Some deepened knowledge about hemorrhoids

Here is some detailled knowledge about hemorrhoids and its symptoms, about factors leading to the development of hemorrhoids, about traditional hemorrhoid treatments and about althernative measures against this ailment. You will also find some diet and lifestyle advices that can help you to get rid of hemorrhoid, and then help you to avoid further outbreaks of hemorrhoids.

What are hemorrhoids and what symptoms do hemorrhoids give?

Hemorrhoids are swollen and blood-filled veins in the anus, around the anal opening or in the lower rectum.

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

The swollen veins may later become infected and inflamed, and this will produce further symptoms. Infected hemorrhoids are even more swollen, tenser and painful.

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.

Many anorectal problems, including fissures, fistulae, abscesses, or irritation and itching (pruritus ani), are not allways due to hemorrhoids.

Hemorrhoids are very seldom dangerous or life threatening. In many cases, hemorrhoidal symptoms will go away within a few days. but they may become persistent or often reappearing.


Different types of hemorrhoids

There are two main types of hemorrhoids, each causing somewhat different problems:

Internal Hemorrhoids residing in the rectal wall inside the rectal opening - Cause bright red blood in the stool and on the toilet paper as the most prominent symptom.

External Hemorrhoids- Cause itching, burning and detectable swelling as prominent symptoms.

An internal hemorrhoid may protrude through the anus outside the body, becoming irritated and painful, which is called as a protruding hemorrhoid.

The causes of hemorrhoids, how does hemorrhoids develop?

Hemorrhoids are often a result of increased pressure in the abdomen and down towards the region around the anus. A weakened connective tissue in blood vessels and the mucous membrans of the rectum and anus also contributes to hemorrhoid development. The third contributing factor is hardened stool that excerts a brutal impact on the rectal tissue.

The ultimate causes of hemorrhoids are therefore everything that causes increased pressure, weak tissue and hard stool. Hemorrhoids may therefore result from factors as:

- Chronic constipation.

- Chronic diarrhea with an excessive intestinal activity.

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

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

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

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

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

- Over-consume of coffee or tea.

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

- Inactivity and lack of exercise.

- Straining during bowel movements.

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

- Food Allergies.

- Pregnancy.

- Aging.

- Anal intercourse that is not done carefully.

Hemorrhoids are generally thought of as a strictly somatic disease. Howebever, the disease has clear psychological connections. A general condition of stress can disturbe the digestion. When a person is stressed, both the nervous system qnd the hormonal system will send spesific signals out to the body. The voluntary muscle apparatus will get signals to tense up. A muscle group getting such signals can be the muscles around the anus, teh levator ani-muslces. The muscular tension can increase the pressure in the anal opening and contribute to hemorrhoids.

The digestive system and many other internal organs will get signals to work less when a person is under psychological stress. This can give a over-filled digestive system and a higher pressure downwards towards the rectal area, and thus contribute to hemorrhoids or worsen hemorrhoids.

The pressure of the fetus in the abdomen during pregnancy, and the straining during childbearth cause the anal and rectal vessels to enlarge. For most women, however, hemorrhoids caused by pregnancy are a temporary problem.


Who gets hemorrhoids and how usual are hemorrhoids?

Studies have shown that 1 out of 3 people below the age of 50 will suffer from hemorrhoids- over 33%. 1 out of 2 people over the age of 50 will suffer from hemoroids. The normal case will last anywhere from a few days to many years.

How to prevent hemhorroids?

The best way to prevent hemorrhoids is to decrease pressure and straining.

This happens when the stool is kept soft so it passes easily, and when the bowel movement has the necessary vigour,

Exercise, including walking, increased fiber in the diet, and enough fluid intake is necessary to achieve decreaced pressure. Good sources of fiber are fruits, vegetables and whole grains. To empty the bowels as soon as possible after the urge occurs, also help get rid of prolonged pressure.

How are hemorrhoids diagnosed?

A thorough evaluation by the doctor is important by bleeding from the rectum or blood in the stool. Bleeding may also be a symptom of other digestive diseases, including colorectal cancer.

The doctor will examine the anus and rectum to look for swollen blood vessels that indicate hemorrhoids and will also perform a digital rectal exam with a gloved, lubricated finger to feel for abnormalities.

