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About hemorrhoids

Origin of the word comes from greek “haimorrhoe”, meaning bleeding (haima = blood, rheo = flow).

Current surveys show that more that 50% of world population suffers from hemorrhoids.

What are hemorrhoids?

Vascular structures disease involving inflammation and the enlargement of the veins in the rectum. They are a kind of "varicose veins" that occur also on legs. Hemorrhoids often occur in anal-rectal area and it is a final 2-3 cm of large intestine.

Hemorrhoids are a natural part of human body. Hemorrhoids are vascular structures (tissues) which help with stool control and act as a sort of cushion composed of arteriovenous channels and connective tissue. Hemorrhoids develop when blood vessels are bulging. The blood flow hinders, the affected tissue stretches and starts bleeding. In next phase it can even emanate from the protruded area. 

Causes of hemorrhoids and factors increasing the risk of hemorrhoid formation

Causes of hemorrhoid formation can differ and are rather unknown. They form more often due to the genetic disposition, irregular bowel habits (diarrhea, constipation), sedentary job, pregnancy, frequent and long sitting (toilet, drivers, cyclist), high blood pressure,  insufficient rectal hygiene, unhealthy lifestyle, including obesity, smoking, bad eating habits, alcohol and coffee abuse, spicy food and recently also stress. 

Types of hemorrhoidal disease

Hemorrhoids are classified into several levels according to the degree of advancement:

  • 1st degree hemorrhoids: occasional bleeding, unpleasant feeling of pressure or pain in anal canal area.
  • 2nd degree hemorrhoids: prolapse upon bearing down. Prolapse spontaneously reduces.
  • 3rd degree hemorrhoids: prolapse upon bearing down but requires manual reduction.
  • 4th degree hemorrhoids: prolapsed cannot be manually reduced

Symptoms of hemorrhoids

Most typical hemorrhoid symptoms include itching, burning, pain in anal region, bright red, rectal bleeding during or following a bowel movement, feeling of incomplete evacuation, increased rectal mucus production, and in the last phase rectal prolapse. In a latter stadium these symptoms may occur simultaneously.

Management

So far, the most commonly known and applied method is pharmacological. Nevertheless it is not always recommended, as it often causes allergies, interacts with other medications and causes side effects. Different food supplements, ointments, suppositories and baths are applied to support the healing, however these methods have temporary therapeutic effect.

Advanced stage of 3rd and 4th degree of hemorrhoids demand surgical procedure.

History of surgical treatment of hemorrhoids is dated from late 19th century (Whitehead's hemorrhoidectomy). Surgical methods underwent many modifications, e.g. Milligan-Morgan method coming from 40ties of the last century.

All above mentioned methods are associated with postoperative complications including significant pain or protracted period of convalescence, often extending 4 weeks' time. Sometimes also uncontrolled stool evacuation and gas release occurred.

Contemporary medicine offers plenty considerable methods, e.g. Barron ligature, Radiofrequency coagulation, Laser therapy, or Hemorrhoidal arterial ligation HAL.

Current science also offers one of the most considerable method: cryotherapy (application of frost) has been found effective. It can be performed in intimate environment at home by the patients themselves. Device of small finger size is applied for approx. 10 minutes into rectum. It is simple to use and very effective. The applicator is called Anurex and was developed in United States.

Diagnosis and visiting doctor

Many people hesitate visiting the doctor or come already in advanced stadium of disease. The sooner you visit the doctor the better. Unfortunately blood in the stool can signalize even more serious diseases. Therefore rectal bleeding should not be underestimated and without further examination be claimed hemorrhoids. Every rectal bleeding must be examined by a doctor.