Thomas P. Sokol, MD received his medical degree from the University of Health Sciences/The Chicago Medical School in 1980. He went on to his general surgical residency at Harbor/UCLA Medical Center and then to the Carle Clinic/ University of Illinois for Fellowship Training in Colon and Rectal Surgery.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Home Remedies, Medication, and Surgery Treatments for Hemorrhoids
It is believed generally that
constipation and straining to have bowel movements promote hemorrhoids and that
hard stools can traumatize existing hemorrhoids. It is recommended, therefore,
that individuals with hemorrhoids soften their stools by increasing the
fiber in
their diets.
Diarrhea is believed to aggravate the symptoms of hemorrhoids and it is
recommended that diarrhea be controlled with fiber and anti-motility drugs.
Over-the-counter products
Many over-the-counter products are sold for the treatment of hemorrhoids.
Products used for the treatment of hemorrhoids are
available as ointments, creams, gels, suppositories, foams, and pads.
Local anesthetics: Local
anesthetics temporarily relieve pain, burning, and itching by numbing the nerve
endings.
Vasoconstrictors: Vasoconstrictors are chemicals that resemble epinephrine, a
naturally occurring chemical.
Protectants: Protectants prevent irritation of the perianal area by forming a
physical barrier on the skin that prevents contact of the irritated skin with
aggravating liquid or stool from the rectum.
Astringents: Astringents cause coagulation (clumping) of proteins in the cells
of the perianal skin or the lining of the anal canal.
Antiseptics: Antiseptics
inhibit the growth of bacteria and other organisms.
Keratolytics: Keratolytics are chemicals that cause the outer layers of skin or
other tissues to disintegrate.
Analgesics: Analgesic
products, like anesthetic products, relieve pain, itching,
and burning by depressing receptors on pain nerves.
Corticosteroids: Corticosteroids reduce inflammation and can
relieve itching, but their chronic use can cause permanent damage to the
skin.
A precise definition of hemorrhoids does not exist, but they
can be described as masses or clumps ("cushions") of tissue within the anal
canal that contain blood vessels and the surrounding, supporting tissue made
up of muscle and elastic
fibers. The anal canal is the last four centimeters through which stool passes
as it goes from the rectum to the outside world. The anus is the opening of the
anal canal to the outside world.
Although most people think hemorrhoids are abnormal, they
are present in everyone. It is only when the hemorrhoidal cushions enlarge that
hemorrhoids can cause problems and be considered abnormal or a disease.
Prevalence of hemorrhoids
Although hemorrhoids occur in everyone, they become large and cause problems in
only 4% of the general population. Hemorrhoids that cause problems are
found equally in men and women, and their prevalence peaks between 45 and 65
years of age.
Anatomy of hemorrhoids
The arteries supplying blood to the anal canal descend into the canal from the
rectum above and form a rich network of arteries that communicate with each
other around the anal canal. Because of this rich network of arteries,
hemorrhoidal blood vessels have a ready supply of arterial blood. This explains
why bleeding from hemorrhoids is bright red (arterial blood) rather than dark
red (venous blood), and why bleeding from hemorrhoids occasionally can be severe.
The blood vessels that supply the hemorrhoidal vessels pass through the
supporting tissue of the hemorrhoidal cushions.
The anal veins drain blood away from the anal canal
and the hemorrhoids. These veins drain in two directions. The first direction
is upwards into the rectum, and the second is downwards beneath the skin surrounding the anus. The dentate line
is a line within the anal canal that denotes the transition from anal skin
(anoderm) to the lining of the rectum.
Formation of hemorrhoids
If the hemorrhoid originates at the
top (rectal side) of the anal canal, it is
referred to as an internal hemorrhoid. If it originates at the lower end of the
anal canal near the anus, it is referred to as an external hemorrhoid.
Technically, the differentiation between internal and external hemorrhoids is
made on the basis of whether the hemorrhoid originates above or below the
dentate line (internal and external, respectively).
As discussed previously, hemorrhoidal cushions in the
upper anal canal are made up of blood vessels and their supporting tissues.
