Hemorrhoids are swelling that contains enlarged blood vessels. Hemorrhoids affected by hemorrhoids are inside or around the buttocks, ie inside the rectum or inside the anus. Most hemorrhoids are mild disease and do not even cause symptoms. If only there are symptoms of hemorrhoids, usually that often happens is:
- Bleeding after bowel movements. The color of the blood is bright red.
- There is mucus after defecation.
- The lump is hanging outside the anus. These lumps usually have to be pushed back inside after a bowel movement.
- Swelling, pain, and redness around the anus.
- Have itching around the anus.
Hemorrhoids or hemorrhoids are common diseases. At age 50, nearly half of adults suffer from itching, discomfort, and bleeding. This may indicate the appearance of a hemorrhoid.
Consult a Doctor
If symptoms do not improve, you should consult your doctor. Especially if you are bleeding or feeling sore. Hemorrhoid symptoms usually disappear by themselves. In addition, this condition can be cured with a simple treatment that can be purchased at a pharmacy without using a prescription.
Doctors can diagnose whether you have hemorrhoids by asking a medical history and also doing a physical exam. The doctor will also check your sewer. Some people are reluctant to see a doctor. You do not need to feel ashamed, all doctors are used to checking and treating hemorrhoids, because this is a very common disease.
Causes of Hemorrhoids Occurrence
The cause of hemorrhoids is actually still unclear. But, the disease is associated with an increase in blood pressure in blood vessels that reside in the anus and surrounding areas.
Increased blood pressure in the area of the anus and rectum can be caused for too long straining during bowel movements. Constipation is the main cause of people pushing. Constipation is usually a result of a lack of nutrients in the dietary fiber.
Some things that increase your risk of hemorrhoids:
- Often lifting heavy objects on a regular basis.
- Older age, which makes the body tissue support become increasingly weak.
- Persistent coughing or frequent vomiting.
- Have a family history of hemorrhoids.
- Often sitting for long.
- Is pregnant.
- Frequent sex through anal ( anal intercourse ).
Hemorrhoid symptoms can disappear after several days without treatment. Hemorrhoids that appear during pregnancy will disappear by itself after you give birth. But making lifestyle changes to reduce pain in the veins of the anus and surrounding areas is highly recommended. Lifestyle changes in question are:
- Drink lots of water. Reduce consumption of caffeine and alcoholic beverages.
- Increase fiber intake in food: fruits, vegetables, brown rice or brown rice, whole grains, nuts, and whole grains.
- Do not delay to defecate. Conversely, if you ignore the urge to defecate, can make the stool hard and dry to force us to push during a bowel movement.
- Exercise regularly: Can prevent constipation, lower blood pressure, and help you lose weight.
- Lose weight.
- Avoid drugs that cause constipation such as painkillers containing codeine.
To overcome the more severe hemoroid, can be used several types of treatment . One of them is by binding of hemorrhoids. This is a non-surgical process. The elastic band is fastened to the bottom of the hemoroid strongly. It aims to cut off blood flow. Hemorrhoids will fall for about a week. Surgery with general anesthesia is sometimes performed . This hemorrhoid operation aims to remove or shrink large hemorrhoids or external types.
Symptoms Of Hemorrhoids (Hemorrhoids)
Symptoms arising from hemorrhoids or hemorrhoids are generally mild. The symptoms can disappear by itself within a few days. Some people do not even realize they have hemorrhoids because they have no symptoms at all. Symptoms that often arise are:
- Bleeding after bowel movements without pain. Blood color will be bright red.
- The lumps hang outside the painful and sensitive anus. These lumps are usually pushed back into after a bowel movement.
- Dirt out by itself through the anus.
- Have itching or irritation, pain, redness and swelling around the anus.
- Mucosal or mucous discharge after defecation.
External hemorrhoids are the hemorrhoids that appear at the bottom of the anal canal, near the anal canal. In this area, the nerves to excite the pain quite a lot. This hemorrhoid feels itchy and can also bleed and clot under the skin. This raises a hard and painful lump.
Classification of Hemorrhoids
Hemorrhoids can be further classified depending on their size and severity:
- Level one: small swellings that appear inside the anal wall and are not visible outside the anus.
- The second level: bigger swelling that comes out of the anus when you defecate and re-enter it by yourself when it's finished defecating.
- Third level: one or more small bumps that hang from the anus and can be encouraged to reenter.
- The fourth level: big bumps that hang from the anus and can not be pushed back.
If you have severe symptoms of hemorrhoids, consult your doctor. Examination of rectal bleeding should be done when it occurs. This is so that doctors can know the possibility of more serious conditions.
