Hemorhoids are varicose veins of the rectum. The hemorhoidal veins are sited in the lowest area of the rectum and the anus. Sometimes they swell, so that the vein walls become stretched, slim, and irritated b passing bowel movements. When these veins bleed, itch, or hurt, they are known as hemorrhoids, or piles. Hemorhoids are divided in two general categories: internal and external.
Formation of hemorhoids
Veins in the rectum and anus are under considerable pressure whenever a stool is passed. Pushing or straining may cause veins in the rectal wall to lump, creating clusters of swollen, or dilated, veins called hemorrhoids. Internal hemorrhoids can form anywhere inside the anal canal, while external hemorrhoids are visible, or just below, the opening of the anus.
Internal hemorrhoids lie far inside the rectum that you can’t see or feel them. They do not usually hurt, because there are few pain sensing nerves in the rectum. Bleeding may be the only sign of their presence. Sometimes internal hemorrhoids prolapse, or enlarge and protrude outside the anal sphincter. If so, you may be able to see or feel them as moist, pink pads of skin that are pinker than the surrounding area. Prolapsed hemorrhoids may hurt, because the anus is dense with pain-sensing nerves. They usually recede into the rectum on their own; if they don’t, they can be gently pushed back into place. Most commonly the blood in stool caused by hemorrhoids is bright red but internal hemorrhoids can be reason for appearance of dark blood in stool.
- They are usually mild and painless.
- There is usually an incomplete bowel clearance and a feeling of incomplete defecation.
- These mostly occur inside of the anus unlike external hemroids.
- Those of you who suffer can explain well how everytime you sit on the commode, you have to struggle very hard to clear your bowels.You have to squeeze your abdominal muscles repeatedly and aggresively to push down those obsitinate dry stools to squeeze their way out through the rectum.
- This somehow pushes forward the hard dry stools few centimeters down through the lower rectum. In doing so you invariably strain the tissues and the blood vessels tremendously. This damages the inner wallls of the rectum in the long run due to over exertion. Neverthless, the stools wriggle their way out through the tortuous anal canal with several fits and starts. Finally you succeed to excreate them out through the anus.
- Under such circumstances its quite likely that you notice tickle of blood stains that flowed along with the fecal matter that you passed and may be few dropped on the rim of the commode as well.
- You realize that there was no feeling of pain at all inspite of the little amount of blood that flowed out resulting from some injury to the tissues and blood vessels in the lower rectum including the anus. This is because the inside of the rectum lacks pain receptors, which makes passing of stools painless, no matter how dry and hard they are. This is quite typical of any internal hemorrhoids.
- The blood oozes because of the bruises. When the veins constrict in the anus, they enlarge. Its vulnerable to punctures under the slightest strain, that cause the blood to leak before its again plugged back due to coagulation of the blood.
- The swollen veins narrows the passage through the anal canal (the portion between the rectum and anus, 2.5 to 4 cm long ). When passing very hard stools, it injures the tissues and blood vessels, as they are pushed hard to forcibly squeeze through the narrowed rectum, towards the anus from where the feces/faeces are excreted outside.
- When the hemorrhoids grow bigger inside they protrude or prolapse through the anus.It may even prolapse upon defecation outside the anal canal but auto retracts immediately upon completion.
- However when oversized, the swollen mass is no longer able to retract back on its own into the anal canal. It has to be gently pushed back into the anus using your fingers.
External hemorrhoids are situated within the anus and are usually painful. If an external hemorrhoid prolapses to the outside (usually in the course of passing a stool) you can see and feel it. Blood clots sometimes form within prolapsed external hemorrhoids, causing an extremely painful condition called a thrombosis. If an external hemorrhoid becomes thrombosed, it can look rather frightening, turning purple or blue, and possibly bleeding. Despite their appearance, thrombosed hemorrhoids are usually not serious and will resolve themselves in about a week. If the pain is unbearable, your doctor can remove the thrombosis, which stops the pain, during an office visit.
- But those that are complex, hangs from the anal sphincter outside the anal canal due to gravity. It remains critically exposed, and can no longer be manually retracted. This can cause acute pain, mucus discharge and puritus ani (itching).
- They are exquisitely painful, more so when the external hemorrhoids are tightly strangulated with presence of blood clot (thrombosis) in it. The pain is so painful that only those who have suffered can best describe it. Other than the kind of pain that one endures either from child birth or kidney stones, the pain from thrombosed external hemorrhoids is the most terrible of all.
Threat of Gangerene from Thrombosed Hemorrhoids – A Remote Possibility
- Hemorrhoids mostly occur in veins. If it did in arteries then the surrounding tissues would be deprived of vital oxygen carried by the blood through the arteries. Eventually the portion of the flesh will die, as the tissues begin to necrotise that causes gangrene to set the flesh to rot.
