Hemorrhoids

Many patients falsely attribute all rectal symptoms to hemorrhoids. Consequently, a precise understanding of this condition is important for proper and adequate treatment. I am surprised to discover that about 50% of the patients who come to my office for the treatment of hemorrhoids DON'T HAVE HEMORRHOIDS! There are other conditions, which mimic hemorrhoids, such as fissures, pruritis, fistulas, warts, abscesses and tumors. The treatments for these conditions are different; often the patient will improve with dietary changes, medications and proper anal care.

What are hemorrhoids?
Hemorrhoids are dilated veins in the anal canal. There are two types of hemorrhoids: internal and external.

Who gets them?
At least 90% of the general population suffers from symptoms referable to hemorrhoids at some time in their life. The problem can start at age 18 usually from poor dietary habits and frequently increase at age 30 except in pregnant and postpartum women and men who lift weights and strain at stools. The incidence apparently increases with age so that at least 50% of people over age 50 have some degree of hemorrhoid formation. Men seem to be affected more than women 40% to 60%.

What causes them?
The most common causes of hemorrhoids are:
1. Straining at stool because of constipation due to low fiber diet.
2. Anal irritation from diarrhea.
3. Anything that causes increased abdominal pressure can also cause hemorrhoids, such as physical exertion (e.g. weight lifting), pregnancy, and "holding in your stool" until you get to your "clean" toilet.
4. Sitting for long periods of time on the toilet (enjoying your reading material)

What are the symptoms?
The most common symptoms associated with hemorrhoids are:
1. Bright red bleeding.
2. A burning sensation at the anus.
3. Itching.
4. Throbbing or aching (sore) pain.

These symptoms are also associated with other anal disorders so a proper diagnosis is necessary.

What can I do about them?
The care of hemorrhoids can be divided into three categories: preventative, temporary relief, and definitive treatment.

 

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