OP: Hemorrhoids

Hemorrhoids, also known as 'piles', are a very common medical problem - so much so that over half the population will develop them at some time or other. However, they usually occur in people over the age of thirty. Because the condition is considered by many to be too embarrassing to talk about, people often suffer in silence - and even prolong the period of time before seeking appropriate medical advice.

What are hemorrhoids?
Hemorrhoids are vascular structures that are located in the wall of the anus and rectum. When they become inflamed or ‘varicosed’ - dilated and swollen - they can enlarge into sac-like bulges that either protrude from the anus, or stay tucked up inside the anal canal.

External hemorrhoids are soft swellings that develop just under the surface of the skin near the opening of the anus. Though they’re usually painless, if a blood clot develops - known as thrombosis - the hemorrhoid becomes a hard lump that is blue or purple in color and can bleed if it ruptures. Worst of all, it hurts. Bowel movements can become extremely painful and the area is so sensitive that even standing or sitting is uncomfortable.

Internal Hemorrhoids develop farther up in the rectum and rarely cause any pain, since this tissue doesn’t have as many sensory nerves. Most people don’t even notice they have them until there’s bleeding or a visible protrusion. It does become painful when the hemorrhoid prolapses, meaning that it protrudes into the anal passage, or past the anus, and cannot be pushed back inside. This is usually caused by straining during a bowel movement.

Causes
According to the American Society of Colon and Rectal Surgeons, the exact cause of hemorrhoids is unknown. However, it is known that pressure on the tiny veins of the anus and rectum is a significant contributor, and can cause the tissues supporting the vessels to stretch. Consequently, the vessels dilate, causing their walls to “become thin and bleed”, and if the stretching continues, the vessels may dilate and protrude.

There are number of things can contribute to and/or aggravate the condition of strained rectal tissue, such as:

aging;
obesity;
excessive straining during a bowel movement;
prolonged constipation or diarrhea;
pregnancy and childbirth;
the overuse of laxatives or enemas;
sitting for extended periods of time;
lifting heavy objects; and/or
anal intercourse.
Symptoms
Any of the following symptom(s) may indicated hemorrhoids:

swelling of hemorrhoidal tissue;
discomfort or pain near the anus or inside the rectum;
burning sensation in the anorectal region;
anal itch;
rectal bleeding;
painful bowel movements; and/or
a sensitive lump(s) in or around the anus.
Instead of suffering in silence - which (as mentioned) is a common trait among hemorrhoid patients - it is best to seek the counsel of a doctor and rule out any other conditions with similar symptoms (e.g. anal fissures - often caused by large, hard bowel movements; or itching - caused by improper hygiene, stress, and chemical or food irritants).

Prevention
The best way to avoid having to experience the embarrassing discomfort and irritation of hemorrhoids is prevention. Increasing fluid intake and eating a high fiber diet is highly recommended because the ‘bulk’ of it will pass through the large intestine more easily, keep bowel movements from being too loose or too solid, and prevent intra-abdominal pressure due to straining. Foods rich in fiber include leafy green vegetables, fresh fruits, beans and bran products. Exercise is also very helpful, as is the practice of careful hygiene, and the use of stool softener medication when necessary.

Treatment
Though they do not improve the underlying condition, non-prescription products such as Preparation H can relieve mild symptoms of internal and external hemorrhoid; they are available in ointment, suppository and medicated wipes form. Treatments like these may include small concentrations of a variety of ingredients, including: phenylephrine - which constricts blood flow, reduces the size of the hemorrhoid and, thus, the associated inflammation; local anesthetics such as Pramoxine to relieve pain; protectants such as glycerin, white petrolatum which provide a coating to minimize soreness; and hydrocortisone to relieve itching.

There are other methods that can be used to deal with hemorrhoids. A sitz bath is a simple method to start with, which essentially involves sitting in a bathtub of plain, warm water for ten to fifteen minutes. The use of a donut shaped cushion can also relieve pressure on the affected area, especially if sitting for extended periods of time. If one’s symptoms are more severe, a doctor may recommend a weightier treatment, such as ‘freezing the hemorrhoid’ with liquid nitrogen or surgically removing it. Another method that can be used is called ‘rubber band’ ligation, which involves placing a band around the hemorrhoid to cut off its blood supply until it eventually falls off.

Final thoughts
In order to avoid having to go through the pain and discomfort of hemorrhoids it is best to eat a healthy diet, get plenty of exercise, and avoid activities that create intra-abdominal pressure. Also, if practicing anal play, be sure to use plenty of lubrication - and only penetrate slowly – and as far as is comfortable.

Posted: 23 Aug 22:42