Hemorrhoids overview On the Web
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Hemorrhoids are varicosities or swelling and inflammation of veins in the rectum and anus. The rectum is the last part of the large intestine leading to the anus. The anus is the opening at the end of the digestive tract where bowel contents leave the body. External hemorrhoids are located under the skin around the anus. Internal hemorrhoids develop in the lower rectum. Internal hemorrhoids may protrude, or prolapse, through the anus. Most prolapsed hemorrhoids shrink back inside the rectum on their own. Severely prolapsed hemorrhoids may protrude permanently and require treatment.
Hemorrhoids were first discovered by ancient Egyptians more than 3,700 years ago.
Hemorrhoids can be classified according to their location as external or internal hemorrhoids. Furthermore, internal hemorrhoids can be graded according to severity into 4 grades.
Differentiating Hemorrhoids from other Diseases
Epidemiology and Demographics
Common risk factors in the development of hemorrhoids are excessive straining, sitting or standing for long periods of time, pregnancy, and chronic constipation.
According to the USPSTF, screening for hemorrhoids is not recommended.
Natural History, Complications, and Prognosis
If left untreated, hemorrhoids may lead to strangulation, anemia, or fecal incontinence. Common complications of hemorrhoids include secondary infection, thrombosis, or strangulation. Prognosis is generally excellent and most cases respond to non surgical treatment. However, surgery gives the best prognosis with the least recurrence rate.
History and Symptoms
Patients with acute prolapsed or thrombosed hemorrhoids usually appear ill and in pain. Physical examination of patients with hemorrhoids is usually remarkable for protruding mass from the anus or palpable mass on digital rectal exam.
Other Imaging Finidings
There are no other diagnostic imaging studies of significance for hemorrhoids.
Other Diagnostic Studies
There is no medical treatment for hemorrhoids. Medical therapy aims to provide symptomatic relief from constipation. Local treatments such as warm sitz baths, cold compress, and topical analgesic (such as nupercainal) can provide temporary relief.
Surgery is not the first-line treatment option for patients with hemorrhoids. Surgical intervention is usually reserved for patients with either complicated or large hemorrhoids (beyond grade III).
Primary prevention of hemorrhoids may include drinking excessive fluids, regular exercise, practicing better posture, and reduction of bowel movement straining and time. Eating a high-fiber diet can make stools softer and easier to pass, reducing the pressure on hemorrhoids caused by straining.
The secondary preventive measures for hemorrhoids are similar to primary preventive measures.