Alternate Names: Rectal lump; Piles; Lump in the rectum
Causes and Risks:
Hemorrhoids are caused by increased pressure in the veins of the anus. The most common cause is straining during bowel movements. Constipation, prolonged sitting during bowel movements, and anal infection are contributing factors. Internal hemorrhoids occur near the beginning of the anal canal, and external hemorrhoids occur at the anal opening. Hemorrhoids may protrude outside the anus. They are very common, especially during pregnancy and after childbirth.The incidence is 2 out of 1000 people.
Prevention:
Avoiding contributing factors and eating a high fiber diet may help to prevent the development of hemorrhoids.
Symptoms:
Signs and Tests:
Rectal examination may be sufficient to diagnose hemorrhoids.
Tests that reveal hemorrhoids include:
Treatment:
Mild cases are controlled by drinking fluids, adhering to a high-fiber diet, and the use of stool bulking agents, such as metamucil. Corticosteroid creams (see corticosteroids - topical) help reduce pain and swelling. Procedural treatments consist of rubber band ligation, or surgical hemorrhoidectomy. These procedures are generally indicated in patients with severe hemmorrhoidal disease, with pain or bleeding, who have not responded to conservative therapy.
Prognosis:
Most treatments are effective, but recurrence is possible if a high-fiber diet with adequate fluids is not adhered to after treatment.
Complications:
Hemorrhoids can become thrombosed-the blood in the enlarged veins clots, and the tissue surrounding the hemorrhoids necroses (dies). Thrombosed hemorrhoids generally require surgical hemorrhoidectomy.
Iron deficiency anemia can result from prolonged loss of blood. Significant bleeding from hemorrhoids is unusual, however.
Call for an appointment with your health care provider if hemorrhoid symptoms do not improve with home treatment.