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Some deepened knowledge about hemorrhoids

The swollen vein use to be soft initially. At the initial stage, hemorrhoids may not produce clear symptoms, and may remain undiscovered.

Itching is a common symptom from hemorrhoids.

The blood in the swollen veins can coagulate, giving a blood clot that clogs the vein and makes the hemorrhoid hard.

Inflamed veins can rupture and give bleeding. The blood from bleeding hemorrhoids is freshly red. Blood in stool or from the anus with other colours, usually originates higher up, and can be a symptom of a serious disease.

A ruptured hemorrhoid gives a sore that can persist for a shorter and longer time and give repeated bleeding.

When ruptured veins heal, they may leave behind permanent scars or residuals of the originally swollen vein.

The tissue around ruptured hemorrhoids is weakened, and will often have difficulty to heal. Sores and bleeding from hemorrhoids can there become a cronic condition.

1. Chronic constipation.

2. Chronic diarrhea with an excessive intestinal activity.

3. A diet with too little vegetable fibres so that the bowel lack stimuli to move the content effectively, and thereby gets overfilled.

4. A diet with too little fat so that the stool gets a hard consistancy.

5. A diet with too much fat, giving the stool a loose consistency that is difficult for the intestines to handle.

6. A habit of drinking too little water, giving a dry and hard stool.

7. A habit of excessive intake of fluid so that the intestines get overfilled and the stool  to loose to handle well.

8. Over-consume of coffee or tea.

9. A habit of heavy lifting or a work implying daily heavy lifting.

10. Inactivity and lack of exercise.

11. Straining during bowel movements.

12. Bad toilet habits, for example not going to the toilet when the need is felt, taking too little time at the toilet and pressing to get the stool out as quickly as possible.

13. A habit of excessive eating with constant overfilling of the stomach.

14. Food Allergies.

15. Pregnancy.

16. Aging.

17. Anal intercourse that is not done carefully.

Generally about treatment of hemorrhoids

What is the best remedy to cure hemorrhoids, depends upon the exact cause of the disease. Generally, a multimodal approach consisting of lifestyle changes, oral drugs and topical drugs work best. Here is a description of effective measures to cure hemorrhoids:

Curing and preventing of the recurrence of hemorrhoids will require relieving the pressure and straining caused by constipation and an excessive intestinal content. This is especially important to prevent the hemorrhoids from protruding. Dietary messures that work as a cure for hemorrhoids are:

- Consume of fiber rich food, such as whole corn cereals and bread, fruit and vegetables.

- Drinking ampy with water each day, and drinking to each meal.

- Having a right amount of fat in the diet, neither very much, nor very little. The fat should be from sources like olives and olive oil, rape oil, walnuts or walnut oil, fish or fish oil, sunseeds or sunseed oil, linen seeds or linen seed oil (flax oil) or other sources containing unsaturated fat. However, combine all these sources to get all the fat variants you need and to avoid overconsuming any fat variant.

- Having four medium sized meals each day and avoiding oversized meals.

- Chewing your food well.

- Do not over-consume coffee or tea, but some coffee or tea each day can stimulate the colon to work better.

- Protecting the tissue in and around the hemorrhoids so that it is not further injured

- Smoothing the rectum to let stool pass more easily.

- Killing bacteria in the rectal tissue causing infection in the hemorrhoids.

- Reducing inflammation in the rectal and anal tissue.

- Reducing pain and discomfort from the hemorrhoids.

- Stimulating the rectal and anal tissue to heal.

Common ingredients in these ointments are petroleum jelly and zink oxide which work protectively and lubricatingly. The ointment may contain hydrocortiosone to reduce inflammation. They may also contain local enestetics to reiieve the pain from hemorrhoids.

Some topical remedis to cure hemorrhoid contain small amounts of nitroglycerin. The substance make the blood vessels in the area relaxe and thereby helps blood flow away from the swallen areas.

Linen seeds soaked in water is a good means to alleviate constipation and to ease the passing of intestinal content through the colon and the rectum.

Supplements containing vegetable fibres can help the intestines to work more effectively, and thus rid the intestinal tract from excessive content and help cure constipation. This will in turn help cure hemorrhoids.

Doctors may suggest a bulk stool softener or a fiber supplement such as psyllium (Metamucil) or methylcellulose (Citrucel) to give the intestinal content a consistency favourable for moving it onwards, and to stimulate intestinal work.

Extracts of the bark from pine trees contain substances that stimulate tissue healing in the rectal zone and can be used to treat hemorrhoid. Pycnogenol is such an extract.

Supplements containing herbs or herbal extracts can help to reduce inflammation and to stimulate healing in the rectum and generally in the whole intestinal tract. Such a general stimulation is useful because tissue weakening seldome are confined only to the rectal region, but can affect larger portion of the intestines. Such supplements generally also contain ingredients that stimulates or moderates the motion and function of the intestines, and thereby help create a condition that favours tissue healing.

