Hemorrhoids, or piles, are one of mankind’s most common and nagging disorders. By themselves, they are rarely serious, but can be extremely troublesome. In some instances, hemorrhoids may mask a more serious disorder, such as colon or rectal cancer. Therefore, the disorder requires the proper diagnosis and treatment by a physician.

Hemorrhoids are dilated (enlarged) veins which occur in and around the anus and rectum. They may be external (outside the anus) or internal and slip to the outside. In both instances, hemorrhoids can be felt and seen as lumps or knots. Internal hemorrhoids may also remain inside the rectum and cannot be felt or seen.

A common cause of hemorrhoids is simply the standing position, in which all the blood above the rectum exerts pressure on the rectal and anal areas. Other conditions contributing to the disorder are: poor bowel habits, constipation, diarrhea, pregnancy, obesity, and especially frequent straining when having a bowel movement. However, some patients will have none of these conditions and still develop hemorrhoids.

Hemorrhoids can produce several uncomfortable, but non-serious problems:

• Thrombosis and Pain – A blood clot may cause severe pain and usually needs immediate medical attention.
• Bleeding – Hemorrhoids, internal or external, can ooze fresh red blood. External hemorrhoids often cause dripping of blood from the anus while sitting on the toilet. The blood might also be seen as soiling of the underwear. Internal hemorrhoids that bleed may produce fresh blood in the stool.
• Itching and Irritation – External hemorrhoids can be itchy, especially if the area is moist and irritated.
• Hemorrhoids do not develop into cancer. However, both hemorrhoids and cancer can cause rectal bleeding. In fact, many disorders can be the cause of rectal bleeding. When rectal bleeding occurs in persons over age 30, and especially in those over age 50, it should be considered a serious problem until an exact diagnosis is made.

Treatment varies depending on where the hemorrhoids are, what problems they are causing, and how serious they are. Often, time and the normal process of healing clear hemorrhoids with little or no specific treatment.

When the disorder requires treatment, the following general measures are recommended:

CONSERVATIVE TREATMENT:

• Keep the anal area clean, using a mild soap and gentle dabbing after a bowel movement. Avoid vigorous rubbing of the area.
• Keep the anus and affected area as dry as possible, using talcum powder and a pad of soft tissue to absorb moisture.
• Eat a diet high in fiber (bran) and roughage. Fiber and bran retain water in the stool, producing soft, bulky stools which are easier to pass and reduce the tendency to develop hemorrhoids. Bulking agents, such as Metamucil, Effersyllium, Konsyl, Citrucel, and Per Diem Fiber, are available in drug stores. These also come in less expensive generic versions.
• Avoid straining when having a bowel movement.
• When thrombosis, pain, and tenderness occur, a 10 to 20 minute hot tub bath two to four times daily brings heat to the area, provides relief from the pain, and promotes healing. This is called a hot Sitz bath.

LIGATION:

A common method of treating internal hemorrhoids is to use a small rubber band to tie off the base of the swollen vein, the blood circulation stops and the hemorrhoid then falls off. Repeat treatments are sometimes necessary.

Other treatments include infrared photocoagulation, lasers, and surgery.