Hemorrhoids: Painless Rectal Bleeding
Hemorrhoids are varicose kind veins of the anal area. They are very similar to a surgical glove squeezed in the fingers to make a large stick out. These bulges filled with blood coagulate and form clots. This particular stretching of the blood vessel created pain, and the clot maintains stretching of the vein leading to continued soreness. New straining right after unique formation of the clot, i.e. from constipation, bowel movements, work or some other kind of constriction of the belly can further stretch this already widened blood vessel and forms a new thin layer around the clot increasing the clot dimension causing more and more continuing pain.
This thin stretched vessel has pressure receptors in it that are perceived as pressure pain and can be inflamed by sitting, direct trauma, toilet paper or restraining. When you've ever had all of them, you know how uncomfortable they could be. Also called "piles", they occur for a number of reasons. One cause is actually gravity. The blood vessels from higher up on the anus start to drop down due to the laxity of the tissue as we grow older. Another cause is the pelvic congestion due to prolonged sitting, straining with heavy lifting or trying to have a bowel movement, or perhaps by the pelvic congestion of pregnancy. Initial symptoms can be a bit alarming. Maybe it's a small amount of fresh blood on the tissue paper after a bowel movement. Then there is the vague itching, generalized discomfort and downright pain that can accompany hemorrhoids. Add to that the discovery of "lumps" in the area by the patient, and you have the makings of a panic.
Imagine for a Moment that You are Looking Into the Anal Area Through an Anoscope
There is a circular line around the mucosa wherever muscles attach to the outer rectum called the "dentate" (or "pectinate") line. If hemorrhoids are above the dentate line, they are called "external," and if they are below the dentate line they are known as "internal." The external ones are more easily seen and felt, while a person may be unaware that they have internal hemorrhoids.
We Will Not Know for Sure What Percentage of the Population Will Get Hemorrhoids
In the us the number who found for medical care of hemorrhoids are usually about 4%. In Great Britain, where they have Socialized Medicine, about 30% of patients present for treatment of this condition. Could in america that the sale of over-the-counter products for them goes into the billions of dollars.
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People who have occupations that require prolonged sitting, for example like truck drivers, get hemorrhoids, as do people who do a lot of heavy lifting. Fighter pilots get hemorrhoids from gravity as well as fighting in opposition to G-forces. Pregnant females get hemorrhoids, as i have said, from pelvic congestion, but later from pushing the infant out during the latter part of labor. Probably the most common cause is straining at bowel movement secondary to chronic constipation.
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What are the treatments for hemorrhoids? Well, believe it or not, increasing fiber in the diet is a wonderful treatment for all signs and symptoms.. Stool softeners haven't been found to help that much. Soluble fiber decreases bleeding and irritative signs and symptoms. Witch Hazel and glycerin astringent wipes can be very soothing to swollen hemorrhoids as well as can often relieve itching. Sometimes, warm sitz baths several times a day can help, as well as sitting on an inflatable "doughnut" cushioning (decreases direct pressure and pinching). If there is an acute clot in a hemorrhoidal vein, it may respond to intermittent ice packs. Occasionally, the E.R. or physician can make a tiny cut in the hemorrhoid and let the clot out, resulting in great relief and final healing.
What are the physician treatments of hemorrhoids? One of the most effective is the outpatient application of special rubber bands to the hemorrhoids. A patient can have around three bands a week. Some medical doctors sclerose (inject that with irritant substance in order to make it shrink) the hemorrhoids by injecting them with 5% greasy phenol, but the results are not as good as with banding.. Some clinics utilize infrared coagulation, cryotherapy (freezing), or various forms of cautery with mixed results. When hemorrhoids are too severe, either open or closed, hemorrhoidectomy will be done in the operating room. The results are generally good, but the time in order to recovery could be prolonged. There have been some good operative results with simply tying over hemorrhoidal artery.
So, what's the take-home message? Hemorrhoids are one of the most common cause of bright red anal bleeding, itching and pain, but this simply can't be assumed in every circumstance. The doctor is going to have to examine your own anus. There are plenty of other things which can cause these symptoms. Please leave your embarrassment in the waiting room and tell the doctor what's been going on. The one thing to consider when sitting in the waiting room is you're not alone, and the more open you are with your doctor the better help he/she can provide for you to getting better. If you are over 50 or have risk factors for colon cancer, you probably need anoscopy and colonoscopy. These are very benign tests in this day and age. Once all the more significant opportunities have been ruled out, then you can start a comprehensive program to treat and manage hemorrhoids, and you will "live happily ever after."
John Drew Laurusonis M.D.
Doctors Medical Center.