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Hemorrhoids are abnormally swollen veins in the rectum and anus.
When these veins are irritated, they cause surrounding membranes
to swell, burn, itch, become painful, and even bleed.
Hemorrhoids bleed when the blood vessels rupture, such as from
straining during a bowel movement. Because bleeding can be a
sign of colon cancer or colon polyps, you should consult with
your doctor whenever you have bleeding from the rectum, blood on
your stools, or blood in the toilet after a bowel movement.
Hemorrhoids are a very common problem. Most men and women will
get them as they get older. Trauma to the anus and any type of
straining can make hemorrhoids worse.
Risk factors and causes in addition to constipation and
straining with bowel movements include constant sitting,
diarrhea, severe or chronic coughing, pregnancy and childbirth,
or heavy lifting.
Conservative measures are successful in alleviating symptoms for
most patients with hemorrhoidal disease:
Bleeding:
Clinical trials have demonstrated that adding fiber to the diet
through supplementation with psyllium or appropriate
commercially available fiber preparations may significantly
reduce bleeding episodes associated with hemorrhoidal disease.
Psyllium as well as methylcellulose adds bulk to stools, making
them softer and easier to pass.
Irritation and itching (pruritus):
Irritation and pruritus associated with hemorrhoids may be
treated by various measures including the following:
Warm sitz baths - During sitz baths, the rectal area is immersed
in warm water for approximately 10 to 15 minutes two to three
times daily. Sitz baths are available in most drugstores; in
addition, portable bowls are commercially available that allow
for their use in the workplace. The effectiveness of warm sitz
baths may be due in part to relaxation of the internal anal
sphincter.
Fiber supplementation may help to alleviate itching potentially
related to fecal soilage, since their bulking effect may reduce
leakage of rectal contents.
Application of various pain-relieving (analgesic) creams:
Creams and suppositories, particularly hydrocortisone, should
not be used for longer than one week unless directed by your
doctor, since they may result in certain side effects, such as
skin rash and inflammation (contact dermatitis) with
pain-relieving creams or skin wasting (atrophy) with steroid
creams.
Patients who continue to have symptoms despite the conservative
measures described above may be candidates for one of various
techniques developed to treat symptomatic hemorrhoids. This can
include rubber band ligation, sclerotherapy, cryotherapy, laser
coagulation or surgery.
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