Hemorrhoids

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What are hemorrhoids?

Hemorrhoids are described as masses or clumps of tissue within the anal canal that contain blood vessels. In other words, it is a condition in which the veins around the anus or lower rectum are swollen and inflamed.

Most people think hemorrhoids are abnormal, however, they are present in everyone. The problem occurs only when the hemorrhoidal cushions enlarge.

Hemorrhoids may result from straining to move stool. Other contributing factors include pregnancy, aging, chronic constipation or diarrhea, and anal intercourse.

There are two kinds of hemorrhoids:
- Internal hemorrhoids - inside the anus - usually don't hurt or itch and you can't feel them because they are inside the rectum. This type of hemorrhoids is pretty harmless, however, when they start to bleeding, they should be treated.
- External hemorrhoids - under the skin around the anus – is the source of most common symptoms we commonly hear about, such as pain, burning, and itching. If it becomes strangulated (cut off from blood supply), a clot can form in it and become an unbearably painful hemorrhoid.
Once the rectal veins have been stretched out and hemorrhoids created, it is difficult to get rid of them completely. They tend to reappear with less straining than it happened in the first place. Good habits and simple medical treatment or supplementation usually control hemorrhoids well. Thus surgery is only recommended in unusually severe cases.

What causes hemorrhoids?

It is hard to give exact answer to this question. There are several theories about the cause, including inadequate intake of fiber, prolonged sitting on the toilet, and constant straining to have a bowel movement (in other words constipation).
     Hemorrhoids are associated with pregnancy as well. It is thought that these conditions lead to increased pressure in the hemorrhoid veins and, in result, causing them to swell.
     Tumors in the pelvis also cause enlargement of hemorrhoids by pressing on veins draining upwards from the anal canal.
     Moreover, liver disease may also cause increased pressure in the veins and also cause hemorrhoids.
     One theory suggests that it is the pulling force of stool, particularly hard stool, passing through the anal canal that drags the hemorrhoidal cushions downward.
     Another theory suggests that with age the supporting tissue that is responsible for securing the hemorrhoids to the underlying muscle of the anal canal deteriorates. With time, the hemorrhoidal tissue loses its anchor and falls down into the anal canal.

What are the symptoms of hemorrhoids?

Many people have hemorrhoids, nevertheless,  not all experience symptoms or they are painless.

The most common symptom of internal hemorrhoids is bright red blood covering the stool, on toilet paper, or dripping into the toilet. Very often an internal hemorrhoid may protrude through the anus outside the body, becoming irritated and painful. The condition is called prolapsed hemorrhoids. Then, you can gently push the hemorrhoids back through the anus and solve the problem. If the problem cannot be solved, then they may swell even more and become trapped outside of the anus.
If your hemorrhoids become entrapped, then you will need to see a doctor.

The external hemorrhoids symptoms may include painful swelling or a hard lump around the anus that happen when a blood clot forms. This condition is known as a thrombosed external hemorrhoid. The pain is usually worse with bowel movements or sometimes with sitting.
This too is a condition that may require a doctor's examination and treatment.

Prevention

Avoiding the causes you will prevent most cases of hemorrhoids, but this advice is sometimes hard to follow. Here are some practical hints to help:
1. If your main job activity is seated, always stand or walk during your breaks. Stand or walk at least 5 minutes every hour and try to shift frequently in your chair to avoid rectal pressure.
2. Always exhale as you strain or lift. Don't hold your breath.
3. Control coughing, diarrhoea and constipation with early treatment before hemorrhoids follow.
4. Remember: No reading or other relaxing activity while on the toilet. If bowel movements take longer than 3-5 minutes, something is wrong. Try to maintain good bowel habits and soften stools should be your highest priority.
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