What is Hemorrhoid?
Hemorrhoids are vascular structures in the anal canal. In their normal state, they are cushions that help with stool control. They become a disease when swollen or inflamed.
What is the sign and symptoms?
Hemorrhoid can be classified into internal and external hemorrhoid.
Internal hemorrhoid
Internal hemorrhoids are located within the rectum, superior to the dentate line (the boundary between the skin and mucous membrane). Internal hemorrhoids tend not to be painful but can cause bleeding on defecation. When they become severe, they can prolapse (protrude out of the anus) and be painful.
Symptoms :
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- Painless bleeding (bright red blood on toilet paper)
- Feeling of incomplete bowel movement
- Prolapse or protrusion of the hemorrhoid (in advanced cases)
External hemorrhoid
External hemorrhoids are located around the outside of the anus, beneath the skin. These hemorrhoids are typically more painful because they are closer to nerve endings. They can cause significant discomfort, especially during bowel movements.
Symptoms :
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- Itching or irritation around the anus
- Swelling and inflammation around the anal area
- Possible blood clots (thrombosis), leading to increased pain
What is the type of Internal Hemorrhoid?
Internal Hemorrhoid is classified into 4 grades as follow:
Grade I:
No prolapse, just prominent blood vessels
Grade II:
Prolapse upon bearing down, but spontaneous reduction
Grade III:
Prolapse upon bearing down requiring manual reduction
Grade IV:
Prolapse with inability to be manually reduced
What are the causes?
- Constipation
- Diarrhea
- Sitting on the toilet for long periods
- Pregnancy
- Lack of exercise
- Low-fiber diets
- Genetics
- Aging
How to prevent Hemorrhoid?
- Eating a high-fiber diet
- Drinking plenty of fluid
- Getting sufficient exercise
- Losing weight for overweight persons
- Avoid heavy lifting
- Avoid straining while attempting to defecate
- Avoid prolonged sitting on the toilet
What is the management for Hemorrhoid?
Hemorrhoid can be classified into internal and external hemorrhoid.
Non-surgery
- Rubber band ligation : It is a procedure in which elastic bands are applied onto internal hemorrhoid at least 1 cm above the pectinate line to cut off its blood supply. Within 5–7 days, the withered hemorrhoid falls off.
- Sclerotherapy : It involves the injection of a sclerosing agent, such as phenol, into the hemorrhoid. This causes the vein walls to collapse and the hemorrhoids to shrivel up.
- Cauterization : This procedure can be done using electrocautery, infrared radiation, laser surgery, or cryosurgery.
Surgery
- Excisional hemorrhoidectomy : A surgical excision of the hemorrhoid.
- Stapled hemorrhoidectomy : It involves the removal of much of the abnormally enlarged hemorrhoidal tissue, followed by a repositioning of the remaining hemorrhoidal tissue back to its normal anatomical position.
- Doppler-guided transanal hemorrhoidal dearterialization : A minimally invasive treatment using an ultrasound Doppler to accurately locate the arterial blood inflow. These arteries are then “tied off” and the prolapsed tissue is sutured back to its normal position.
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