Hemorrhoids, also called piles, are swollen blood vessels in the lower rectum or anus. They can occur inside the rectum (internal hemorrhoids) or near the anal opening (external hemorrhoids). Hemorrhoids often cause bleeding during bowel movements, pain even extreme pain, itching, and discomfort.
In the USA it is estimated that over 10 million people suffer from hemorrhoids. They commonly develop in people between the ages of 45 and 65 and are more common in women than men.
What are hemorrhoids?
Hemorrhoids are usually caused by increased pressure due to pregnancy, being overweight, or straining during bowel movements. The causes swollen veins. And this extra pressure can also cause hemorrhoids to swell and bulge, which can lead to bleeding.
There are internal and external hemorrhoids. Internal hemorrhoids are located inside the rectum, while external hemorrhoids develop around the anal opening.
What do hemorrhoids look like?
Internal hemorrhoids are usually small, swollen veins in your rectum. But they can be large veins that bulge from the anus to the rectum. External hemorrhoids look like lumps or masses around the anus.
Prolapsed hemorrhoids are internal hemorrhoids that bulge from the anal opening. A strangulated hemorrhoid is an internal hemorrhoid that becomes trapped outside the anal opening.
What are risk factors for developing hemorrhoids?
There are several factors that can increase your risk of developing hemorrhoids, including:
Age - as we age, the tissues supporting the veins in the anal area weaken and stretch. This can cause the veins to bulge and eventually become symptomatic.
Pregnancy - as the uterus expands during pregnancy, it puts extra pressure on the veins in the pelvis and rectum. This can cause them to bulge and eventually become symptomatic.
Being overweight - excess weight can put additional pressure on the veins in the anal area, causing them to bulge and eventually become symptomatic.
Straining during bowel movements - this can happen because of constipation and hard stools causing you to strain to have a bowel movement. It can also happen if you have diarrhea and are straining to control your bowel movements. This is a major factor in causing hemorrhoids
Sitting on the toilet for long periods of time - this can cause increased pressure on the veins in the anal area, causing them to bulge and eventually become symptomatic.
Anal intercourse - this can cause trauma to the veins in your anal canal, which can lead to hemorrhoids.
Are hemorrhoids dangerous?
Hemorrhoids are rarely dangerous or life-threatening. However, they can be very painful. They can be associated with an anal fissure which is a tear in the lining of the anal canal. Anal fissures can be very painful and may require medical treatment.
Hemorrhoids can also bleed, which can lead to anemia if left untreated. This is why it is important to see your doctor if you have any rectal bleeding so that they can rule out other more serious causes of bleeding.
What are the symptoms of hemorrhoids?
The most common symptom of hemorrhoids is rectal bleeding, and bright red blood, during bowel movements. There can be blood in the toilet bowl or on toilet paper. For symptomatic hemorrhoids, most hemorrhoid symptoms include pain, itching, and discomfort in the affected area. If a blood clot forms in external hemorrhoid, it can be very painful (thrombosed hemorrhoid).
How are hemorrhoids diagnosed?
Hemorrhoids are usually diagnosed by a physical exam. Your doctor will look for swollen blood vessels in the anal area. They may also do a digital rectal exam, where they insert a gloved finger into the rectum to feel for any abnormalities.
In some cases, your doctor may recommend a colonoscopy or sigmoidoscopy to rule out other conditions, such as colorectal cancer.
How do I get rid of hemorrhoids?
There are several things including lifestyle changes you can do to get rid of hemorrhoids.
If you are constipated, you can take over-the-counter laxatives or stool softeners including fiber supplements to help make it easier to have a bowel movement. High-fiber foods like whole grains are important to soften stool. Also, it's important to drink plenty of fluid.
Home treatments include sitting in a warm sitz bath for 20 minutes to help relieve the pain and swelling.
If your hemorrhoids are bleeding, you can try using over-the-counter (OTC) treatments like hemorrhoid cream or ointment to help with the symptoms.
If these home remedies don't work, or if your hemorrhoids are large and painful, your doctor may recommend other treatment options.
How are hemorrhoids treated?
For hemorrhoids treatment, internal hemorrhoids can often be treated with home remedies, such as dietary changes, increased fiber intake, and sitz baths. However, if these measures don't work, your doctor may recommend one of the following procedures to treat hemorrhoids:
Rubber band ligation - a rubber band is placed around the base of an internal hemorrhoid to cut off its blood supply. This causes the hemorrhoid to wither and eventually fall off.
Sclerotherapy - a chemical solution is injected into the blood vessels around the hemorrhoid, causing them to shrink.
Infrared coagulation - a device is used to deliver infrared light to the blood vessels around the hemorrhoid, causing it to shrink.
Laser surgery - a beam of laser light is used to destroy the tissue around the hemorrhoid.
Hemorrhoidectomy - a surgical procedure performed by a colon and rectal surgeons to remove hemorrhoids. It is usually only recommended for severe cases that don't respond to other treatments.
Hemorrhoid embolization (emborrhoid technique): a modern "pinhole" technique where a tiny catheter is placed into an artery near your groin (or wrist) and a miniaturized catheter advanced to the arteries feeding your hemorrhoids. Blood flow to the hemorrhoids is then blocked by tiny coils and particles.
How do I find out which treatment is best for me?
An Imaging & Interventional Specialist can provide a free medical consultation for go over your history and review your medical chart and imaging and, if needed, discuss with other members of your care team. They will discuss with you your best treatment option.
Why choose Imaging & Interventional Specialists?
Imaging & Interventional Specialists are leaders in interventional radiology and experts in the minimally invasive procedures that will address your hemorrhoids.
Our physicians perform “pinhole” procedures every day offering this region's leading, world-class, state-of-the-art solutions for hemorrhoids. Our minimally invasive image-guided procedures are cutting-edge technology without the cutting, without the scalpel. You leave with a Band-Aid!
At Imaging & Interventional Specialists board-certified physicians offer in-house testing for diagnosis and to develop an individualized treatment program for your hemorrhoids