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Causes Of Hemorrhoids
The true cause of hemorrhoids or hemorrhoids is still unclear. But in most cases, it is thought to be strongly associated with increased pressure in the bloodstream within or around the anus. This pressure causes the blood vessels in the buttocks to swell or become inflamed.
People at Risk of Hemorrhoids
Below are some conditions that can increase your risk of hemorrhoids or hemorrhoids.
- Continuous constipation disease due to dietary fiber deficiency.
- Obese or overweight.
- Have anal sex.
- Prolonged diarrhea .
- Family health history with hemorrhoids, makes you more at risk of suffering from hemorrhoids or hemorrhoids.
- Too often sit for long.
- Persistent cough and vomiting.
- Often lifting heavy loads.
- Pregnancy as a condition that can increase pressure on blood vessels in the pelvis. The blood vessels will dilate and the hemorrhoids will appear. Hemorrhoids will usually heal after you give birth.
- Growing age. As age gets older, the body support network gets weaker. This condition can increase the risk of exposure to hemorrhoids.
Diagnosis Of Hemorrhoids
Hemorrhoids or hemorrhoids can be easily diagnosed by a doctor by checking your back or anal canal for swelling of the blood vessels. If there is a hemorrhoids, the doctor will check the location, size, and proposed treatment plan based on the severity of the hemorrhoids or hemorrhoids suffered.
Some people are reluctant to see a doctor. You do not need to feel ashamed, all doctors are used to dealing with this common disease. You just need to tell the symptoms and the pain you feel. For example you are experiencing weight loss, changes in bowel pattern, or if the dirt becomes dark and sticky.
Digital Rectal Examination
When the exterior of the anus has been examined, the doctor may also have a digital rectal examination (DRE). This rectal examination is performed to check the condition of the lower bowel (rectum), whether there is growing mass or other abnormalities.
In this examination procedure, the doctor will wear gloves and use lubricant. The doctor uses his index finger to check for any abnormalities in the rectum. This check should not be painful, but you may feel a bit uncomfortable. Anal rectal examination in general only takes a few minutes.
Proctoscopy Procedure Procedure
Follow-up examination using a proctoscope may be required. Proctoscopy is an anal canal examination using special iron or plastic binoculars called proctoscopes. The anal canal is the last part of the rectum before the anus, which consists of a muscle ring that contracts and relaxes when it is not and will defecate. While the rectum is a muscular channel with a length of about 20 cm that connects the large intestine with the anus. Anus itself is a part of the body where the dirt, stomach contents and gas from the body.
With this procedure, the doctor can see the entire anal canal or the last part of the colon that is the rectum. It is possible that the doctor will take tissue samples from within the rectum to be examined in the laboratory. This tissue sampling is termed a biopsy.
After rectal examination or proktoscopy, doctors can know the type of hemorrhoid suffered at once size. Doctors will be very helpful if you know the size and type of hemorrhoids you have. With it doctors can determine the best hemorrhoids treatment.
Treatment Of Hemorrhoids
Hemorrhoids or hemorrhoids often disappear by themselves within a few days, but there are many treatments to relieve itching and discomfort. Makes a simple dietary change and does not hurt during a bowel movement, usually advised by a doctor as an initial treatment.
Sometimes a more invasive treatment is required. This treatment depends on the location of the hemorrhoids. Whether the hemorrhoids are above, below, or on the dentate line ( dentate line). The dentate line is the boundary line on the anal canal wall that separates the area that is able to feel the pain of an area that is unable to feel. Handling without surgery on the hemorrhoids will be very painful if the hemorrhoids grow at or below the dentate line. Because the nerves in that area can detect pain. If this happens, a hemorrhoid surgery will be recommended.
Changes in Diet and Self-Maintenance
If the hemorrhoids are caused by constipation , you should try to keep the stool soft and you can defecate regularly. The goal is that you do not push while defecating. To do that, you can increase your fiber intake in your diet. Some good sources of fiber are breads from whole grains, cereals, fruits, and vegetables.
You should also drink plenty of water and avoid consumption of caffeinated beverages such as tea, coffee and soda. Follow these suggestions as you go to the toilet:
- Tap slowly into the butt area instead of wiping it.
- After defecation, use soft tissues or use special baby tissue to clean the buttocks area. Do not wear dry and coarse textured toilet paper.
- Avoid straining during defecation, this habit can aggravate hemorrhoids.
Recommended Type of Treatment
An ointment that can be bought freely
A variety of creams, ointments, and suppositories are available at drug stores without the need for a prescription. Suppository is a type of medicine that is inserted directly into the anus. Such drugs can be used to relieve the swelling or discomfort felt by the patient.
