🔅 HAEMORRHOIDS

– Haemorrhoids, also known as piles, are swollen and inflamed veins in the rectum or anus. They can cause pain, itching, bleeding, and discomfort in the anal area. Haemorrhoids can develop when there is too much pressure on the veins in the lower rectum or anus. This can be due to various factors, such as:

i). Straining during bowel movements, especially if you have chronic constipation or diarrhea.

ii). Sitting for long periods of time, especially on the toilet.

iii). Being obese or overweight.

iv). Being pregnant, as the enlarged uterus can compress the veins in the colon.

iii). Having anal intercourse, which can irritate the veins in the anus.

iv). Having a family history of haemorrhoids.

v). Aging, as the tissues that support the veins can weaken and stretch over time.

SYMPTOMS OF HAEMORRHOIDS

– The symptoms of haemorrhoids depend on the type and location of the haemorrhoids. There are two types of haemorrhoids: internal and external. Internal haemorrhoids are inside the rectum and usually do not cause pain or discomfort. However, they can bleed during or after bowel movements, and sometimes protrude out of the anus, causing irritation and inflammation. External haemorrhoids are under the skin around the anus and can cause itching, pain, swelling, and bleeding. Sometimes, external haemorrhoids can form a blood clot, called a thrombosed haemorrhoid, which can be very painful and hard to the touch.

DIAGNOSIS OF HAEMORRHOIDS

– Haemorrhoids can be diagnosed by a visual examination of the anus and rectum. Sometimes, a digital rectal exam or a sigmoidoscopy may be performed to check for internal haemorrhoids or other conditions that may cause similar symptoms, such as: anal fissures, fistulas, or cancer.

TREATMENT OF HAEMORRHOIDS

– Haemorrhoids can be treated with various methods, depending on the severity and type of the haemorrhoids. Some of the treatment options are:

💫 Medication

– Over-the-counter or prescription ointments, creams, suppositories, or pads can be applied to the affected area to relieve pain, itching, and inflammation. They may contain ingredients such as hydrocortisone, lidocaine, or witch hazel. Oral painkillers, such as acetaminophen, ibuprofen, or aspirin, can also be taken to ease discomfort. However, these medications should not be used for more than a week, as they can cause side effects or complications, such as skin thinning, bleeding, or ulcers.

💫 Non-surgical procedures

– These procedures can be done in a doctor's office or clinic, and involve cutting off the blood supply to the haemorrhoids, causing them to shrink and fall off. They include:

i). Rubber band ligation: A rubber band is placed around the base of the haemorrhoid, cutting off its blood flow. The haemorrhoid and the band will fall off within a few days.

ii). Sclerotherapy: A chemical solution is injected into the haemorrhoid, causing it to harden and scar. The haemorrhoid will then shrink and disappear over time.

iii). Infrared coagulation: A device that emits infrared light is used to burn the haemorrhoid tissue, causing it to clot and shrink.

iv). Bipolar diathermy and direct current electrotherapy: A device that delivers electric current is used to destroy the haemorrhoid tissue, causing it to dry up and fall off.

💫 Surgery

– Surgery may be needed for large, severe, or recurrent haemorrhoids that do not respond to other treatments. Surgery can be done under local, regional, or general anesthesia, and involves removing the haemorrhoid tissue with a scalpel, a laser, or a stapler. Surgery can be more effective and long-lasting than other treatments, but it can also cause more pain, bleeding, and complications, such as infection, urinary retention, or anal stenosis. Surgery may include:

i). Hemorrhoidectomy: The haemorrhoid tissue is cut out and the wound is stitched or left open to heal.

ii). Hemorrhoid stapling: The haemorrhoid tissue is pulled up and stapled to the wall of the rectum, cutting off its blood supply and reducing its size.

iii). Hemorrhoidal artery ligation: The arteries that supply blood to the haemorrhoids are tied off with stitches, causing the haemorrhoids to shrink.

PREVENTION OF HAEMORRHOIDS

– Haemorrhoids can be prevented or reduced by making some lifestyle changes, such as:

• Eating a high-fiber diet, which can soften the stools and make them easier to pass. Foods that are rich in fiber include fruits, vegetables, whole grains, legumes, nuts, and seeds. Fiber supplements, such as psyllium or methylcellulose, can also be taken to increase the fiber intake.

• Drinking plenty of fluids, which can help keep the stools moist and prevent dehydration. Water, juice, tea, and soup are good sources of fluids. Alcohol, caffeine, and carbonated drinks should be avoided, as they can cause dehydration and irritation.

• Exercising regularly, which can improve blood circulation, muscle tone, and bowel function. Moderate physical activity, such as walking, swimming, or cycling, can be done for at least 30 minutes a day, three times a week. Heavy lifting or straining should be avoided, as they can increase the pressure on the veins in the rectum and anus.

