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Hemorrhoids are veins in the rectum or anus that have become swollen and painful. Sometimes they go away by themselves, but in other cases they can cause lingering pain, itching, and bleeding. There are two types of hemorrhoids: those that are just inside the anus or lower rectum (internal) and those that are outside the opening to the anus (external). You can have both at the same time. Internal hemorrhoids usually don't cause pain or discomfort, while external hemorrhoids often do. However, internal hemorrhoids can protrude outside the anus (prolapsed hemorrhoid) and become painful. In some cases, a blot clot (thrombosis) may form in the vein, making the hemorrhoid more painful. Sometimes these hemorrhoids require surgery.
Signs and Symptoms
Symptoms of hemorrhoids include:
Hemorrhoids are a type of varicose vein that tends to occur as we get older; about 75% of Americans have hemorrhoids at some point. Being constipated or passing large, hard stools may contribute to developing hemorrhoids. In many cases, however, there is no obvious cause. In addition to age and constipation, other contributing factors include the following:
Your doctor can often diagnose external hemorrhoids by looking. For internal hemorrhoids, your doctor may do a rectal examination (inserting a gloved finger in the rectum). Your doctor may also use an anoscope or sigmoidoscope to look inside the anal canal.
It's important to avoid being constipated so that you don't strain when having a bowel movement, so adding more fiber (from fruits, vegetables, and whole grains) to your diet can be helpful. You may want to consider fiber supplements. Drink plenty of fluids (at least 8 glasses per day) and exercise regularly.
Medications can ease pain and discomfort while hemorrhoids heal. In addition, certain lifestyle measures can help you feel better and even prevent the recurrence of hemorrhoids.
Try the following approaches to reduce the pain and itching from hemorrhoids:
There are also dietary and other lifestyle steps you can take to prevent or treat constipation, which will help you avoid hemorrhoids.
See also: Constipation
Surgery and Other Procedures
For cases that don't respond to home treatments, your doctor may recommend other procedures:
Rubber band ligation -- A tiny rubber band is placed around an internal hemorrhoid, which cuts off the blood supply and causes the hemorrhoid to fall off.
Sclerotherapy -- Used to treat varicose veins, in this procedure a chemical solution is injected into the vein, which causes the hemorrhoid to collapse.
Doppler guided hemorrhoidal artery ligationi -- A relatively new procedure to help safely treat hemorrhoids.
Surgery -- If other options fail, your doctor may recommend a hemorrhoidectomy.
Nutrition and Dietary Supplements
The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, you should take herbs only under the supervision of a health care provider.
Witch hazel (Hamamelis virginiana), applied topically or used as a sitz bath, may temporarily shrink hemorrhoids and relive symptoms. Many "pads" used to treat hemorrhoids contain witch hazel.
Other herbs that are often suggested for hemorrhoids, but which lack scientific evidence of benefit, include:
Although few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of hemorrhoids based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type. A constitutional type is defined as a person's physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual. The following are examples of remedies from which a homeopath might select to treat someone with hemorrhoids.
Prognosis and Complications
Most treatments for hemorrhoids are very effective. Talk with your health care provider if the hemorrhoids are still a problem after 1 - 2 weeks. To prevent hemorrhoids from coming back, eat a high-fiber diet and drink plenty of fluids. This is especially important if you get hemorrhoids often.
The blood in the enlarged veins may form clots, and the tissue surrounding the hemorrhoids can die. Hemorrhoids with clots generally require surgical removal.
Severe bleeding may also occur, although it is unusual.
Alonso-Coello P, Guyatt G, Heels-Ansdell D, Johanson JF, Lopez-Yarto M, Mills E, Zhou Q. Laxatives for the treatment of hemorrhoids. Cochrane Database Syst Rev. 2005 Oct 19;(4):CD004649. Review.