Do not use any of the above medications for more than one week, unless the doctor advises. These products can cause side effects such as rashes and inflammation. All types of treatment should be combined with a good diet and keep introspective. There is no evidence of which treatment is more effective. Ask your doctor or pharmacist about products that work for you.
Do not forget to read the guidelines on each drug before using or consuming it. It is not advisable to use more than one drug product simultaneously.
Use of corticosteroid cream
If you have inflammation or inflammation inside or around the anus, your doctor will recommend the use of corticosteroid cream. Do not use this cream more than seven days in a row. This cream can make the skin around the anus thinning and worsen irritation.
Pain relief medication
Paracetamol Â as one of the painkillers, can help relieve pain due to hemorrhoids. Avoid painkillers like codeine. This drug can cause and worsen constipation.
Products containing local anesthetics may also be advised by doctors to treat hemorrhoids. For example a topical treatment that can be purchased directly, and should only be used for several days. Oles can make skin more sensitive. This drug can help some people who experience a very painful hemorrhoids. Ask your doctor before taking this medicine.
Use of laxatives or laxatives
If you have constipation, your doctor will give you a laxative or laxative prescription. This type of treatment will help smooth the process of defecation.
Handling of Hemoroid Without Surgery
If dietary changes and medication do not produce results, the doctor will refer to a specialist. The specialist can make sure you are suffering from hemorrhoids and suggest appropriate treatment.
If the hemorrhoids are found to be above the dentate line, non-surgical procedures such as binding or sclerotherapy will be recommended.
Binding of hemorrhoids
This binding involves an elastic strap fastened firmly on the base of the hemorrhoids to cut off the blood flow. Without blood flow, hemorrhoids will be released after a week of treatment.
This binding process is a daily procedure. This process does not require anesthesia and the patient can return to normal activities the next day. Discomfort and pain may appear for a day or two. Oral pain medication is effective enough to overcome this pain. If necessary, the doctor will prescribe a drug with a much stronger dose.
You may not realize when the hemoroid is released. Usually will be released when you defecate. If you notice any mucus or mucosa within seven days after the binding procedure, the hemorrhoids are removed. After binding, there will be a little blood on the toilet paper. That's normal, but there should be very little bleeding. If you have a lot of bright red blood or blood clots, go immediately to the nearest emergency department.
Tukak or wound may appear on the binding site. Tukak usually heal by itself without treatment. To know more, consult a doctor.
Injection of sclerotherapy
Treatment with the name sclerotherapy may be used as a substitute for binding of hemorrhoids. In the sclerotherapy process, chemical solutions are injected into the veins of the anus. This injection will relieve pain by making nerve endings become numbness at the injection site. This injection also makes the hemoroid tissue hardens and eventually formed a wound. After about one and a half months, the size of the hemorrhoids will be smaller or shrink.
After injection, avoid exhausting exercise throughout the day. You may feel temporary pain or slight bleeding. You should be able to resume normal activities, including work, a day after the injection of sclerotherapy.
Coagulation with infrared
Infrared coagulation is sometimes also used to treat hemorrhoids. In the process, a device emitting infrared light is used to burn the hemorrhoidal tissue. This step also serves to cut off blood flow.
In addition to infrared, the same procedure can also be done using an electric current. This method is better known as diathermy or electrotherapy for hemorrhoids.
Although most hemorrhoids can be treated with the method described above, there are 10 percent of all hemorrhoids patients who eventually have to undergo surgery.
Surgery will be advised if other treatments and treatments for hemorrhoids or hemorrhoids have been tried and unsuccessful. Surgery can also be performed if the hemorrhoids are not suitable for treatment without surgery. There are many surgical procedures for hemorrhoids.
Hemorrhoidectomy is a surgical removal of the hemorrhoids. Usually performed with general anesthesia. You will fall asleep and not feel pain during the rapture. Conventional hemorrhoidectomy involves a small opening of the anus. It serves to cut the hemorrhoids. You need seven days leave to recover.
Surgery will be performed on the tissue around the hemorrhoids. Blood vessels that swell in the hemorrhoids will be bound to prevent bleeding. After that, the hemorrhoids are removed. The area of operation may be sewn closed or left open. Medical gauze cloth is used to cover the wound.
You will feel pain and pain after surgery or even weeks afterwards. But this can be overcome with painkillers. Consult your doctor if the pain persists. The likelihood of hemorrhoids returning after hemorrhoidectomy is 5 percent. This figure is lower than for non-surgical hemorrhoid treatment.
To reduce the risk of hemorrhoid recurrence, increasing the intake of fiber in the diet is very important.