• Practicing good hygiene, which can prevent infection and irritation in the anal area. The anal area should be kept clean and dry, and gently wiped with moistened toilet paper or a soft cloth after each bowel movement. Soap, alcohol, or perfumed products should not be used, as they can cause dryness and inflammation. Cotton underwear and loose-fitting clothing should be worn to allow air circulation and reduce sweating and friction.

• Using the toilet properly, which can prevent constipation and straining. The urge to have a bowel movement should not be ignored or delayed, as this can harden the stools and make them difficult to pass. The toilet should be used for no more than 10 minutes at a time, and excessive pushing or straining should be avoided, as this can damage the veins in the rectum and anus. A footstool or a squatting position can be used to raise the knees above the hips, which can ease the passage of stools.

• A warm bath or a sitz bath, which is a shallow tub of warm water that covers the hips and buttocks, can be used to relax the anal muscles and relieve pain and itching.

COMPLICATIONS RELATED TO HAEMORRHOIDS

– Haemorrhoids can cause some complications, such as:

🔅 Anemia: Chronic bleeding from haemorrhoids can lead to anemia, which is a condition where the red blood cells are low in number or function. Anemia can cause weakness, fatigue, paleness, shortness of breath, and dizziness.

🔅 Strangulated haemorrhoid: A haemorrhoid that protrudes out of the anus can become trapped by the anal sphincter, which is the muscle that controls the opening and closing of the anus. This can cut off the blood supply to the haemorrhoid, causing severe pain, swelling, and infection. A strangulated haemorrhoid requires immediate medical attention, as it can lead to tissue death and gangrene.

🔅 Anal fissure: A haemorrhoid that causes straining or hard stools can tear the lining of the anus, causing a small cut or crack, called an anal fissure. An anal fissure can cause pain, bleeding, and spasms in the anal sphincter, making it difficult to have a bowel movement. An anal fissure can heal on its own with proper care, or it may need surgery to repair it.

🔅 Anal fistula: A haemorrhoid that becomes infected can form an abscess, which is a collection of pus, in the anal or rectal area. The abscess can burst and create a tunnel, called a fistula, between the anus and the skin or another organ, such as the bladder or the vagina. An anal fistula can cause pain, discharge, and foul-smelling odor, and it can increase the risk of further infection. An anal fistula may need surgery to drain the pus and close the tunnel.

STAGES OF HAEMORRHOIDS, THEIR SYMPTOMS, & APPROACHES IN REGARDS TO TREATMENT & PREVENTION

– Haemorrhoids or piles, are swollen and inflamed veins in the rectum or anus. They can cause pain, itching, bleeding, and discomfort in the anal area. Haemorrhoids are classified into four stages or grades, depending on the severity and location of the condition.

🔅 Grade 1

– The haemorrhoids are inside the rectum and do not protrude out of the anus. They may cause bleeding during or after bowel movements, but usually do not cause pain or discomfort. Grade 1 haemorrhoids can be treated with home remedies and lifestyle changes, such as eating a high-fiber diet, drinking plenty of fluids, exercising regularly, and avoiding straining or sitting for long periods of time. Medication, such as ointments, creams, or suppositories, can also be used to relieve inflammation and itching.

🔅 Grade 2

– The haemorrhoids protrude out of the anus when straining, but go back inside on their own when the straining stops. They may cause bleeding, pain, and irritation. Grade 2 haemorrhoids can be treated with the same methods as grade 1, but may also require non-surgical procedures, such as: rubber band ligation, sclerotherapy, or infrared coagulation, to cut off the blood supply to the haemorrhoids and make them shrink and fall off.

🔅 Grade 3

– The haemorrhoids protrude out of the anus and do not go back inside on their own. They have to be pushed back manually. They may cause bleeding, pain, swelling, and infection. Grade 3 haemorrhoids can be treated with the same methods as grade 2, but may also require surgery, such as haemorrhoidectomy, stapling, or artery ligation, to remove the haemorrhoid tissue or reduce its size and blood flow.

🔅 Grade 4

– The haemorrhoids are permanently protruded and cannot be pushed back inside. They may cause severe bleeding, pain, swelling, and infection. They may also form blood clots, called thrombosed haemorrhoids, which can be very painful and hard. Grade 4 haemorrhoids usually require surgery to treat them, as they are unlikely to respond to other methods.

#OUTLOOK

– Haemorrhoids are a common and usually harmless condition that can affect people of any age and gender. They can be treated with various methods, depending on the type and severity of the haemorrhoids. Most haemorrhoids will heal on their own or with home remedies and lifestyle changes within a few weeks. However, some haemorrhoids may persist or recur, and require medical or surgical intervention.

– Haemorrhoids can be prevented or reduced by maintaining a healthy diet, fluid intake, exercise, hygiene, and toilet habits. Haemorrhoids can cause some complications, such as bleeding, infection, or tissue damage, which may need prompt medical attention. Haemorrhoids can affect the quality of life and well-being of the affected person, but they are not life-threatening and can be managed effectively with proper care and treatment.