Hemorrhoids are very common, affecting nearly half of people age 50 and over, but many people are too embarrassed to seek medical treatment for them. Dr. Malone, can you tell us about hemorrhoids?
Definitely, Major Spencer. Hemorrhoids are swollen or inflamed blood vessels around the anus and rectum. Swollen blood vessels near the anal opening are called external hemorrhoids. Internal hemorrhoids occur inside the rectum and above the anal opening.
Hemorrhoids may develop as a result of repeated straining to have a bowel movement, which often happens as a result of chronic constipation. Pregnancy and routinely lifting heavy weights can also increase the pressure inside the abdomen, which can lead to hemorrhoids.
Many people have hemorrhoids, but have no symptoms. When symptoms do occur, external hemorrhoids can cause pain, itching, pressure, and bleeding. The most common symptom of internal hemorrhoids is painless rectal bleeding, which is usually seen as bright red blood on the toilet paper or in the toilet bowl.
Most hemorrhoids resolve on their own or with simple treatments. Providers may recommend that people with hemorrhoids avoid straining, and they may suggest dietary changes, including high-fiber diet, and over-the-counter medications to treat constipation. Over-the-counter and prescription creams and suppositories are available to soothe symptoms associated with hemorrhoids.
In cases where hemorrhoids do not go away on their own, providers may recommend an alternative, definitive treatment based on size and type of the hemorrhoids. These treatments include:
- Rubber bands placed around the hemorrhoid, which forces it to clot and eventually form a scar
- Injection sclerotherapy, which involves a chemical injected directly into the hemorrhoid to make it clot
- Infrared coagulation, which uses heat to destroy the hemorrhoid, or
- Surgery to remove the affected blood vessels