Hemorrhoids or piles are not a disease directly, but the colloquial term for hemorrhoidal disease. Hemorrhoids themselves, are natural swelling bodies in the anal area. If the hemorrhoids become engorged with blood and its drainage is disturbed, one speaks of hemorrhoidal disease. These knot-like bulges in the mucous membrane are accompanied by the typical symptoms, such as itching, burning pain, oozing and bleeding in the anal space.
What are hemorrhoids?
Schematic representation of the different degrees of disease in hemorrhoids. Click to enlarge. Even if most people do not know it, but everyone already has hemorrhoids. They are natural nodular swelling bodies on the anus and sphincter. Hemorrhoids are supplied with blood and provide a healthy and natural seal between the anus and the rectum. Thus, hemorrhoids are not a disease. However, they can become inflamed, which then provides the familiar painful symptoms. The well-known complaints by which hemorrhoids are known should rather be described medically as hemorrhoidal disease. In this case, especially the nodes are greatly enlarged and bulging and then provide painful reactions in the anal area.
Causes
The causes of hemorrhoidal disease can be wide-ranging. Often constipation, obesity and connective tissue weakness are considered the main causes. Especially when the anal region is under high pressure, as with strong pressing during defecation. Thus, hemorrhoids can be particularly common in chronic constipation. Other causes are also predominantly sedentary activities and pregnancy. Hemorrhoids also occur more frequently in old age, as the sphincter muscle is often more slack in mature people than in younger people.
Symptoms, complaints and signs
Complaints and symptoms are divided into four stages. However, not all complaints have to occur in every affected person in every stage, but it is equally possible that the symptoms relevant to one stage, occur in the other stages. Even slight burning and itching in the anal area must be taken seriously, as these symptoms are often the first signs of hemorrhoids. If not clarified and treated, pain will subsequently occur when sitting and during defecation. In rare cases, especially if the dilatation of the lower rectal veins is prolonged, bleeding from them may occur. While itching and burning are considered unpleasant, bleeding is very serious. If blood loss is prolonged, the general condition of the affected person deteriorates. It happens again and again that a hemorrhoidal nodule becomes infected. Then a coarse, bulging lump develops, which causes severe pain. In stage one, the affected person often does not yet know that he suffers from hemorrhoids, only sometimes notices some blood on the toilet paper. Burning, itching and oozing occur in stage two, stage three is characterized by a foreign body sensation and the feeling of not being able to empty the bowel completely. Stage Four is characterized by severe pain and major problems with bowel movements.
Disease progression
The course of enlarged hemorrhoids or hemorrhoidal disease can vary. It depends on whether the affected person seeks medical treatment, treats himself or simply does nothing and waits. In this case, it is more than advisable to consult a doctor regarding hemorrhoids in order to prevent unwanted complications and severe pain in time. In case of untreated hemorrhoids, sore spots occur mainly due to the friction of toilet paper. These areas may ooze and form eczema or ulcers known as anal fissures. In addition, widespread infections can spread, as there are many bacteria especially in the anal region. It is not uncommon for painful foci of pus and abscesses to develop in this context, which can then only be removed surgically. Likewise, when the hemorrhoids burst open, unpleasant bleeding can occur, which then requires medical treatment.
Complications
Hemorrhoids cause a variety of symptoms that can severely limit the patient’s daily life. In most cases, severe and burning pain occurs, which is also associated with itching.The skin is red in the affected areas and it is not uncommon for the patient to find blood in the stool. The bloody bowel movements may also cause panic attacks. Furthermore, ulcers and eczema can form, which are fraught with complications. Likewise, the affected person suffers from infections and inflammations in the anal region. Many people are ashamed of hemorrhoids, so inferiority complexes and lowered self-esteem may result. Treatment of hemorrhoids usually takes place without special complications and quickly leads to a positive course of the disease. Mainly ointments and creams are used. The affected person must also pay attention to a healthy lifestyle. In severe cases, surgical interventions have to be performed, but likewise there are no special complications. After treatment, most of the symptoms disappear again and the patient’s life expectancy is not reduced by hemorrhoids.
When should one go to the doctor?
