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External hemorrhoids
- Itching or irritation in your anal region
- Pain or discomfort
- Swelling around your anus
- Bleeding
Internal hemorrhoids
- Internal hemorrhoids lie inside the rectum. You usually you can't see or feel them, and they rarely cause discomfort.
- Painless bleeding during bowel movements. You might notice small amounts of bright red blood on your toilet tissue or in the toilet.
Lifestyle choices​
The veins around your anus tend to stretch under pressure and may bulge or swell.Hemorrhoids can develop from increased pressure in the lower rectum due to:
- Straining during bowel movements
- Sitting for long periods of time on the toilet
- Having chronic diarrhea or constipation
- Being obese
- Being pregnant
- Eating a low-fiber diet
- Regular heavy lifting
Complications
Complications of hemorrhoids are rare but include:
- Anemia : Rarely, chronic blood loss from hemorrhoids may cause anemia, in which you don't have enough healthy red blood cells to carry oxygen to your cells.
- Strangulated hemorrhoid : If the blood supply to an internal hemorrhoid is cut off, the hemorrhoid may be "strangulated," which can cause extreme pain.
- Blood clot : Occasionally, a clot can form in a hemorrhoid (thrombosed hemorrhoid). Although not dangerous, it can be extremely painful and sometimes needs to be lanced and drained.
Treatment
People with obesity are more likely to develop a number of potentially serious health problems, including:
- Eat high-fiber foods : Eat more fruits, vegetables and whole grains. Doing so softens the stool and increases its bulk, which will help you avoid the straining that can worsen
- Soak regularly in a warm bath or sitz bath. : Soak your anal area in plain warm water for 10 to 15 minutes two to three times a day. A sitz bath fits over the toilet.
- Oral pain relievers. : You can use acetaminophen (Tylenol, others), aspirin or ibuprofen (Advil, Motrin IB, others) temporarily to help relieve your discomfort.
Diagnosis
Your doctor might be able to see external hemorrhoids. Diagnosing internal hemorrhoids might include examination of your anal canal and rectum.
- Digital examination : Your doctor inserts a gloved, lubricated finger into your rectum. He or she feels for anything unusual, such as growths.
- Visual inspection : Because internal hemorrhoids are often too soft to be felt during a rectal exam, your doctor might examine the lower portion of your colon and rectum with an anoscope, proctoscope or sigmoidoscope.
Minimal Invasive Procedures
- Rubber band ligation : Your doctor places one or two tiny rubber bands around the base of an internal hemorrhoid to cut off its circulation. The hemorrhoid withers and falls off within a week.
Hemorrhoid banding can be uncomfortable and cause bleeding, which might begin two to four days after the procedure but is rarely severe. Occasionally, more-serious complications can occur.
- Injection (sclerotherapy) : Your doctor injects a chemical solution into the hemorrhoid tissue to shrink it. While the injection causes little or no pain, it might be less effective than rubber band ligation.
Surgical procedures
- Hemorrhoid removal (hemorrhoidectomy) : Choosing one of various techniques, your surgeon removes excessive tissue that causes bleeding. The surgery can be done with local anesthesia combined with sedation, spinal anesthesia or general anesthesia.Hemorrhoidectomy is the most effective and complete way to treat severe or recurring hemorrhoids .
- Hemorrhoid stapling : This procedure, called stapled hemorrhoidopexy, blocks blood flow to hemorrhoidal tissue. It is typically used only for internal hemorrhoids.
Stapling generally involves less pain than hemorrhoidectomy and allows for earlier return to regular activities. Compared with hemorrhoidectomy, however, stapling has been associated with a greater risk of recurrence and rectal prolapse, in which part of the rectum protrudes from the anus.