- An external thrombosed hemorrhoid must not be neglected. If the blood remains stagnant for too long in the swollen veins, large blood clot will set in. The blood will keep oozing from the damaged tissues and collect under the skin to clot, due to prolong lack of muscle movement. The toxin cells just cannot be flushed away, as circulation of blood becomes sluggish.
- It begins to then block the veins that cause it to massively swell under pressure, as the heart pumps blood harder. But that too has its limitations, and the cell toxins quickly spreads. In extreme and rare cases it may also spread to the arteries and block blood circulation, resulting in gangrene from cell necrosis.
Treatments for External Hemorrhoids using Non Surgery Methods
There are however many ways to get rid of hemorrhoids other than surgery. These includes:
- Shrinking of small hemorrhoids using injection,
- Banding hemorrhoids by tying of special rubber/latex band around the affected portion using a special instrument,
- Photo coagulation that uses pointed infra red light to stop bleeding,
- Super freezing using cryogenic treatment with liquid nitrogen to discard the external hemorrhoid portion,to allow healthy tissues to grow in its place.
- Laser light for faster and painless treatment,
- Cutting and coagulation of hemorrhoidal tissue using ultrasonic technology (Harmonic Scalpel),
- Transanal Hemorrhoidal Dearterialisation using proctoscope and doppler ultrasound flowmeter to stop blood flow to the hemorrhoids by stitching the artery below,
- Atomizing hemorrhoids by using a wave of the Atomizer Wand. The hemorrhoids are vaporized or excised one or more cell layers at a time using the Atomizer.
Natural Cure for at Home Hemorrhoid Treatment
There are ten important suggestions to cure your hemorrhoids:
- Drink plenty of water, at least eight glasses in a day. This will help to keep the stools to remain moistoned and aid in lubricating its passage through the rectum. Thus help to reduce chronic constipation, if any.
- Avoid fizzy drinks or carbonated beverages (such as coke or soda) and any caeffine as they dehydrate the body quickly.
- Avoid food that is high on flour and sugar, such as white breads, cakes, pastries, pasta (made of white flour smothered in cream sauce) etc.
- Eat more vegetable (beans, lentils, cheakpeas, soyabeans etc.) and fruits rich in fibres such as raw apples and pears with skin, bananas, orange, any nuts.
- Eat whole grain food e.g oats, 100% whole-wheat pasta or brown bread rich in high fibre. According to the American Dietetic Association, an average intake of 30 gms of fibre is recommended.
- You can also gulp down a glass of water with teaspoon of Psyllum, a natural husk, that helps in easy bowel movement.
- Take in more biofavonoids such as those found in citrus fruits, green/black tea and dark chocolates. It helps to strengthen the walls of blood vessels and reduce inflammation. Its especially good for bleeding hemorrhoids during pregnancy.
- Keep your anus clean and disinfectant using medicated soap and water.
- Exercise and move frequently such as by walking or climbing up few steps to a floor or two.
- Avoid sitting too long at one place to avoid prolong compression of the blood vessels in your bottom
- Kerosene oil also can be applied to the area at nights and washed away in the morning or good old Preparation H cream which also contains some kerosene and other healing properties.
Treatment of Hemorrhoids – Surgical and Non Surgical Methods
Most hemorrhoid treatment does not require any surgery at all. Only when it becomes far too complex and severe such that there is unusual discharge of pus or uncontrolled bleeding accompanied with unbearable pain in the area. The doctors usually suggest for immediate surgery of the piles in such situations.
Types of Surgery for Treatment of Thrombosed Hemorrhoids
Conventional hemorrhoid surgery includes:
1. Milligan-Morgan Technique,
2. Ferguson Technique,
3. Stapled Hemorrhoidopexy (PPH Procedure),
All of which more or less requires full theater operation and hospitalization for post operative care (at least 3 days). You will also need time to recover completely after a painful hemorrhoid surgery, before your bowels begin to function normally. You may even suffer from anal stenosis, in case the pile surgery turns complicated. However in each case there are both advantages and disadvantages, none of which can claim total and effective cure.
How Hemorrhoids Affect Normal Life
- Hemorrhoids by nature are not life threatening unless prolonged without treatment. However they make life miserable. They cause enough pain and distress to the patient. Daily routine is disturbed. The person is physically and psychologically traumatized.
- Prolong blood loss due to bleeding from piles may result in anemia i.e. cause iron deficiency in the blood. If it grows far too big for him or her to manage, the pain becomes unbearable. The person would under such circumstance need immediate medical intervention for relief and treatment.
- Most often doctors advise for surgery to such patients. However there are plenty of non surgical methods to cure hemorrhoids safely.
(pic from learnzon.com)