Hemorrhoids

What are hemorrhoids?

Hemorrhoids are among the ailments which widely affect the general population regardless of gender. 8 out of 10 people come down with a form of it, yet the disease goes mostly neglected. Hemorrhoids are the varicose dilations of the hemorrhoidal veins situated in the upper and middle regions of the rectum.

Hemorrhoidal disease goes unnoticed due to the fact that it does not always have an influence on the general state of health of the individual. On the other hand it is very important to obtain a consult from a specialized proctologist should there appear any primary manifestations of the hemorrhoids. This is due to the fact that the disease may easily be misjudged as something more severe which can have a serious negative impact on the organism.

Categories of hemorrhoids

Hemorrhoids can be categorized based on the mechanism through which they appear, or based on their positioning, their evolution, or the state of the affliction.

Classifying hemorrhoids based on the mechanism through which they appear

There are 2 categories of hemorrhoids: primary hemorrhoids and secondary hemorrhoids (from other afflictions). Primary hemorrhoids represent the majority of cases, and secondary hemorrhoids mirror manifestations of other diseases, or they mask these illnesses (such as cirrhosis of the liver, presence of tumor formations in the pelvis, rectal cancer or colon cancer).

Hemorrhoids may also be hereditary or acquired.

Classifying hemorrhoids based on their positioning

Based on their positioning, hemorrhoids may be external or internal.

External hemorrhoids are formed through the dilation of the lower rectal venous plexus, whereas the internal hemorrhoids are formed from the superior rectal venous plexus. In certain rare cases interstitial hemorrhoids may also form when hemorrhoidal nodules situate themselves under the Hilton white line.

Classifying hemorrhoids based on their clinical evolution

The clinical evolution of the hemorrhoidal disease may occur as a long process without complications or it may appear through acute crises.

Chronic hemorrhoids have an oscillating evolution and manifest themselves through itching or the presence of a foreign body and the seepage of blood during the process of defecation.

Acute hemorrhoids (hemorrhoidal thrombosis) is a complication of the chronic process and is manifested through intense and pressing pain, edema and redness in the anal region, symptoms associated with fever and difficult defecation.

Chronic hemorrhoids have 4 stages, based on the way they are manifested and their severity.

The symptoms of hemorrhoidal disease

Anal itching and the sensation of anal-rectal difficulty are the primary symptoms of the presence of hemorrhoids.

Itching is localized in the area between the buttocks or at the edges of the anus, and is caused by the mucus, which irritates the skin, or by the different types of infections cause by microorganisms commonly associated with this disease. Itching may become so intense and persistent that it causes the irritation of the skin.

The sensation of anal-rectal difficulty is caused by the fact that the internal hemorrhoidal package manifests itself similarly to the presence of a foreign body. Continence becomes difficult, intestinal transit is disturbed and the loss of a few drops of blood is also possible together with the feeling of anal tension.

Symptoms may include superficial bleeding, the blood being of a bright red color. Such emissions may be erratic or even permanent and may cause anemia.

The prolapsed internal hemorrhoids or their surfacing outside of the anal canal may be a further symptom. In rare cases this may be a sign of spasms of the sphincter muscles. Blood flow may be restricted at the level of the strangled hemorrhoids. Such a strangulation and the prolapse of the hemorrhoids are severe afflictions that require specialized surgical intervention.

Causes and risk factors of hemorrhoidal disease

A person may suffer from hemorrhoids even if he/she leads a healthy life. Lifestyle choices and bad habits may thus serve as their cause through their negative influence on health conditions. Among these risk factors we may enumerate the following:

  • Constipation and frequent diarrhea
  • Excessive standing
  • Sedentary lifestyle
  • Intense and prolonged physical activity
  • Lifting weights
  • Low-fiber diets
  • Incorrect intestinal habits
  • Inadequate local hygiene, and localized irritation caused by spicy nutrition
  • Sitting for long periods
  • Being overweight and obesity
  • Other associated afflictions, such as cardiac insufficiency, cyrosis, pelvic tumor, hernia, genitourinary prolapse, spinal cord injury, prostate injury
  • Labor
  • Old age
  • Genetic heritage

Hemorrhoids can be prevented through a healthy lifestyle, a diet rich in fiber, which accelerates bowel movement, and through eating small amounts of food at a time. Preferably one should avoid drinking alcohol, coffee, and smoking, as these habits are risk factors which cause the onset of the affliction.

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