The wall of the gut contains a network of blood vessels – arteries that supply it with fresh oxygen-rich blood and veins that carry away blood containing wastes and carbon dioxide. Sometimes the blood vessels become swollen particularly in the lowest parts of the gut – the wall of the rectum and anus. This is known as a hemorrhoids or commonly as piles. It tends to cause significant discomfort and even pain at times thereby affecting normal bowel habit. Hemorrhoids are more common in a person after the age of 45 years, with the prevalence increasing as a person gets older. It is more frequently seen in the elderly who tend to suffer with bowel conditions such as constipation. It is estimated that more than half of all older adults either have hemorrhoids or experience the first symptoms of hemorrhoids even though the condition may not develop fully.
Causes of hemorrhoids
Hemorrhoids arises as a result of excessive pressure on the wall of the bowel which causes the veins to stretch. Eventually these veins become distended and swell. This usually results from long-term conditions such as :
- Constipation or diarrhea
Hemorrhoids can persist for years or even decades without causing significant symptoms to compel a person to seek medical attention. In most cases it is a matter of straining during bowel movements and sitting on the toilet for long periods of time that the eventually leads to hemorrhoids. This is further complicated with age which leads to weakening of the wall of the vein. It is more likely to occur in a person with one or more of the risk factors mentioned above.
Symptoms of hemorrhoids
There are two types of hemorrhoids – internal and external. Simply, internal hemorrhoids occur in the rectum and external hemorrhoids occur in the anal canal which is slightly lower down. There may be a slight variation in symptoms between internal and external hemorrhoids. Since the internal hemorrhoids do not always cause as overt symptoms as external hemorrhoids, it is sometimes must buy patients which ultimately delays them from seeking treatment.
The common symptoms includes :
- Bleeding during and after bowel movements most often noticed when wiping.
- Itching and discomfort of the anus.
- Pain and burning in the anus.
- Anal leakage where fluid and specks of feces soil the underwear.
- Swelling and painful lumps in the anal region.
External hemorrhoids lie just under the skin around the anus whereas internal hemorrhoids are higher up in the rectum. In severe cases, the swollen veins of internal hemorrhoids can protrude through the anus.
Although a mild case of hemorrhoids can be well managed without medical treatment, it is advisable that every person suffering with hemorrhoids seeks medical advice. This is especially relevant for the elderly because some of the symptoms of hemorrhoids can be attributed to colorectal cancer which is more likely to occur with advancing age.
Treatment of hemorrhoids can be either medical or surgical and involves conservative measures as well. Medical treatment involves the use of ointments, suppositories and other topical applications which help to relieve the symptoms of hemorrhoids. At the same time conservative measures need to be instituted such as :
- Drink plenty of water to help with bowel movements and soften the stool.
- High fiber falls and fiber supplements for easier bowel movements.
- Avoid sitting on the toilet for too long and straining to pass stool.
- Exercise and weight loss.
Surgical measures are necessary for hemorrhoids that do not respond to the measures above. Some of these procedures are minor and aimed at shrinking the veins. Other major procedures may remove the vein or shrink the vein with more aggressive methods. Although these procedures are relatively safe and have little complications, each individual case has to be assessed particularly with the elderly who may have various other underlying conditions that can lead to post-operative complications.
Last Updated: January 11th, 2012 by