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- A hemorrhoid is the dilation (i.e., swelling, enlargement) of a vein of the inferior or superior blood vessel collection known as the hemorrhoidal plexus that supplies blood to the lower part of the rectum and the anus.
- Hemorrhoids are similar to varicose veins seen on the legs, which over time and with constant pressure, tend to stretch and, when irritated, swell, leading to pain, itching, discomfort, burning and bleeding.
- Hemorrhoids can be internal (inside
the rectum, a bit distant from the anus) or external, hanging near the anus and protruding outside. Internal hemorrhoids are less problematic than external -- the only symptom is often bright red blood on the toilet paper.
- External hemorrhoids, on the other hand, can become very painful, itchy, and burning, and if strangulated, may form a blood clot (thrombosed hemorrhoid) and give rise to a painful hard lump around the anus.
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- Protruding mass through the anus
- Pain
- Itching
- Burning
- Bleeding
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- Constipation and chronic straining often due to a diet low in vegetables, fruits, and other fiber sources.
- Genetic factors may play a role.
- Pregnancy and childbirth
- Aging
- Chronic diarrhea
- Chronic coughing
- Sitting for long periods of time
- Constant heavy lifting
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- Based on history and clinical examination by a physician
- The exam will require direct observation of the anal area and a digital rectal exam, in which the doctor lubricates his gloved index finger and inserts it through the anus, in order examines the rectum.
- An anoscope, proctoscope, and sigmoidoscope are all devices that can be used to get a better look at the rectum, especially if a problem other than hemorroids is suspected.
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- Avoid straining
- Avoid prolonged sitting.
- Increase dietary fiber and fluids (6-8 glasses water a day if not contraindicated).
- Citrucel and Metamucil are bulk fiber stool softeners that are effective resources for treating constipation.
- Senokot and other bowel stimulants are other types of laxatives used to treat constipation.
- Always take laxatives recommended by your doctor and try to take only the natural sources, such as Psyllium based products.
- Laxatives are not to be taken for a period greater than 2 weeks, and if you have constipation for longer than 2 weeks notify your physicians.
- If bleeding occurs contact your doctor immediately.
- For painful hemorrhoids, Sitz baths (plain warm water for about 15 minutes) 3-4 times per day may help.
- Ice packs applied directly on a swollen hemorrhoid may help in reducing the inflammation and swelling.
- Hemorrhoidal creams, foams and suppositories containing hydrocortisone (e.g. Anusol HC) may be prescribed to reduce the swelling, burning and itching.
- Over-the-counter preparations such as Preparation H may help some sufferers.
- If diarrhea is present, anti-diarrheal medication may help.
- Pain medications such as Tylenol may help with the pain. Nonsteroidal anti-inflammatory medications such as aspirin and Aleve may also help reduce swelling, but can increase the risk of bleeding.
- In some patients with problematic hemorrhoids, a surgeon may be consulted.
- Surgical methods to remove or reduce the hemorrhoids include rubber band ligation (a rubber band placed around the dilated veins to cut off circulation), sclerotherapy (hemorrhoids injected with chemical solution), Laser or infrared light coagulation (burn the hemorrhoids), and hemorrhoidectomy.
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