Hemorrhoids are inflammations that form in the veins that are located along the rectum as well as in the anus. Hemorrhoids are also commonly known under the popular designation of “almorranas.” Visually, hemorrhoids are small pads that carry submucosal tissue that contain the venules and superficial arterioles of the space occupied by the anus.
Why do Hemorrhoids Arise?
Hemorrhoids arise for different reasons, although they are normally due to the effort made when defecating. The following causes such as those originating from hemorrhoids can be noted.
- Effort at the time of defecating.
- Hemorrhoids produced by a long time of constipation. Being constipated requires a greater effort when defecating, and that effort is suffered by the veins of the anal canal at the time of dilation, having problems when returning to its original and natural state.
- The habit of sitting for long periods of time.
- Infections located in the anal area.
- Diseases that present with hemorrhoids as a symptom, (Example: Hepatic cirrhosis).
- A poor diet can not only produce a principle of hemorrhoids but also aggravate them by the intake of certain foods that we will see later.
- Bad habits when defecating. It tends to spend more time than it should be sitting in the toilet bowl (normally we take magazines, newspapers, books, mobile phone, etc.) and this favors the appearance of the piles and the complication of these once they appear.
- It has also been proven that there is an inheritance burden in the appearance of the piles. It is thought that there may be a predisposition to suffer from such problems.
- It is well known that women tend to suffer from hemorrhoids during pregnancy. The natural tendency is that they disappear after delivery.
- Loading excess weight can also be one of the causes.
Because of their location, hemorrhoids or piles are usually classified into 2 large groups:
- Internal hemorrhoids: They are located within the anal area, at the point where the rectum begins.
- External hemorrhoids: Its location is right in the canal hole, and in good numbers of cases it usually extends outward.
What are the Main Symptoms?
The symptom that refers to the greatest number of patients, and for which this problem is known is pain located around the area of the anus.
“Pain that is usually accompanied by the presence of bright red blood between the stool, as well as in the toilet”.
In addition to pain and blood, the presence of inflamed veins around the anus show the presence of hemorrhoids.
What Treatments are Available for Hemorrhoids?
Much has been written about hemorrhoid treatment, without there being a unique solution to this problem. Below we review the different solutions indicated in this regard. Fundamentally, two types of hemorrhoid treatment can be contemplated: surgical and non-surgical treatments that include the full range of therapies and natural remedies that we will see below.
Non-Surgical and Natural Treatments:
- Diarrhea: Try to control the presence of diarrhea, and in case of appearance extinguish them in the shortest possible time. The acidity of the stool in diarrhea contributes to the worsening of the general state of hemorrhoids.
- Anal hygiene: Maintain a careful hygiene around the anus area.
- Treat the anal area carefully: Never rub or scratch this area, in this way we avoid hurting it and the possible appearance of infections is being prevented.
- Constipation: It is essential to correct the appearance of possible constipation, so that the rectum and anus are not forced when making bowel movements. A higher intake of fiber, as well as vegetables and fruits will help fight constipation effectively.
- Sitz baths: Apply, after defecating, small sitz baths with warm water for approximately fifteen minutes. After the bath wash the area with cold water. It is very important not to apply soap or bath gels.
- Avoid efforts: The most obvious solution of all is to try to avoid any effort when defecating.
- Toilet paper: Avoid using toilet paper, regardless of its softness. Whenever possible use the bidet for cleaning and when drying the area, do it carefully and never rubbing.
- Ice: Apply ice, never directly on the affected area, in a cloth or cloth for fifteen minutes once or twice a day. It will help reduce inflammation in the area.
- Defecation time: Try to reduce it to the minimum possible. We usually talk about the five minutes as the limit figure or cap to be sitting defecating.
- Creams: There are products that need no prescription and can be used in the treatment of hemorrhoids. We can find creams to reduce irritation, inflammation, itching and pain. In this case it is important to take into account the conditions of use of the product in question, since some of them cannot be used when hemorrhoids are bleeding. On the other hand, as we always indicated, it is very important to consult all possible treatment with our doctor
The majority of patients with grades I, II and III of hemorrhoidal disease in which medical treatment fails can be treated by outpatient treatments such as elastic bands, sclerotherapy and infrared coagulation. The hemorrhoidal band is the most effective option.
