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Hemorrhoids is basically a condition in which the veins around the anus and lower rectum become swollen and inflamed.

Hemorrhoids are classified either as being:

1. Internal - where the hemorrhoids occur inside the rectum. These are generally painless as there are no pain receptors in this region, and most people are unaware of their presence. They occasionally bleed when the veins rupture due to excessive straining or the passage of hard stools.

2. External - where they occur below the anal verge (where pain receptors are present). These tend to be visible and a lump may be felt. External hemorrhoids are prone to thrombosis (blot clot forms inside the pile). When this happens, sudden pain is experienced.

Hemorrhoids are also classified according to their degree of prolapse:

• Grade I - internal hemorrhoids, not prolapsed.

• Grade II - piles are pushed out (prolapsed) on straining, but spontaneously reduce.

• Grade III - piles prolapse on straining, and have to be pushed back manually.

• Grade IV - piles are prolapsed and cannot be manually reduced.

SYMPTOMS:

Bleeding is the earliest symptom. At first, it is minimal fresh bleeding, occurring during defaecation as a "splash in the pan", or seen on the toilet paper after wiping.

Prolapse is a much later symptom, progressing from Grade II to IV if the underlying cause is not managed. Prolapsed piles can become trapped outside the anal opening if the anal sphincter muscle goes into spasm. Should this happen, blood supply to the hemorrhoid, gets cut off and the pile becomes strangulated.

External hemorrhoids can cause irritation to the skin resulting in itching. As mentioned earlier, external piles can become thrombosed causing significant pain.

CAUSES:

In general, anything that causes frequent, sustained increase in pressure in the ano-rectal region, can cause hemorrhoids to develop. They include:

• Spending a long time sitting or squatting during defaecation.

• Excessive straining due to constipation.

• Pregnancy and childbirth.

• Obesity

• Portal Hypertension - causing increased back pressure to the rectal veins.

PREVENTION:

Ensure you drink sufficient fluids, take in more fibre, exercise and establish regular bowel movement habits, all to help prevent constipation. This is especially so during advanced pregnancy. Sometimes, medication may be required to ensure smooth passage of stools.

Do not spend too long sitting at the toilet bowl during defaecation. Be as efficient as possible.

There is some evidence which suggests that squatting commodes are better than the sitting ones in reducing or preventing hemorrhoids.

DIAGNOSIS:

Hemorrhoids can be diagnosed via a thorough physical examination by your doctor. External hemorrhoids may be clearly visible. Internal hemorrhoids require insertion of a proctoscope for visualization, as being soft, internal piles cannot be felt by an examining finger.

It is worth remembering that not all bleeding during defaecation is due to piles. It may be a sign of something more sinister, such as colon cancer, which may co-exist or exist independently of piles. Hence, your doctor may advise for you to have a colonoscope to exclude more serious conditions in your colon, if you have:

1. Signs and symptoms of a more sinister cause

2. Risk factors for colon cancer, such a a positive family history

3. You are above 50 years of age (or younger in high risk groups) presenting with rectal bleeding

TREATMENT:

Home Remedies

• Increase fluid and fibre intake to prevent constipation

• Warm Sitz baths, several times a day to soothe painful, inflammed external piles. Sit in a tub filled a few inches of warm water 3 times a day and after each bowel movement for at least 15 minutes. Thoroughly dry the skin after each session.

Medication

• To treat and prevent constipation

• Topical creams, ointments and suppositories to reduce inflammation and discomfort

• Oral medication to shrink the hemorrhoids

• Oral medication to manage pain and inflammation eg. Non-steroidal anti-inflammatory drugs

Surgical Treatment

• Thrombosed piles can be treated with a simple excision to bring quick relief.

• Rubber band ligation - tiny rubber bands are placed at the base of the internal pile to cut off its blood supply. The pile withers and falls off after a few days. This procedure is generally not painful (though may be a little uncomfortable) because it is placed in a region devoid of pain receptors.

• Injection (sclerotherapy) - chemicals are injected into the pile to cause it shrink. Also generally a painless procedure.

• Hemorrhoidectomy - surgical excision of the pile is recommended for severe hemorrhoids.

• Stapled hemorrhoidectomy - resection of soft tissue above the dentate line, thus disrupting blood flow to the hemorrhoid. Much less painful than traditional hemorrhoidectomy and has faster recovery time.

• Transanal Haemorrhoidal Dearterialisation (THD) - a precise, ultrasound-guided ligation of the blood vessels which supply the piles. Much less painful than traditional hemorrhoidectory with shorter downtime.

So, if you think you may have piles, do consult your doctor. Once he has excluded more serious conditions, he will be able to recommend the most appropriate treatment for you, depending on the nature and type of hemorrhoids you have.

hemorrhoidal suppositories - great video!

Hemorrhoids treatment

Medical

Drug treatments are to relieve pain (analgesics or anti-inflammatory), regulate the bowel (laxatives) to improve venous flow (veno-tonic drug called), to reduce swelling and calm the local inflammation (suppositories and creams), protect the lining of the anal canal (creams and suppositories).

There is currently only few scientific studies providing a formal assurance of effectiveness of these products.

Instrumentation therapy

Instrumental treatments are made during the consultation. They all aim to strengthen the support of internal hemorrhoids by creating a scar area on top of them. They do not remove the hemorrhoids.

The formation of a scar area is the creation of a minor burn to the wall by a chemical agent (MS), electrical (electrocoagulation), heat (photocoagulation) or by affixing a suction located at the top of the hemorrhoid (rubber tube).

These treatments are generally well tolerated because they are conducted on a non sensitive area of the anus.

The complications seen after these actions represent less than ten percent of patients: it is mostly pain and bleeding.