There usually are three major
hemorrhoidal cushions oriented right posterior, right anterior, and left
lateral. During the formation of enlarged internal hemorrhoids, the vessels of
the anal cushions swell and the supporting tissues increase in size. The bulging
mass of tissue and blood vessels protrudes into the anal canal where it can
cause problems. Unlike with internal hemorrhoids, it is not clear how external
hemorrhoids form.
Rectal bleeding (hematochezia) refers to the passage of bright red blood from the anus. Rectal bleeding may be moderate to severe and most bleeding comes from the colon, rectum, or anus. Common causes include anal fissures, hemorrhoids, diverticulitis, and more.
Diarrhea is a change is the frequency and looseness of bowel movements. Cramping, abdominal pain, and the sensation of rectal urgency are all symptoms of diarrhea. Absorbents and anti-motility medications are used to treat diarrhea.
There are many symptoms involved in the 1st, 2nd and 3rd trimesters of pregnancy. The first early pregnancy symptom is typically a missed period, but others include breast swelling and tenderness, nausea and sometimes vomiting, fatigue and bloating. Second trimester symptoms include backache, weight gain, itching, and possible stretch marks. Third trimester symptoms are additional weight gain, heartburn, hemorrhoids, swelling of the ankles, fingers, and face, breast tenderness, and trouble sleeping. Read more to learn about recommended procedures and tests for each stage of a healthy pregnancy.
Constipation is defined medically as fewer than three stools per week and severe constipation as less than one stool per week. Constipation usually is caused by the slow movement of stool through the colon. There are many causes of constipation including medications, poor bowel habits, low fiber diets, abuse of laxatives, hormonal disorders, and diseases primarily of other parts of the body that also affect the colon.
A skin tag is a small benign growth of skin that projects from the surrounding skin. Skin tags can vary in appearance (smooth, irregular, flesh colored, dark pigment, raised). Skin tags generally do not cause symptoms unless repeatedly irritated. Treatment for skin tag varies depending on the location on the body.
Anal itching is the irritation of the skin at the exit of the rectum, known as the anus, accompanied by the desire to scratch. Causes include everything from irritating foods we eat, to certain disease and infections. Treatment options include local anesthetics, vasoconstrictors, protectants, astringents, antiseptics, keratolytics, analgesics, and corticosteroids. If condition persists, a doctor examination may be needed to identify an underlying cause.
An anal fissure is a small tear or cut in the skin lining of the anus. Pain and/or rectal bleeding during bowel movements are common symptoms of anal fissures. Treatment involves increasing liquid intake, using stool softeners and avoiding foods that may not be well-digested.
Laxatives for treatment of constipation include over-the-counter preparations such as bulk-forming laxatives, stool softeners, lubricant laxatives, stimulant laxatives, saline laxatives, enemas and suppositories. Some over-the-counter laxatives are not recommended for patients with specific diseases or conditions. Some laxatives may have negative adverse effects if taken over long periods of time.
Portal hypertension is most commonly caused by cirrhosis, a disease in which results from scarring of a liver injury. Other causes of portal hypertension include blood clots in the portal vein, blockages of the veins that carry the blood from teh liver to the heart, and a parasitic infection called schistosomiasis.
Pregnancy can bring challenges like weight gain, stretch marks, varicose veins, heartburn, constipation, hemorrhoids, problems sleeping, and wondering if it is safe to have sex while pregnant. Learn how to manage and move through these challenges during pregnancy.
Rectal bleeding (known medically as hematochezia) refers to the passage of red blood from the anus, often
mixed with stools and/or
blood clots. (It is
called rectal bleeding because the rectum lies immediately above the anus, and although the bleeding indeed may be coming from the rectum, as discussed later,
it also may be coming from other parts of the gastrointestinal tract.) The
severity of rectal bleeding (i.e., the quantity of blood that is passed) varies widely.
Most episodes of rectal bleeding are mild and stop on their own. Many patients report only passing a few drops of fresh blood that turns
the toilet water pink or observing spots of blood on the tissue paper. Others may
report brief passage of a spoonful or two of blood. Generally, mild rectal
bleeding can be evaluated and treated in the doctor's office without
hospitalization or the need for urgent diagnosis and treatment.
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