The objectives of outpatient treatment are 3:
- decrease vascularity
- reduce redundant tissue
- increase hemorrhoidal fixation to the rectal wall to minimize prolapse
These procedures are tolerated relatively well, causing minimal discomfort and pain. However, patients should understand that there is a recurrence rate (hemorrhoids may return) that is variable, so repeated applications may be necessary.
Rubber Band Ligature: Rubber band ligation is frequently used and is effective for treating symptomatic internal hemorrhoids. However, the risk of complications, although low, and pain tend to be greater than with other treatment modalities. The most common complications are anorectal pain, rectal bleeding, thrombosed external hemorrhoids and vasovagal symptoms, which occurs between 1% and 3% of patients. In patients taking anticoagulant products, this procedure is contraindicated due to excessive bleeding after performing the procedure.
Sclerotherapy: It is done by injecting 3 to 5 ml of a sclerosant into the internal hemorrhoid. It is a relatively simple procedure that can be used for internal bleeding and small hemorrhoids. The success rates are between 75% and 89% for hemorrhoids grade I to III. Unfortunately, longer-term follow-up shows higher recurrence rates than with other procedures. This approach may be attractive to patients who have a tendency to bleed, such as those taking platelet or anticoagulant antiplatelet products. Complications are rare.
Infrared Coagulation: Infrared coagulation is the direct application of infrared waves that results in necrosis of the proteins within the hemorrhoid. It is used primarily for grade I and II hemorrhoids.
Surgical Treatments: It should be noted that the surgical means of hemorrhoid treatment should be used as long as all the habits described within the non-surgical treatment have been put into practice. When performing a surgical intervention you can opt for more or less invasive methods, the choice will be determined by the state in which the affected area is located. Among the less invasive treatments, the following can be highlighted:
- Cryotherapy: The cryotherapy is based on the freezing of the area affected by hemorrhoids.
- Laser photocoagulation: The laser technique is used to burn hemorrhoids.
- Photocoagulation performed with infrared rays: Similar to the prior art, but based on the use of infrared.
- Sclerotherapy: It consists of injecting a substance specially formulated to destroy the hemorrhoidal tissue.
- Banding: Banding is also known as “Ligature performed through hemorrhoidal bands.” Basically it consists of placing a rubber around the homorids so that it cuts the circulation to be small pretuberances. In this way the tissue undergoes a necrosis, so the hemorrhoid disappears.
For this type of intervention, both a general anesthesia and an anesthesia of the specific area to be operated can be used. Hemorrhoidectomy is the type of surgery that is most commonly used to remove swollen veins. In this case, there are two types of basic procedures: open and closed intervention. The open intervention involves removing the hemorrhoids with an electric scalpel and leaving the wound open so that it can heal on its own. The closed intervention, on the other hand, consists in removing the tissue affected by hemorrhoids, leaving the area closed. In the case of invasive treatments, they are used for hemorrhoids of level 3 and / or 4. Most patients with thrombosed external hemorrhoids benefit from surgical excision within 72 hours of the onset of symptoms. Strong grade of recommendation based on evidence of poor quality. Although most patients treated conservatively will experience a final resolution of their symptoms, excision of thrombosed external hemorrhoids results in faster resolution of symptoms, lower incidence of recurrences and longer remission intervals. Most excisions can be done in the outpatient setting, but others may need more extensive surgical intervention in the operating room.
In short, whenever possible, we recommend using natural remedies for the treatment of hemorrhoids, due in part to the amount of side effects and complications that accompany the most aggressive methods.
One of the most important factors when it comes to coping with hemorrhoids is to take maximum care of our diet. In fact, it is a crucial factor that will have an impact on any other remedy or treatment that we can implement. In fact, problems such as constipation can make the state of our hemorrhoids worse. The basis of an adapted diet is to increase all those foods rich in fiber. Fiber has a very positive action when it comes to preventing and improving constipation. By its very nature and composition, the fiber manages to soften the stool, so when defecating it is not necessary to make a greater effort thus contributing to affect the area in which we suffer from piles. Among the foods rich in fiber can be mentioned legumes (beans, peas, lentils, etc.), fruits and vegetables. While these foods are recommended for our diet, there are others that we should avoid at all costs. Basically, they are the following.
- Coffee and alcoholic beverages: Due to their vasoconstrictor characteristics it is advisable to avoid the consumption of these substances.
- Spicy foods: The intake of this type of food will help increase the sensation of pain in the affected area. Also avoid spicy sauces and derivatives with the presence of spices and pepper.