Already when there is a suspicion that hemorrhoids may be present, a doctor should be consulted in the short term. The first symptoms such as burning or bleeding during bowel movements should be the trigger for a visit to the doctor. Many patients are reluctant to go to the doctor, especially when the symptoms are not yet particularly severe. However, treatment is particularly uncomplicated in the early stages of the disease. If the symptoms have progressed further, i.e. in addition to bleeding, itching and burning, hemorrhoids are already protruding from the anus, a specialist should be consulted immediately. Occasionally, hemorrhoids will retract on their own or can be pushed back by hand without major problems. However, the symptoms of hemorrhoids will continue to worsen rapidly without treatment. Although treatment is still successfully possible later in the course of the disease, the risk of incontinence also increases. In addition, the doctor will want to rule out other, much more serious conditions with similar symptoms – colon cancer, for example, should be mentioned. Patients can either contact their family doctor, who can make an initial assessment. However, it makes more sense to go directly to a specialist. These are either proctologists, who specialize in diseases of the rectum, or urologists or dermatologists.
Treatment and therapy
Treatment of hemorrhoids depends on the intensity of the symptoms. Nevertheless, medical help should always be sought. For milder symptoms, hemorrhoid ointments or hemorrhoid suppositories are mostly successful. In case of large or very complicated hemorrhoids, surgical intervention may also be considered. In addition to medical treatment through ointments and suppositories, dietary changes should be made to ensure softer bowel movements. Likewise, all foods that stimulate constipation should be avoided. These include chocolate, red wine and white flour products. Instead, attention should be paid to a diet rich in fiber. This can be achieved with plenty of raw vegetables (fruits and vegetables). Whole grain products are also good. In addition, one should move more. Sports, hiking or gardening are the best ways to do this. You should also drink a lot. If possible, 2 liters per day. In addition to diet, hygiene also plays a key role in the treatment and recovery from hemorrhoids. Baths with chamomile extracts are very suitable for this purpose. However, cosmetics and fragrances should be avoided, as they only irritate the anal region unnecessarily.
Prevention
As a rule, hemorrhoids can be well prevented by a balanced diet rich in fiber, as well as by sufficient exercise, since these measures themselves ensure healthy and regular bowel movements. In addition, the doctor can also prescribe hemorrhoid ointments and anti-inflammatory suppositories. In cases of large or very complicated hemorrhoids, surgical intervention may also be considered.
Follow-up care
There are some remedies for hemorrhoids that you can use to help yourself. To relieve the discomfort, hemorrhoid ointments, creams, suppositories, anal tampons or various home remedies such as sitz baths, among others, are applicable. The self-help measures relieve the discomfort, but this does not make the hemorrhoids go away. The cause of the occurrence of hemorrhoids must be determined so that they can be eliminated.In this case, the affected person should consult a doctor. He will then advise the person in detail and find ways and means to combat the hemorrhoids. The family doctor can prescribe all ointments and creams against hemorrhoids, but it is recommended to go to a proctologist. The proctologist is specialized in the treatment of diseases such as hemorrhoids and can provide specific help. To prevent the worsening of hemorrhoids, the affected person should make sure that he does not get constipated. To prevent this, a lot of exercise should be on the daily schedule. For example, going swimming or cycling is suitable for this purpose. A balanced diet is also important. Those affected should drink at least 1.5 to 2 liters of water a day and eat plenty of fruit and vegetables. Care should be taken to wear cotton underwear, as this is more tolerable for irritated skin.
This is what you can do yourself
In the case of hemorrhoids, the affected person can use various methods and techniques to alleviate the discomfort in everyday life or to prevent the disease in time. Basically, in case of problems as well as skin changes at the anus, the use of laxatives should be avoided. In case of itching, this should not be indulged in unabatedly, as otherwise open wounds and a spreading of germs may occur. Likewise, anal intercourse and the use of love toys for the anus should be avoided if possible, as this can also cause damage to the skin. Caution is advised when going to the toilet. Sufficient rest and a prior intake of [[fluid balance|fluids]] are helpful. Pressing and heavy squeezing during bowel movements should be avoided. Adequate exercise should be taken during the day. However, overloading and excessive straining should be avoided. The food consumed should be rich in vitamins and have a high fluid content. All foods that can cause constipation should be avoided. They include bananas, white bread, potatoes or rice. In the case of hemorrhoids, dietary fibers, such as cereals, whole grain bread, fruits and oatmeal are recommended. Wearing tight clothing in the intimate area should be avoided. Likewise, clothes with synthetic fibers should be exchanged for cotton ones. The abdomen should be adequately protected from exposure to cold.
