Hemorrhoids are swollen, inflamed veins around the internal or external anus. About 75% of people will have hermorrhoids at some point in their lives. Hemorrhoids tend to occur in pregnant women and older adults. They form when there is excessive chronic pressure around the anus due to chronic constipation, straining during bowel movements and prolonged toilet sitting.
Hemorrhoids are not dangerous but can cause a variety of symptoms. Internal hemorrhoids can bleed resulting in bright red blood coating stool, dripping into the toilet and staining toilet paper. Internal hemorrhoids can also prolapse out of the anus and if they don’t spontaneously return can cause symptoms of pain and itching. External hemorrhoids can form blood clots called a thrombosis and subsequently bleed and cause pain. When the clot dissolves a skin tag will remain which can become painful and itch.
A detailed history and physical examination can reveal the presence of hemorrhoids and other anorectal problems including fissures, skin tags, abscesses, et al. Colonoscopic evaluation may be needed to rule out other causes for anorectal symptoms especially bleeding.
Certain life-style changes can reduce the swelling of hemorrhoids and relieve hemorrhoid symptoms. Eating a high fiber diet with plenty of water and decreasing anal pressure by not straining and sitting on the toilet for prolonged periods of time are helpful measures. Over the counter creams can also provide temporary relief. If symptoms persist visit Dr. Mantas to explore other treatment options including prescription creams and suppositories and in office rubber band ligation, infrared coagulation or mono/bipolar diathermy. In rare instances a surgical approach is needed.