- Refined sugars: Despite the general upward tendency to consume refined sugar, the organism does not do any good with the intake of these types of sugars. Given its low fiber contribution, constipation is favored. Similarly, we point here foods such as sweets and candies.
- Cereals (not whole grains) : This type of food is already processed, and in the process of elaboration the majority of the factory contribution has been lost, so its value in this sense is certainly scarce.
Dietary changes consisting of adequate fluid and fiber consumption is the main non-interventionist, first-line therapy for patients with symptomatic hemorrhoids. This is a strong recommendation, based on evidence of moderate quality. Constipation and impaired bowel habits can play a significant role in many patients with symptomatic hemorrhoids. For grades III and IV, more aggressive treatments may be needed as an operation, but for less severe or advanced cases the increase in dietary fiber intake and fluid intake has been shown to improve symptoms of medium to moderate prolapse. and bleeding. Patients should also be advised to maintain proper bowel habits, to avoid bleeding and prolapse.
The Importance of Hygiene:
Hygiene takes on a special role in the case of almorranas. It is crucial to maintain an optimal state of health in the affected area. As far as possible, it is advisable to stop using traditional toilet paper and find other more suitable solutions. Basically, two methods for cleaning after defecation can be recommended:
- Use wet toilet paper: There are a large number of solutions on the market, from wet toilet paper to baby wipes. It is important not to rub, but carefully clean the affected area, making sure there are no remains.
- Water baths: If we are at home, another option is to wash directly with water (in the traditional way). It is more than advisable that we only use water and not soap, or bath gels, as we could irritate the skin.
Home Remedies for Hemorrhoids:
There are many home remedies for hemorrhoids that are commonly accepted from tradition. Although from here we cannot advise any of them explicitly, we will then inform you:
It is said that the regular intake of cayenne pepper favors the elasticity of the veins of the anus, thus recovering its natural state. To put it simply, pepper “deflates” the affected veins. The home remedy is simple, take a teaspoon of cayenne in a glass of water every morning until you notice improvement.
Garlic and its Antibacterial Strength:
The antibacterial force of garlic is advised to prevent possible infections in the anal canal. As is known, a possible complication of hemorrhoids are infections, which is why we used to emphasize proper cleaning after each bowel movement. Garlic fights the secretions of the state of almorranas.
Cold Water Baths:
Cold water baths is the most commonly used natural treatment for hemorrhoids, since the temperature of the water acts as an analgesic. They can perform two or three baths a day, as they are especially beneficial in the case of external piles.
Tea Tree Oil Bath:
We continue with the sitz baths. Another widespread natural remedy is to perform a sitz bath on which ten drops of tea tree oil have been poured. It is good that we take a bath between ten and fifteen minutes.
Another well-known natural remedy is to mix five tablespoons of lemon juice in half a glass with cold water. Once we have the mixture ready, we will take a cloth (soft texture), soak the solution and put it on the affected area for ten or fifteen minutes.
How to Prevent Hemorrhoids?
The best way to prevent hemorrhoids is to ensure that the stool is always soft. To prevent hemorrhoids and avoid hemorrhoid symptoms we can do the following:
- Eat foods high in fiber. Eat more fruits, vegetables and whole grains. This softens the stool and increases its volume, which will help you avoid constipation and having to squeeze a lot, which is the cause of hemorrhoids or causes a worsening of hemorrhoid symptoms if they are already present. The fibers must be added to the diet slowly, to avoid problems with gas.
- Drink lots of fluids. Drink six to eight glasses of water and other liquids, but not alcohol, every day, to avoid constipation.
- Consider fiber supplements. Many people do not take the recommended amounts of fiber in the daily diet (20 to 35 grams). Studies have shown that fiber supplements that are bought over the counter help relieve the symptoms of hemorrhoids and their bleeding. These products help maintain soft stools and regularity. If you use fiber supplements, be sure to drink all the liquid we have advised before, because if not, the constipation that occurs will be even worse for hemorrhoids.
- Do not force. Strengthening and holding your breath when defecating creates great pressure in the veins of the rectum.
- Use the bathroom as soon as you feel the need. If you endure until you feel like it, the stool will lose fluid and become harder, making evacuation more difficult.
- Do exercise. Maintain some activity to prevent constipation and avoid pressure in the veins, which can occur after long periods of sitting or standing without moving. Exercise can also help you lose weight, which contributes to the production of hemorrhoids.
- Avoid long periods without movement, while sitting or standing. Above all, sitting for a long time increases the pressure in the veins of the rectum and anus.