Articles

Don't Suffer in Silence
October 26, 2010

Hemorrhoids are one of the most common ailments for men and women alike.  They affect more than half the population at some point in their lives.  Onset commonly occurs after age of 30, but hemorrhoids are reported in people of all ages.  More than 525,000 patients in the United States are treated annually for symptomatic hemorrhoids.  Of these, approximately 10-20 percent will require surgical treatment for their condition.

Hemorrhoids are one of the most common ailments known in both men and women but many suffer in silence rather than discuss hemorrhoid treatment with their doctor.  Each of us has veins within the anus that tend to stretch under pressure, somewhat like varicose veins in the legs.  It is believed these veins exist to protect and cushion the anal canal.  When these veins swell, they are called “hemorrhoids”.  One set of veins is inside the rectum (internal hemorrhoids) and another is under the skin around the anus (external hemorrhoids).

Internal hemorrhoids usually are not painful, but may bleed.  Sometimes, an internal hemorrhoid may stretch until it bulges outside the anus.  This is called a prolapsed hemorrhoid. A prolapsed hemorrhoid may shrink back inside the rectum on its own over time, or it may be gently pushed back inside.  External hemorrhoids involve the veins around the anus.  They can be itchy or painful an can sometimes crack and bleed.  If a blood clot forms, one may feel a tender lump on the edge of the anus, and see bright red blood on toilet paper or in the toilet after a bowel movement.

Hemorrhoids can affect men and women alike; however, an individual may be more likely to get hemorrhoids as they age or if their parents had them.  Pregnant women often get hemorrhoids because of the strain from carrying the baby and from giving birth. For most women, such hemorrhoids are a temporary problem.  Obesity, straining during bowel movements, sitting too long on the toilet, or standing or lifting too much can make hemorrhoids worse. Constipation is often the main cause of hemorrhoids.  Many anorectal problems, including fissures, fistulae, abscesses, or irritation and itching, also called pruritus ani, have similar symptoms and are incorrectly referred to as hemorrhoids.

Hemorrhoids usually are not dangerous or life threatening.  In most cases, hemorrhoidal symptoms will go away within a few days.

Although many people have hemorrhoids, not all experience symptoms.  The most common symptom of internal hemorrhoids is bright red blood covering the stool, on toilet paper, or in the toilet bowl.  However, an internal hemorrhoid may protrude through the anus outside the body, becoming irritated and painful.  This is known as a  prottuding hemorrhoid.
 
Symptoms of external hemorrhoids may include painful swelling or a hard lump around the anus that results when a blood clot forms.  This condition is known as a thrombosed external hemorrhoid.  In addition, excessive straining rubbing, or cleaning around the anus may cause irritation with bleeding and /or itching, which may produce a vicious cycle of symptoms.  Draining mucus may also cause itching.

A thorough evaluation and proper diagnosis by the doctor is important any time bleeding from the rectum or blood in the stool occurs.  Bleeding may also be a symptom of other digestive diseases, including colorectal cancer.  The doctor will examine the anus and rectum to look for swollen blood vessels that indicate hemorrhoids and will also perform a digital rectal exam with a gloved, lubricated finger to feel for abnormalities.  To rule out other causes of gastrointestinal bleeding, the doctor may examine the rectum and lower colon, or sigmoid, with sigmoidoscopy, or the entire colon with colonoscopy.
Sigmoidoscopy and colonoscopy are diagnostic procedures that also involve the use of lighted, flexible tubes inserted through the rectum.

The best way to prevent hemorrhoids is to keep stools soft so they pass easily, thus decreasing pressure and straining, and to empty bowels, as soon as possible after the urge occurs. Exercise, including walking, and increased fiber in the diet help to reduce constipation and straining by producing stools that are softer and easier to pass.

A number of methods may be used to remove or reduce the size of internal hemorrhoids.  Rubber band ligations, Sclerotherapy and infrared coagulation can often be accomplished in the office with minimal discomfort.  More severe cases will frequently require surgical treatment, including newer minimally invasive procedures such asa a “Stapled Hemorrhoidectomy”. Symptomatic external hemorrhoids often will require surgery to relive symptoms.

Colon and rectal surgeons are experts in the surgical an non-surgical treatment of colon and rectal problems.  They have completed advanced training in the treatment of colon and rectal problems in addition to full training in general surgery.  Colon and rectal surgeons treat benign and malignant conditions, perform routine screening examinations and surgically treat problems when necessary.

Don’t suffer in silence, consult a board certified colon and rectal surgeon today!

Andrew S. Ross, M.D.,F.A.C.S.,F.A.S.C.R.S.
Clinical Assistant Professor of Biomedical Science
Florida Atlantic University
Colon and Rectal Surgeon
Surgical Associates of Palm Beach County