As an extremely common perianal disease, hemorrhoids do not discriminate between men and women, young and old, and are not so deadly as to form a fatal blow, but they can sometimes cause unspeakable pain.
Hemorrhoids, the incidence of which may be higher than anyone expected, with internal hemorrhoids topping the list, followed by mixed and external hemorrhoids. The prevalence of hemorrhoids increases with age, with the highest prevalence in the 35 to 59 age group.
1. Causes of Hemorrhoids
It is generally accepted that the main cause of hemorrhoids is the weakening of the anal cushion and support of the anal canal. The anal cushion is located under the mucosa at the end of the anal canal and rectum, and when it is working properly it helps the internal and external sphincters work together to ensure that the anal canal closes properly, thus maintaining the integrity of the anal structure.
There are many reasons that can disrupt the normal functioning of the anal cushion, and when the cushion is disrupted it becomes congested and hypertrophied or even relaxed and fractured, and functionally its elasticity continues to weaken, and over time the submucosal venous plexus of the rectum becomes varicose and deformed, and hemorrhoids are formed.
So what can disrupt the normal functioning of the anal cushion?
In fact, a variety of unhealthy habits and lifestyles can be the culprit in destroying the “jugular” environment, such as wrong bowel habits, a low-fiber diet, long-standing, sitting and squatting, etc.
In addition to the causes, the clinical manifestations of hemorrhoids can also be various, mainly including
Bleeding (bleeding during or after a bowel movement is the most common symptom, usually bright red blood covering the surface of the stool), anal swelling, hemorrhoids prolapsing from the anus, pain, itching, and discomfort at the anus, etc.
Having hemorrhoids not only affects the patient’s quality of life to a greater or lesser extent but if they repeatedly rupture and bleed they can lead to secondary anemia and in extreme cases can cause life-threatening hemorrhaging.
2. Classification and staging of hemorrhoids
Hemorrhoids can be divided into internal, external, and mixed hemorrhoids, using the dentate line as a boundary. Those located above the dentate line are called internal hemorrhoids.
According to the degree of prolapse, internal hemorrhoids are medically classified into four degrees, and the treatment plan will differ according to the degree of staging.
Those below the dentate line are called external hemorrhoids. When the veins of the external hemorrhoid are dilated, repeatedly inflamed, and prolapsed, it can cause discomfort such as localized itching and bleeding at the anus, and if a thrombus forms within external hemorrhoid, it can cause severe pain that is unbearable for normal people.
In addition to internal and external hemorrhoids, there is also a type of mixed hemorrhoid, which refers to the fusion of internal and external hemorrhoids at the same point to form hemorrhoid.
3. Treatment of Hemorrhoids
First of all, hemorrhoids that are not symptomatic do not require special treatment, and conservative treatment can alleviate the condition of most patients. However, when symptoms that affect the quality of life (such as blood in the stool, prolapsed hemorrhoids, pain, etc.) appear, it is time to seek medical attention.
The treatment of hemorrhoids is mainly to alleviate the symptoms, not to cure them, and surgery is generally not considered until they are very serious.
The first thing we can do to face hemorrhoids is to adjust our diet and lifestyle. Develop good eating habits, increase the amount of water you drink daily and the amount of dietary fiber in your food, eat more fruits and vegetables, eat less spicy and stimulating foods, avoid dry stools and constipation symptoms, stay focused when going to the bathroom, avoid forceful bowel movements, and use wet toilet paper to gently wipe afterward.
If you still can’t improve your hemorrhoids by changing your habits, you can take medication under the guidance of your doctor. When conservative treatment does not work, you can choose surgical treatment according to the actual situation.
There are many surgical options, and the specific choice depends on our specific assessment, but for those of us who choose surgical solutions, post-operative maintenance is also very important. Generally speaking, there are fewer complications after surgical hemorrhoidectomy, the most common being post-operative bleeding.
Even after surgery, the days afterward should not be taken lightly, as good defecation habits and a happy mood need to be maintained postoperatively, and a diet with increased fiber (e.g., wheat cellulose pellets) and fluid intake may improve bleeding symptoms and facilitate fecal excretion.
In general, there is no one-and-done treatment for hemorrhoids, but ultimately it is important to reduce the triggers that can lead to their development, eat more vegetables and fruits, eat less spicy food and drink more water, change positions more often, and develop good bowel habits.