thin veins that may bleed. If straining continues without intervention, hemorrhoids may protrude externally.

Common Symptoms of Hemorrhoids

• Bleeding during bowel movements

• Lump formation in the anal area

• Anal itching

• Pain or sensitivity

• Swelling and discomfort

Are You Sure You Have Hemorrhoids?

Many adults mistakenly assume their symptoms are caused by hemorrhoids. If you experience bleeding, itching, pain, or swelling, do not immediately conclude that you have hemorrhoids. A doctor’s examination can rule out more serious conditions such as polyps, colitis, or colorectal cancer. If you notice rectal bleeding, consult a doctor immediately. Anal itching is rarely caused by hemorrhoids.

Appropriate Treatment Methods

Treatment for hemorrhoidal disease includes both surgical and non-surgical approaches.

Non-Surgical Treatment

In many cases, dietary changes bring significant relief. Doctors recommend:

• Increasing fiber intake with plant-based foods

• Reducing cholesterol-rich foods

• Drinking at least five glasses of water daily

Medication for Hemorrhoids

• Eat fiber-rich foods and stay hydrated

• Reduce consumption of animal fats

• Engage in regular exercise such as walking, cycling, swimming, or jogging

• Avoid unnecessary trips to the toilet

• Do not strain excessively while defecating

• Use prescribed ointments or suppositories

• Take warm sitz baths for 10 minutes daily

Following these steps, symptoms typically improve within 2–7 days, and visible lumps shrink within 4–6 weeks. If you experience persistent pain, you may have thrombosed hemorrhoids (blood clot formation), requiring medical intervention.

Minimally Invasive Treatment Methods

• Banding (Rubber Band Ligation): This method cuts off blood supply to the hemorrhoid, leading to natural shrinkage and detachment within a few days.

• Coagulation Therapy: A light source generates small burns to stop bleeding and shrink the hemorrhoid.

• Injection Therapy: A solution is injected into the hemorrhoid to reduce size and bleeding.

These techniques only work for internal hemorrhoids. Applying them to external hemorrhoids causes severe pain.

Surgical Treatment

Severely enlarged hemorrhoids do not respond to non-surgical methods. Surgery is necessary in cases of:

• Thrombosed external hemorrhoids with severe pain

• Internal hemorrhoids resistant to banding

• Hemorrhoids that protrude and cannot be repositioned

• Persistent bleeding

Surgical intervention involves removal or repositioning of hemorrhoidal tissue using traditional or stapler techniques. These procedures do not require hospitalization and can be performed under local anesthesia with a short recovery period.

Post-Treatment Care

• Mild pain or discomfort may be felt for 48 hours, but recovery is quick.

• Avoid aspirin or blood-thinning medications to prevent bleeding.

• Take warm sitz baths for relief.

• Consume fiber-rich foods and drink plenty of water to regulate bowel movements.

• Engage in daily physical activity and resume normal routines immediately.

When to Contact Your Doctor

Seek medical assistance if you experience:

• Persistent pain lasting over three days

• Increasing pain in the days following treatment

• Painful anal swelling

• High fever, chills, or difficulty urinating

• Severe constipation (no bowel movements for three days)

• Frequent watery stools (more than three times in 24 hours)

• Excessive bleeding (more than a small glass of blood)

• Multiple episodes of bloody stools within three hours

• Discharge of pus from the anus