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 bulge. These bulges filled with blood coagulate and form clots. This particular stretching of the blood vessel is painful, and the clot maintains stretching of the vein causing continued soreness. Brand new straining right after initial formation of the clot, i.e. from constipation, bowel movements, labour or some other form of constriction of the abdomen can further stretch this already broadened blood vessel and forms a new thin layer throughout the clot increasing the clot dimensions causing more and more continued 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 these, you know how uncomfortable they could be. Also known as "piles", they occur for a number of reasons. One cause will be 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 hard work 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 victim, 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 exactly where muscle tissue attach to the outer rectum called the "dentate" (or "pectinate") line. If hemorrhoids are above the dentate line, they are called "external," and when they are below the dentate line they are classified as "internal." The external ones are more easily seen and felt, while a person may be unaware that they have internal hemorrhoids.
We Don't Know for Sure What Percentage of the Population Gets Hemorrhoids
In the usa the number who existing 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 the usa that the sale of over-the-counter products for them goes into the billions of dollars.
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Difference Between Hemorrhoids and Colon Cancer
In other cases, blood in the stool could be an indication of something more serious. Let's take a look at both hemorrhoids and colon cancer so you can be ...
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 aircraft pilots get hemorrhoids from gravity as well as fighting in opposition to G-forces. Pregnant girls 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.
What are the treatment options for hemorrhoids? Well, believe it or not, increasing fiber in the diet is a superb treatment for all symptoms.. Stool softeners haven't been found to help that much. Soluble fiber decreases bleeding and irritative symptoms. Witch Hazel and glycerin astringent wipes can be very calming in order to swollen hemorrhoids and can often relieve itching. Sometimes, warm sitz baths several times a day can help, as well as sitting on an inflatable "doughnut" cushion (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 there, resulting in great relief as well as ultimate healing.
What are the physician remedies of hemorrhoids? Among the most effective is the outpatient application of specific rubber bands to the hemorrhoids. A patient can have up to three bands a week. Some doctors sclerose (inject it with irritant substance in order to make it shrink) the hemorrhoids by injecting them with 5% oily phenol, but the results are not as good as with banding.. Some clinics use infrared coagulation, cryotherapy (freezing), or various forms of cautery with mixed results. Any time hemorrhoids are too severe, either open or closed, hemorrhoidectomy is actually done in the operating room. The results are generally good, but the time to recovery may be lengthy. There have been some good operative results with simply tying off the hemorrhoidal artery.
So, what's the take-home message? Hemorrhoids are the most common cause of bright red anal bleeding, itching and pain, but this simply cannot be assumed in every situation. The doctor is going to have to examine your anus. There are plenty of other things which can cause these symptoms. Please leave your shame 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 obtaining 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 possibilities 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.