An oral medicine containing nonsteroid anti-inflammatory drugs (NSAIDs) is sometimes used to reduce inflammation, swelling and pain.

• Warm tub baths several times a day in plain, warm water for about 10 minutes can help in accute worsening of hemorrhoids.

• A small enema can help flush out content from the rectum and alleviate the burdon on the rectal tissue. This will allow the blood vessels to heal better. However, big enemas can increase the abdominal pressure and worsen the haemorrhoids. Therefore big enemas usually should not be used.
   

To stress down or learning some relaxing technique, for example medication or yoga exercises,  can be of help in curing hemorrhoids, if a stressful situation conribute to digestive problems and muscular tension in the anal region.

- Infrared coagulation. An instrument is used to direct ifrared irradiation to the haemorrhoids, thus warming them so that the blod inside the hemorrhoid coagulates. This will make the hemorrhoid loose the blood supply so that it dies.

- Electric coagulation. By this method electric current is sent through the hemorrhoid. The current warms the blood in the hemorrhoid so that it coagulates and the hemorrhoid dies.

- Rubber band ligation. A rubber band is placed around the base of the hemorrhoid inside the rectum. thus cutting off circulation, causing the  hemorrhoid to wither away in some days.

- Sclerotherapy. A chemical solution is injected around the blood vessel to shrink the hemmoroids.

- Stapled hemorrhoidiopexy. By this method one staples the tissue together under and around the hemorrhoid so that the hemorrhoid looses blood supply, dries out and falls off, and the tissue stapled together under the original hemorrhoid grows together without leaving a great sore before the healing is completed.

- Doppler guided trans-anal arterial ligation (THD). By this techique one finds out which arteries supply the hemorrhoid with blood by a device that measures the blood flow in the arteries inside the rectum, and then one closes these arteries by binding around them. Thus the hemorrhoid looses blood supply and shrinks.

Perianal absess: This is an infection in the area around the anus resultin in an absess. Swelling, pain and sometimes fever are symptoms. Most often the abcess is caused by infection in the anal glands located at the bottom of the anal crypts just inside the anal opening. Perianal absess is treated by cutting it open and draining out the content.

Levator ani syndrome: Levator ani syndrome gives episodes of rectal pain lastings somewhat 20 minutes or more (Proctalgia fugax), or a continous discomfort in the anal region. It consists of tension in the muscles around the anus, and may be caused by a chronic stress condition. Levator ani syndrom can be treated by hot baths or packs, nonsteroidal anti-inflammatory drugs, muscle relaxants, or massage of the levator muscle muscle or the anal area. Irritation from hemorrhoids may cause tension in the levator ani muscles and cause this syndrome.

Pruritus ani: Pruritus ani is lasting or frequent itching in the anal opening. It may be caused by leakage of stool or irritants comming to the anal area through the stool. This leakage can be caused by hemorrhoids.

A photographic illustration of hemorrhoids

The photographic  illustration beneath shows the placement and shape of internal hemorrhoids. The hemorrhoids are seen through an endoscope. The dark object in the middle is the endoscope going in through the anus. The tip of the endoscope is flexed towards the anal opening so that the hemorrhoids can be viewed. External hemorrhoids generally look the same as those in the picture, but are placed at the outside of the anal opening or prop out throug the anal opening.

The size of the hemorrhoids can vary very much and be much greater and more inflated than those viewed in this image. New hemorrhoids whithout any coagulated blood are soft, and there is a gradual development from nornal blood vessel tissue to ripe hemorrhoids. The hemorrhoids seen at the periphery are still developing and some of them are still difficult to separate visually from normal tissue.

Eventually blood coagulates inside the hemorrhoids. When blood coagulates in a hemorrhoid, it get gradually harder and can enlarge because blood do not pass through the vessel any more, but fill up. In the picture such hemorrhoids look bluish.

Often hemorrhoids get infected and inflamed and thereby get grossly swallen. This occurs usually in hemorrhoids with coagulated blood. When  At least one such swallen hemorrhoid is seen in the picture. It looks like a a big white object in this picture due to reflexes of light from the endoscope. It takes up much of the anal opening and makes the passage narrow.

Old thrombosed hemorrhoids   (those with coagulated blood) where the inflammation is over  will shrink again. Eventually the coagulated blood disappears and the hemorrhoid develops into protruding  objects consisting only of connective tissue. The blue object in the middle is probably a hemorrhoid in the process of shrinking again after an inflammation, and the stalked objects in the middle are old hemorrhoids where the coagulated blood has disappeared.

The hemorrhoids in the middle may equally be classified as external hemorrhoids, since hemorrhoids within the anal passage can prop out or remain inside according to pressure in the colon and rectum, according to tension in the muscles around the anus and according to the elasticity of firmness of the issues in the anal region.