For the uninitiated, hemorrhoids (piles) and rectal prolapse are not the same. Hemorrhoids – are swollen tissues that contain veins and that are located in the wall of the rectum and anus. While rectal prolapse – is the protrusion of the rectum through the anus.

Hemorrhoids may become inflammed, develop a blood clot (thrombus), bleed or become enlarged and protrude. Hemorrhoids that remain in the anus are called internal hemorrhoids, those that protrude outside the anus are called external hemorrhoids.

Hemorrhoids may develop from repeated straining during bowel movements, and constipation may make straining worse. Liver disease increases the blood pressure in the portal vein, sometimes leading to formation of hemorrhoids.

Hemorrhoids can bleed, typically after a bowel movement, producing blood streaked stool or stain on the toilet paper. The blood may turn water in the toilet bowl red. However, the amount of blood is usually small, and hemorrhoids rarely lead to severe blood loss or anemia.

Hemorrhoids that, protrude from the anus may need to be pushed back gently with a finger, or they may go back by themselves. Hemorrhoids may swell and become painful, if its surface is rubbed raw or if a blood clot forms in it. Less commonly hemorrhoids, may discharge mucus, and create a feeling that the rectum is not completely emptied. Itching in the anal region (pruritis ani), is not a symptom of hemorrhoids but it may develop because the painful area is difficult to keep clean. Doctors readily diagnose swollen, painful hemorrhoids by inspecting the anus and rectum.

How do we treat hemorrhoids?

   Usually, hemorrhoids do not require treatment, unless they cause symptoms. Taking food that make stool soft like – paw paw, banana, oranges, vegetable, cucumber, carrots etc, may relieve constipation and the straining that accompanies it.

Bleeding hemorrhoids can be treated with any injection of a substance that causes the veins to become obliterated with scar tissue, this procedure is called – injection sclerotherapy. I shall not mention the name of the injection for fear of abuse. So please consult your doctor.

Large internal hemorrhoids and those that do not respond to injection sclerotherapy are tied off with rubber bands. The procedure is called – rubber band ligation – this causes the hemorrhoids to wither and drop off painlessly. The treatment is applied to one hemorrhoid at a time, at intervals of 2 weeks or longer. Three to six treatments may be needed.

Hemorrhoids, may also be destroyed using a laser – laser destruction, an infrared light – infrared photocoagulation or an electric current – Electrocoagulation.

Surgery may be used if other treatments fail. When hemorrhoids with a blood clot causes pain it is treated with warm sitz bath – baths in which the person sits in warm salty-water, and local anesthetic ointment applied. Pain and swelling usually diminish after a short while. And clots disappear after 4 to 6 weeks. Always be medically guided.

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