Hemoroid Artery Ligation
Hemorrhoid artery ligation is an operation to reduce blood flow to your hemorrhoids. Usually performed with general anesthesia. This procedure involves inserting a small ultrasound examiner into the anus. This tool produces high sound waves, these waves that help the surgeon find the location of blood vessels that swell in and around your anus. It is these blood vessels that supply blood to your hemorrhoids.
Each blood vessel is sutured so that blood flow to the hemoroid is cut off. This process makes the hemoroid shrink or shrink a few days afterwards. This suture procedure can also be done to reduce the hemorrhoids that hang outside the anus.
Hemorrhoid ligation is an alternative surgery that proves to be effective in addition to hemorrhoidectomy. Ligation of the hemorrhoid artery causes less pain than hemorrhoidectomy, so the satisfaction of patients undergoing this procedure is also higher. Most people who undergo ligation of the hemorrhoidal artery can return to their daily activities faster than those who undergo other surgical procedures in the treatment of hemorrhoids.
There is a small risk of bleeding and pain during defecation after this procedure, but these symptoms will improve within a few weeks.
Also known as stapling . This is an option other than conventional hemorrhoidectomy. This procedure is performed to deal with a hemoroid that hangs outside the anus. This step is done with general anesthesia, but this procedure is rarely performed because it has the risk of serious complications.
At the time of operation, part of the anorectum or the last part of the colon will be clamped or stapled. That way, the possibility of hemorrhoids to hang outside the anus becomes smaller. In addition, the blood supply to the hemorrhoids is also reduced. This results in hemorrhoid shrinkage.
Recovery time of this clamping procedure is faster than hemorrhoidectomy. You can also get back to work faster, which is about seven days after the operation. This procedure also tends to be less painful. But after this clamping, more patients had hemorrhoids that hung outside the anus when compared after the hemorrhoidectomy surgery.
There are few complications that can also occur after this operation, for example the appearance of fistulas in the female vagina. Fistula is a channel formed between the anus and vaginal opening. The other complications resulting from stapling procedures are perforations or holes in the rectum.
Other handling such as surgery with freezing and surgery using laser light are also available. Consult your doctor to know more about various ways of hemorrhoids treatment.
Risks That Can Come Up After Hemoroid Surgery
Complications can arise after hemorrhoids surgery, but the risk of the appearance of serious conditions is quite small. Here are some possible risks:
- Loss of control in defecating
- Fistula ani. Small ducts that appear between the anus and the skin surface, near the anus.
- Urine retention. Difficulty emptying the bladder.
- Stenosis or anal narrowing of the anus. The highest risk of stenosis is the hemorrhoids that are on the anal wall of the anal canal.
- Bleeding or removing blood clots during bowel movements. Usually occurs approximately seven days after surgery.
- Infection. This risks the appearance of an abscess or a pile of pus. You will be given antibiotics to reduce the risk of infection.
The above problems can be treated with medication or advanced surgery. Ask about the risks that may occur to the surgeon, before you choose to perform the surgery.
You should seek immediate medical attention immediately, if the following symptoms appear postoperatively:
- Pain worsens or swelling develops around the anus.
- Trouble in urination.
- Excessive bleeding.
- Fever .
Prevention Of Hemorrhoids
The best way to prevent hemorrhoids or hemorrhoids is to keep the stool soft and easily removed. To prevent and reduce the symptoms of hemorrhoids, here are some suggestions that can be done:
- Eat foods rich in fiber. Eat more fruits, vegetables, nuts, and seeds. By eating this type of food will soften the stool and increase the amount spent. Add fiber slowly to avoid problems with gas.
- Drink plenty of fluids. Drink six to eight glasses of water and also other beverages (non-alcoholic) every day. This is also to keep the stool soft.
- Consider taking fiber enhancement supplements. Many people still lack the recommended fiber intake in their diet. Some fiber-enhancing supplement products can keep the stool soft, but be sure to drink eight glasses a day if taking this supplement. Otherwise, supplements can lead to constipation or even worsen it.
- Do not overdo it. Pulling and holding your breath while trying to remove dirt creates greater pressure on the blood vessels in the lower rectum.
- Immediately defecate if you already want to. If you wait to defecate until the desire disappears, the stool can become dry and difficult to remove.
- Exercising. If too much standing or sitting, try to keep active to help prevent constipation and reduce pressure on blood vessels. Exercising also helps to lose overweight or obesity . This obesity contributes to the appearance of hemorrhoids.
- Avoid sitting too long. Sitting too long, especially in the toilet, can increase the pressure on the veins in the anus.
- Avoid lifting heavy objects. If you must, always exhale when lifting things. Do not hold your breath while lifting.
- If pregnant, sleep on your side. This position can lower the pressure on blood vessels in the pelvis and help prevent hemorrhoid enlarged.