Hemorrhoids, or piles, are a common problem for men and women. The rectal lining in your anus consists of an orange-ish tissue full of mucus glands that are very similar to the rest of the rectal lining and easily become infected or strained. The very fact of this portion of the digestive tract being exposed predisposes it to disease and infection, hemorrhoids and rectal cancer being two prominent examples.
The Anus and Rectum
The anus is the opening at the end of the digestive tract, mostly exposed. The rectum is the internal portion of the tract end where feces is held before release. Any condition affecting the rectum will invariably have an affect also on the anus. Hemorrhoids, for instance, are not confined to one or the other but most often express themselves in both regions.
The veins from the anus lead into what is called the “portal vein,” which leads straight to the liver and general circulation. This is why the liver becomes important when diagnosing and treating some rectal conditions.
The sphincter of the anus is the muscular ring that controls egestion (defecation) and is kept closed and functional subconsciously by the autonomic nervous system. To diagnose conditions or problems with the anus or rectum, a physician will inspect the skin in the region for any abnormalities. In women, the vagina may also be examined. An ansocope and/or proctoscope is also used to view into the interior of the rectum. If concerns or symptoms extend further into the digestive tract, a sigmoidoscope will be used to enter into the intestine by as much as two feet.
Enemas may be administered to clear and anesthetize the rectal area; the resultant material may also be tested under microscopic examination to see if there is any infection.
Hemorrhoids are not the only condition of the rectum, although they are the most common. Hemorrhoids are also the rectal issue most strongly associated with an increased risk of cancer. Speak to your doctor for more information.
Hemorrhoids are swollen tissues containing veins located around the wall of the rectum and anus. They swell during and between bowel movements and can become very painful. They become inflamed and may even develop a blood clot, or thrombus, which sticks out from the anal or rectal tissue and feels sensitive to the touch. Those protrusions that stay in the anus are called “internal,” while those that move outside of the anus to the surrounding tissue are called “external” hemorrhoids.
The main cause of hemorrhoids is constipation. Straining during bowel movements causes increased pressure on the hepatic portal vein—the major artery that delivers blood from the gastrointestinal tract and spleen to the liver—which causes hemorrhoids to form.
Hemorrhoids may lead to an anal fissure. This is a tear or ulcer in the lining of the anus or in the surrounding tissue. These can either come from excessive straining or from the pressure of a large, oddly-shaped, or painful bowel movement. Once there is a fissure, the sphincter goes into spasm and healing of the region becomes a difficult process.
Fissures are painful, perhaps even more so than hemorrhoids, and there will be pain and bleeding shortly after a bowel movement. However, the anguish from a tear lasts only several minutes or hours and does not recur until there is a need for another bowel movement. Repeated pain from an anal fissure is usually what drives people to see the doctor.
Oftentimes, a bad anal tear is confused for a hemorrhoid. Due to the pain and discomfort, almost anything in the region is thought to be a result of hemorrhoids, but it is important to go the doctor if there is any pain in the rectum or anus, as topical treatments sold to help with the symptoms of hemorrhoids will have no affect on an anal fissure.
A tear or a hemorrhoid may also lead to a pus-filled patch in the area caused by bacterial infection, known as an anorectal abscess. Such rectal issues, as mentioned above, expose the area to opportunistic bacteria that can either colonize the tissue or skin, or infect an open wound.
Such an abscess under the skin will be red, swollen, and tender—not unlike a hemorrhoid. In fact, because of their similarities in pain and appearance, these are also confused for hemorrhoids. If the abscess is higher in the rectum it may cause no problems in the rectum or anus but instead cause fever and pain in the abdomen. Abscesses are easy to treat: once they are identified by a physician they are drained and the tissue eventually goes back to its normal state.
You may also suffer from proctitis, which is a swelling of the rectum with painless bleeding and some dicomfort. With ulcerative proctitis, there are ulcers in the rectum. The lining is inflamed and there is discomfort, pain, and itching that may extend as far as four inches into the digestive tract. This condition is more common today than it once was and it may result in worse rectal conditions, or swelling of the colon (colitis). You can get proctitis from contracting a venereal or sexually transmitted disease. Salmonella is commonly the cause, yet antibiotics or ointments that kill good and needed digestive bacteria may be at fault also.