Alonso-Coello P, Zhou Q, Martinez-Zapata MJ, Mills E, Heels-Ansdell D, Johanson JF, Guyatt G. Meta-analysis of flavonoids for the treatment of haemorrhoids. Br J Surg. 2006 Aug;93(8):909-20. Review.
Belcaro G, Cesarone MR, Errichi B, Di Renzo A, Grossi MG, Ricci A, Dugall M, Cornelli U, Cacchio M, Rohdewald P. Pycnogenol treatment of acute hemorrhoidal episodes. Phytother Res. 2010;24(3):438-44.
El Nakeeb A., et al. Rubber band ligation for 750 cases of symptomatic hemorrhoids out of 2200 cases. World J Gastroenterol. 2008;14(42):6525-30.
Eshghi F, Hosseinimehr SJ, Rahmani N, Khademloo M, Norozi MS, Hojati O. Effects of Aloe vera cream on posthemorrhoidectomy pain and wound healing: results of a randomized, blind, placebo-control study. J Altern Complement Med. 2010;16(6):647-50.
Feldman: Sleisenger & Foredtran's Gastrointestinal and Liver Disease, 8th ed. Philadelphia, PA: Saunders Elsevier Inc. 2008.
Ferri: Ferri's Clinical Advisor 2010, 1st ed. Philadelphia, PA: Mosby Elsevier Inc. 2009.
Gan T, Liu YD, Wang Y, Yang J. Traditional Chinese Medicine herbs for stopping bleeding from hemorrhoids. [Review] Cochrane Database Syst Rev. 2010;(10:CD006791.
Goldstein L. Ask the midwife. Prevention and care of hemorrhoids, including homeopathic remedies. Birth Gaz. 2000;16(2):13-16.
Ho Y, Tan M, Seow-Choen F. Micronized purified flavonidic fraction compared favorably with rubber band ligation and fiber alone in the management of bleeding hemorrhoids. Dis Colon Rectum. 2000;43:66-9.
Jiang ZM, Cao JD. The impact of micronized purified flavonoid fraction on the treatment of acute haemorrhoidal episodes. Curr Med Res Opin. 2006 Jun;22(6):1141-7.
Kaidar-Person O, Person B, Wexner S. Hemorrhoidal Disease: A Comprehensive Review. Journal of the American College of Surgeons. 2007;204(1).
Lyseng-Williamson KA, Perry CM. Micronised purified flavonoid fraction: a review of its use in chronic venous insufficiency, venous ulcers, and haemorrhoids. Drugs. 2003;63(1):71-100.
MacKay D. Hemorrhoids and varicose veins: a review of treatment options. Altern Med Rev. 2001;6(2):126-140.
Misra MC, Parshad R. Randomized clinical trial of micronized flavonoids in the early control of bleeding from acute internal haemorrhoids. Br J Surg. 2000;87(7):868-872.
Panpimanmas S, Sithipongsri S, Sukdanon C, Manmee C. Experimental comparative study of the efficacy and side effects of Cissus quadrangularis L. (Vitaceae) to Daflon (Servier) and placebo in the treatment of acute hemorrhoids. J Med Assoc Thai. 2010;93(12):1360-7.
Riss S, Weiser FA, Schwameis K, Mittlböck M, Stift A. Haemorrhoids, constipation and faecal incontinence: is there any relationship? Colorectal Dis. 2011;13(8):e227-33. doi: 10.1111/j.1463-1318.2011.02632.x.
Srivastava JK, Shankar E, Gupta S. Chamomile: A herbal medicine of the past with bright future. Mol Med Report. 2010;3(6):895-901.
Staroselsky A, Nava-Ocampo AA, Vohra S, Koren G. Hemorrhoids in pregnancy. Can Fam Physician. 2008;54(2):189-90.
Vazquez JC. Constipation, haemorrhoids, and heartburn in pregnancy. Clin Evid (Online). 2010; pii: 1411.
Review Date: 1/12/2012
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
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