Hemorrhoids, which can be found in people of all ages and genders, affect your well-beings, confidence and your normal daily activities. The anal bleeding can be serious and requires urgent hospitalization.
Dr. Nattaporn Nuanuthai, our general surgeon at Bangkok Hospital Hua Hin shares that hemorrhoids are caused by the dilated superficial veins at the anus. Normally, these veins drain blood back to the lower abdomen and if people with high abdominal pressure, whether they have chronic constipation, habits of reading or using the phone while defecating or in some careers that require prolonged standing, people who are overweight and pregnant women, the blood are back pressured causing congestion in the venous system in the anal area which consequently causes hemorrhoids.
In general, hemorrhoids can be found in two areas. The first area or external hemorrhoid, as the name suggested, are detected by the patient as a lump around the anus. It can also be very painful if a complication occurs. The other is internal hemorrhoids which may cause bleeding during defecation. The bleeding can show as a stain on the tissue paper or dripping of blood after passing stool.
The internal hemorrhoids are categorized into 4 grades, as follows
Grade I: The internal hemorrhoids are limited only in the anal canal. Nothing shows at the anus.
Grade II: The hemorrhoids protrude during a bowel movement but spontaneously retract themselves to the original state after the defecation.
Grade III: The hemorrhoids protrude and remain protruded after the defecation. It requires manual pushback.
Grade IV: Hemorrhoids cannot be pushed back inside the anus and remained palpable. The symptoms aggravate when they become swollen and inflamed with possible bleeding. The bleeding may persist and cause chronic blood loss and anemia in some cases.
The hemorrhoids can be diagnosed from the history and physical examination by a physician. Although The majority of hemorrhoid cases have presented with rectal bleeding, there are other diseases or conditions showing similar symptoms including important diseases such as colorectal cancers which may be found with hemorrhoids. After the physical examination, if bleeding defecation cannot be explained from hemorrhoids or have other history with suspected colorectal cancer, patients should receive a colonoscopy which is a endoscopic examination of the colon and rectum. Moreover, patients with a lump around the anus with hemorrhoids in mind, it is also necessary to rule out other conditions such as infectious diseases or skin cancer of the rectal area.
The treatment of hemorrhoids in patients with few symptoms will start with non-surgical approach. The physician will recommend all hemorrhoid patients to change their lifestyle to reduce the risk factors causing increasing of the abdominal pressure which in turn cause dilation of venous network in the anal area. The recommendations are as follows,
- Drink at least 8 – 10 glasses of water per day to help soften the stool for easier passing.
- Eat vegetables and fruits with high fiber to prevent constipation
- Avoid spicy foods, tea, coffee, pickles and alcohol.
- Promote regular defecation and avoid holding or forcing defecation. Mild laxatives can be helpful.
- Refrain from reading book or using the phone while defecating to reduce the time of straining during defecation.
- Avoid activities that require sitting or standing for a long time along with lifting heavy objects.
- Exercise regularly, get enough rest and avoid stress
- Keep clean around the anus. The cleaning with hard toilet paper or chemicals should be avoided as they may cause irritation.
- Lose excessive weight.
When the abnormal symptoms occur such as severe bleeding or the hemorrhoids become swollen and painful and you are unable to them back into the rectum, the patients should see a doctor for a proper management. It is advisable not to leave the hemorrhoids for a long time because more severe symptoms can develop and complicate the treatments.
After the patient has changed the lifestyle, this will help to improve the symptoms of hemorrhoids. In some cases, the symptoms are not improved, it is necessary to receive medical treatments at the hospital. The surgical intervention with hemorrhoidal rubber band or hemorrhoidectomy may require depending on the severity of the disease and doctor’s discretion. However, Dr, Nattaporn also shares that even the hemorrhoids have been treated, they may come back if the risk factors are still there. Therefore, after treatments, the patient is still required to avoid all risk factors causing these hemorrhoids.
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For more information, please contact:
General Surgery Clinic, Bangkok Hospital Hua Hin, Tel. 032-616-833 or Call Center Tel. 032-616-800