The effects are not immediately be felt and sometimes you have to repeat one to two times the sessions. The disappearance of signs involving more than two out of three during the first year after treatment. Nevertheless, the benefits tend to diminish with time.

Surgical treatment

Surgery for hemorrhoids is generally used three methods:

* A small intervention (called thrombectomy) can be performed under local anesthesia in consultation if necessary to remove an area external hemorrhoidal pain.

* A classic response (called hemorrhoidectomy type Milligan Morgan) is performed under general anesthesia when will remove the external and internal hemorrhoids.

Removal usually involves three areas wider (three packages), the wounds are left open or partially closed.

The consequences of intervention are usually painful for at least the first 10 days in eight out of ten.

The pain is more intense when the saddle. It often requires the use of powerful painkillers like morphine and nonsteroidal anti-inflammatory. The healing is slow. It was completed on average 4 to 6 weeks after surgery.

This act requires on average three to four weeks off work. The hospital stay varies greatly from one center to another (between one and five days) and one patient to another.

Complications are common: they concern a person in five. In the early period, it is temporary difficulties in bowel movements or urination, excessive bleeding that can occur sometimes several days after surgery. In the late period, there is a narrowing of the anus or scar problems (generally mild) to control gas or stool.

Hemorrhoids treatment

Medical

Drug treatments are to relieve pain (analgesics or anti-inflammatory), regulate the bowel (laxatives) to improve venous flow (veno-tonic drug called), to reduce swelling and calm the local inflammation (suppositories and creams), protect the lining of the anal canal (creams and suppositories).

There is currently only few scientific studies providing a formal assurance of effectiveness of these products.

Instrumentation therapy

Instrumental treatments are made during the consultation. They all aim to strengthen the support of internal hemorrhoids by creating a scar area on top of them. They do not remove the hemorrhoids.

The formation of a scar area is the creation of a minor burn to the wall by a chemical agent (MS), electrical (electrocoagulation), heat (photocoagulation) or by affixing a suction located at the top of the hemorrhoid (rubber tube).

These treatments are generally well tolerated because they are conducted on a non sensitive area of the anus.

The complications seen after these actions represent less than ten percent of patients: it is mostly pain and bleeding.

The effects are not immediately be felt and sometimes you have to repeat one to two times the sessions. The disappearance of signs involving more than two out of three during the first year after treatment. Nevertheless, the benefits tend to diminish with time.

Surgical treatment

Surgery for hemorrhoids is generally used three methods:

* A small intervention (called thrombectomy) can be performed under local anesthesia in consultation if necessary to remove an area external hemorrhoidal pain.

* A classic response (called hemorrhoidectomy type Milligan Morgan) is performed under general anesthesia when will remove the external and internal hemorrhoids.

Removal usually involves three areas wider (three packages), the wounds are left open or partially closed.

The consequences of intervention are usually painful for at least the first 10 days in eight out of ten.

The pain is more intense when the saddle. It often requires the use of powerful painkillers like morphine and nonsteroidal anti-inflammatory. The healing is slow. It was completed on average 4 to 6 weeks after surgery.

This act requires on average three to four weeks off work. The hospital stay varies greatly from one center to another (between one and five days) and one patient to another.

Complications are common: they concern a person in five. In the early period, it is temporary difficulties in bowel movements or urination, excessive bleeding that can occur sometimes several days after surgery. In the late period, there is a narrowing of the anus or scar problems (generally mild) to control gas or stool.

Hemorrhoids are one of the most common ailments people suffer from these days. A more common word being used by people to call this ailment is piles. They are usually located at the lower part of the digestive tract which is the lower rectum or surrounding the anus. This can be described as swelling of the veins in the wall of the rectal area. Swelling is caused by irritation, inflammation or itching in the anal canal. When this happens, it is important to find a cure as soon as possible. It is because with this condition, the longer you wait, the more it becomes worse. There are times when it progresses to a more severe case, in which it is more difficult to find a cure.

There are different treatments available for this common ailment. These various treatments range from natural, herbal, home and medical remedies. However, it is initially treated by stopping the symptoms. The most popular way of reducing the symptom is with the use of warm sitz baths. You will have to do this several times a day, using warm water for about 5-10 minutes. Another method worth mentioning is the use of ice. You can use ice packs in the swollen anal region to reduce the swelling. Other people also use petroleum jelly, creams such as cortisone and hemorrhoidal creams and suppositories to the area that is affected. When you are suffering from this condition, it is important to wear loose clothing and also cotton underwear.

Hemorrhoids are one of the most common ailments people suffer from these days. A more common word being used by people to call this ailment is piles. They are usually located at the lower part of the digestive tract which is the lower rectum or surrounding the anus. This can be described as swelling of the veins in the wall of the rectal area. Swelling is caused by irritation, inflammation or itching in the anal canal. When this happens, it is important to find a cure as soon as possible. It is because with this condition, the longer you wait, the more it becomes worse. There are times when it progresses to a more severe case, in which it is more difficult to find a cure.

There are different treatments available for this common ailment. These various treatments range from natural, herbal, home and medical remedies. However, it is initially treated by stopping the symptoms. The most popular way of reducing the symptom is with the use of warm sitz baths. You will have to do this several times a day, using warm water for about 5-10 minutes. Another method worth mentioning is the use of ice. You can use ice packs in the swollen anal region to reduce the swelling. Other people also use petroleum jelly, creams such as cortisone and hemorrhoidal creams and suppositories to the area that is affected. When you are suffering from this condition, it is important to wear loose clothing and also cotton underwear.

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Hemorrhoids is a common but uncomfortable problem that can be a warning sign of something more serious like colon cancer.