All of the above conditions are often a result of hemorrhoids, linked to the presence of hemorrhoids, or are confused for hemorrhoids themselves. The only way to be properly treated for any of them is to go to a physician who may give you a sigmoidoscopic, anoscopic, or proctoscopic examination to determine the cause of the discomfort or bleeding.
There is a wide range of treatments for conditions of the rectum, including hemorrhoids. Sometimes the operation is a simple one and will almost always be diagnosed either with a gloved-hand examination or a deeper inspection with an anoscope, proctoscope, or sigmoidoscope.
Sometimes diagnosed hemorrhoids cause no symptoms at all, in which case no treatment will be necessary. If a hemorrhoid has a blood clot it can become painful and red in which case a warm sitz bath, or hip bath, is used to clean the area, relieve pain, and increase the blood flow. This is just a tub of warm water up to the hips which is sat in until pain is relieved. Witch hazel is also used in a compress for pain relief. Most often, these easy treatments relieve the pain and the hemorrhoids and blood clots will disappear within four weeks.
In extreme cases of bleeding or pain, a doctor may cut into the clot and remove it as an immediate treatment. There may otherwise be an injection of a substance that induces scar tissue in the veins to stop the bleeding which is called “injection sclerotherapy.” This is a common procedure and very often results in a healing of the hemorrhoids.
Some hemorrhoids are too large or swollen to heal with this procedure and in this case the individual protrusions are tied off with rubber bands until they dry up and fall off naturally. This approach is called ligation and it can be quite uncomfortable, although the discomfort will only last until the hemorrhoids fall away. It is painless, although it takes a while since only one hemorrhoid at time can be treated and requires an interval in between of more than two weeks for healing.
If this common treatment fails, hemorrhoids are burned off with “laser destruction” or “infrared photocoagulation,” or electrified with electrocoagulation. All procedures are safe and fast, relative to the time it takes to rubber band ligate them.
Hemorrhoids and Diet
In addition to sitz baths and pain-relieving compresses, proper diet has been shown to reduce the incidence and pain relevant to hemorrhoids.
Since constipation is the main cause of hemorrhoids, foods that allow a smooth and easy bowel movement are of the utmost importance for a hemorrhoid sufferer. That means fiber. Fiber is a plenteous and readily available food and is even used in many constipation medicines sold over the counter. Save money, and be healthier by eating more fiber-rich foods like whole grains, root vegetables (potatoes, turnips, yams), raw green and leafy vegetables, and yogurts. Nuts and dried fruits also help. If you maintain these as a regular part of your diet, you are sure to have an easier time in the bathroom.
Doctors also prescribe psyllium, which is a natural stool softener. Psyllium is a naturally growing soft dietary fiber that can be purchased at any health food store and in many large grocery stores. The American Journal of Clinical Nutrition published a study of psyllium and recommended its daily intake for a healthy diet, and especially for those who are constipated.
Finally, hydration is a key part of proper digestion. Without enough water in your system, food is digested more slowly and is harder to egest. Staying hydrated is a big part of healthy bowel movements and doctors recommend two liters of water a day or more.
There is no food item that will relieve hemorrhoid pain and the only methods of immediate relief from hemorrhoids are listed above. They usually involve some kind of procedure, the invasiveness of which will depend on the level of discomfort and location of the protrusion. A fiber-rich and well-hydrated diet is a preventative measure which will not only ease your bowel movements but provide you with a healthier all around diet. In the 1990s, a study at a Danish Central Hospital Discharge concluded that hemorrhoids were associated with an increase risk of rectal cancer. That means that a diet low in red meat, including only a small or healthy portion of lean meat in the evening meal, has multiple good effects for your digestion and bowel movements as well.
Eating more fiber and less red meat means better rectal health.