The rectum may be examined closer with an anoscope, a hollow, lighted tube useful for viewing internal hemorrhoids, or an optical device, proctoscope, useful for more completely examining the entire rectum.

If other causes of gastrointestinal bleeding is suspected, the doctor may examine the rectum and lower colon (sigmoid) with sigmoidoscopy or the entire colon with colonoscopy. Sigmoidoscopy and colonoscopy are diagnostic procedures by the use of lighted, flexible tubes inserted through the rectum, furnished with bundles of optical fiber to carry the internal picture to the doctors eye.


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:


Treatment of hemorrhoids by adjusting the diet

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.


Treatment of hemorrhoids with locally applied medicines

Creams or ointments to be smeared around and in the rectal opening or be placed into the rectum can be of great help. These medicines can consist of purely natural ingredients or also contain syntetic pharmacological effectors. The purpose of these topical drugs are:

- 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. Also suppositories with much of the same ingredients can be used with the same purposes.

In an acute situation with stuffed content in the anus one can use suppositories or small enema ampoules that stimulate the colon to contract, and thus help the colon and rectum get rid of excessive or stuffed content. This alleviates the pressure on the rectal tissue and make it easier for the tissue and vessels to heal from hemorrhoids. However, the contraction caused by suppositories and enemas are often so strong that the pressure on the hemorrhoids is greatly increased during the contractions. Using suppositories and enemas frequently can therefore worsen the hemorrhoids.


Oral treatment of hemorrhoids

Oral treatment of hemorrhoids can have the aim of treating causal conditions as for example cure constipation and ease the passing of intestinal content and stool. Oral medicines can also aim at reducing inflammation and stimulating the tissue in the rectal area to heal.

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.

Physiological treatments of hemorrhoids

Hemorrhoids can also be alleviated by certain physical treatment metods:

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.


Psychological treatments of hemorrhoids

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.


The importance of exercise


Daily physical exercise will stimulate the digestive system to work mor efficiently. This will hinder teh intestines to be over-filled and relieve pressure towards the rectal area. Regular physical exercise can help prevent hemorrhoids and help cure hemorrhoids.


Surgical methods to treat hemorrhoids

Sometimes hemorrhoids must be treated endoscopically or surgically to shrink and destroy the hemorrhoidal tissue. The doctor will perform the procedure during an office or hospital visit.

Usable surgical methods arenomerous. A problem with surgical methods is the sore surface left after the surgery. This sore gives pain and complication during bowel movements for some. There is a continual strive to find new surgical methods that reduces that complication as much as possible.

- 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.

- Hemorrhoidectomy. Serious internal or external hemorrhoids may require removal by cutting the hemmorrhoids out surgically.

(The word hemorrhoid is often misspelled. Variants found in the net are: hemorrids, hemmorids, hemorhoids, hemmorhoids, hemoroids, hemmoroids, hemhoroids, hemhorroids, hemorroids)


About some conditions that may be associated with hemorrhoids

Some common conditions may be caused by hemorrhoids, exist along with hemorrhoids or cause hemorrhoids. Some of these are:

Anal fissures: Anal fissures are longitudinal tears in the anal opening. They may result as a consequence of hemoorhoids that have lasted long and have effected changes in the anal tissue. usually they occur in the midline in the front or back side of the anal opening. Fissures located otherwise can be a symptoms of Chron's disease. Anal fissure can be treated with a diet regulating the digestion. 1 percent hydrocortisone cream may help. Also supplemets that are primarily ment to treat hemorrhoids may help for anal fissures.

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.




Internal hemorrhoids seen from the inside through a colonoscope with bent tip (A free picture form wikipedia.org)


About colon cleansing

A colon distended by old waste and gas production  will effect a pressure upon all the organs in the abdomen and all pelvic organs. This will to some extend disturbe the sirculation of blood and lymphe to and have a disturbing effect on all inner organs. This disturbing effect can even reach the heart and lungs. Cleaning out the colon may therefore have a positive effect on all inner organs, and also benefit the potence and sexual abilities.





(An enema device for colon cleansing (A free picture from wikipedia.org)

Colon cleansing have the aim of flushing out all or most of the content of the colon. This can be done by many enamas after each other using a simple enama device, but a more advanced irrigation set is practical. The enema solution should  contain salts so that the salt concentration is the same as in human blood to avoid the body fluids to be dangerously diluted by osmosis.