|
Hemorrhoid: Causes and Treatment
Hemorrhoids
are actually found in everyone and refer the clumps of tissue within the anal
canal that are composed of blood vessels and their surrounding tissue, made of
muscle and elastic fibers that supports them. This normal tissue becomes
enlarged in 4% of the population, usually in the 45 and older age group, but
people of all ages, even infants, can develop this condition. The
hemorrhoid
tissue has a rich supply of blood from arteries, which is oxygenated and bright
red, that is carried away from the tissue by veins after the oxygen is
depleted. Hemorrhoids are thought to be caused by not enough fiber in the diet,
and constipation, but there is little experimental supporting evidence.
However, pregnancy does cause hemorrhoidal tissue to enlarge. It is also
thought that as we age, hemorrhoidal tissue losses its muscle support and slides
down toward the anal canal.
When this
happens the tissue can enlarge and even protrude from the anal canal. The
tissue is tender and contact with intestinal contents will further inflame and
rupture it, resulting in bleeding and pain.
Hemorrhoids
are given a rating system that describes their severity, first degree is a
hemorrhoid that bleeds, but is not prolapsed.
Second-degree hemorrhoids are prolapsed but retract on their own (with or
without bleeding). Third-degree hemorrhoids are prolapsed and must be manually
pushed back in. Fourth-degree hemorrhoids are prolapsed and cannot be
pushed back in. They may contain blot clots and affect much of the lining of the
rectum.
The symptoms include the appearance bright red blood, together with anal itching
and pain and usually bring a patient into the doctors office. A diagnosis can
be made on the basis of these symptoms but a
colonoscopy
will probably be performed to see the internal involvement of the problem.
There are a number of treatments available, depending upon the degree of the
Hemorrhoid.
The first step in treating and preventing hemorrhoids is to increase dietary
fiber, by eating fresh and dried fruits, vegetables, grains, and cereals. It is
recommended that a diet should contain 20-30 grams per day of fiber, however
most Americans eat less than 15 grams daily. Supplemental fiber (psyllium,
methylcellulose, or calcium polycarbophil) can be taken to increase fiber
intake. Diarrhea can worsen the symptoms of
hemorrhoids and it must be controlled with anti-motility drugs.
There are many
over-the-counter medications for hemorrhoids that contain ingredients to reduce
the symptoms of hemorrhoids, such as local anesthetics like Benzocaine, benzyl
alcohol, Dibucaine, Dyclonine, Lidocaine, Pramoxine, or Tetracaine. Other
helpful ingredients are vasoconstrictors that reduce the size of blood vessels
become, which may reduce swelling of the surrounding tissue. They also reduce
pain and itching. Vasoconstrictors include: Ephedrine sulfate, epinephrine and
phenylephrine. These active ingredients are usually formulated together with a
protectant gel or cream that prevents irritation of the perianal area by forming
a physical barrier on the tissue. Aluminum hydroxide gel, glycerin, lanolin,
mineral oil calamine and cod liver oil are all types of protectants that are
commonly found in topical hemorrhoidal medications, along with
antiseptics which inhibit bacterial growth.
For cases that
do not respond to these types of formulation, a stronger form of
corticosteroids, which reduce inflammation and can relieve itching, can be
prescribed for short-term use.
More serious form of hemorrhoids, or resistant
cases can be treated by a physician, who can use a number of techniques such as
ligation or sampling, which close of the blood supply to the tissue. Surgery
can be performing, but few patients require this as most respond well to
treatment. |
.gif){kind=small}