What is Hemorrhoids (Hemorrhoids)? Hemorrhoid Symptoms and Treatment

Hemorrhoids, popularly known as yeast or hemorrhoids, is characterized by varicose-like enlarged vascular balls around the anus and in the rectum.

What is Hemorrhoids?

Hemorrhoids, the origin of which cannot be understood most of the time, is seen in approximately one quarter of adults. External hemorrhoids are defined as discomfort with symptoms such as breech bleeding, defecation being different or irregular and pain during defecation, when it is on the lower part of the skin and on the outside of the anus.
The discomfort that occurs in the last part of the large intestine or the rectum as it is called in medical language is called internal hemorrhoids. In some cases, hemorrhoids, known as anal fissure, mixed with cracks in the breech area or abscesses around the anus, is a disease that leads to a decrease in the quality of life of the person. Hemorrhoid tissue, which is found in every person, is a pillow-like tissue that prevents the person's involuntary defecation and gas and fluid outflow. Hemorrhoids, which are mostly seen in people who work sitting or standing still, are a disorder caused by the loosening of the vein around the anus and the sagging of a piece of tissue.
Hemorrhoids can get stuck from time to time and cause bleeding. In the presence of hemorrhoids that do not cause any symptoms in the initial stages of the disease, the person does not notice this situation. However, as the disease progresses, symptoms such as itching, discomfort, pain and bleeding occur. If a clot forms inside the hemorrhoid, the pain can be very severe. In some cases, in the presence of hemorrhoids that require surgical intervention, it is recommended that the person change their lifestyle first. While internal (internal) hemorrhoids are usually painless, external hemorrhoids can cause extremely severe pain.

What are the Stages of Hemorrhoids?

Internal hemorrhoids formed in the rectum are examined in four different stages:

Stage: Even though the breast-shaped piece of tissue formed by the hemorrhoid during defecation moves correctly in the anus later it returns to its original state. This situation, which causes minor bleeding, is noticed by the bleeding in the form of staining on the toilet paper. Since the hemorrhoids formed at this stage do not protrude, they can only be visualized by rectoscopy.

Stage: The piece of tissue formed by the hemorrhoid during defecation comes out with straining and re-enters when defecation ends.

Stage: The hemorrhoid breast protrudes out of the anus. This tissue can only enter the anus when pushed with a finger. It often causes edema formation and pain. These pieces of tissue cannot be pushed inward. Fecal stains can be seen in the laundry because it cannot be cleaned sufficiently after defecation. The person may feel pain in the breech region while sitting.

What are the Symptoms of Hemorrhoids?

Although hemorrhoid disease does not cause any symptoms in the early period, it may cause the following symptoms in the later stages:

• Rectal bleeding,
• Discharge, swelling or feeling of wetness in the rectal area,
• Hard swelling in the anus, the size of a chickpea,
• Itching,
• Defecation
• Pain or burning during defecation.

Pain in the early stages of the disease is not usually caused by hemorrhoids. This condition is mostly a symptom of different diseases such as thrombosed hemorrhoids, perianal abscess and anal fissure. In addition, rectal bleeding may occur due to reasons such as anal fissure, perianal fistula, perianal abscess, thrombosis and rectal cancer. The cause of the fresh and bright red bleeding coming from the anus can only be understood with the control of a physician. Therefore, it is extremely important for people with bleeding complaints to consult a physician.

What Causes Hemorrhoids?

Every healthy individual has a pillow-like structure rich in vessels in the breech region. This structure helps the person hold their stool. However, in the presence of hemorrhoids, these tissue fragments can swell, droop, bleed, and cause pain and soreness. This disorder, which is mostly seen in the middle age group, can rarely be seen in people younger than 20 years old.
The main reason for the formation of hemorrhoids is constipation and, accordingly, spending a long time on the toilet. In addition to this condition that causes straining for a long time, diarrhea, sedentary lifestyle, advanced age, excessive alcohol consumption, sports activities such as horse riding and cycling, and long-term sitting practices such as driving and piloting. Having spouses, pregnancy and childbirth, types of cancer in the pelvic region and colon cancer can also cause hemorrhoids.

Hemorrhoids in Pregnancy

The blood volume in the body of the expectant mother during pregnancy is 25% to 40%. rate increases. Due to the gradual enlargement of the uterus, pressure occurs on the veins. This can cause problems such as varicose veins and hemorrhoids.
Progesterone hormone, which increases during pregnancy, causes some relaxation of the vessel walls. In addition to all these, the enlargement of the uterus and the differentiation of the hormonal order may slow down bowel movements and lead to constipation. Depending on all of these factors, hemorrhoids may occur in expectant mothers. Therefore, it is recommended that pregnant women take plenty of fluids and have a diet rich in fiber foods. During constipation, you should not sit on the toilet for a long time and should not strain. In the presence of recurrent constipation, a physician should be consulted.

How to Diagnose Hemorrhoids?

After the person applies to the physician with complaints caused by hemorrhoid symptoms, the physician first listens to the person's history and performs an anal examination. Rectoscopy is performed in patients with bleeding complaints to rule out other diseases. After clarification of the diagnosis of hemorrhoids in patients older than 40 years of age, the physician may suggest colonoscopy to the patient and request the investigation of the presence of a large intestine tumor. In the light of all the data, the person is diagnosed with hemorrhoids.

How to Treat Hemorrhoids?

Hemorrhoids, which cause a decrease in the quality of life of the person, can be treated with medication, interventional treatment methods and/or surgical operation.

• In the medicated treatment methods preferred for hemorrhoids in the first and second stage, cortisone-containing ointments, analgesic creams to reduce pain, and other drugs that help regulate blood circulation are used. In addition to medications, she may also recommend a sitz bath with warm water.
• Sclerotherapy, which is one of the interventional treatment methods, is also known as needle therapy among the people. In the sclerotherapy method, the drug is injected directly into the veins inside the hemorrhoid tissue.
• In the band ligation or band strangulation method, the treatment is done in a few sessions. Neck of hemorrhoid formation It is ensured that the hemorrhoids fall by suffocating with mi band.
• Laser burning technique is another interventional treatment method. In the laser treatment method, which is performed in a few sessions, it is aimed to close the vascular ball. Thus, the hemorrhoids are extinguished.

Do Hemorrhoids Recur?

Even if the existing hemorrhoid is corrected with surgery, the disease has the potential to recur. It is known to recur (recurrence) between 1.5% and 15% in patients who underwent surgery, and at a rate of 10-50% in patients who did not undergo surgery. Reasons for recurrence include:

• Surgical technique applied during the surgery,
• Continuation of constipation,
• Failure to correct dietary habits.

After Hemorrhoid Surgery

The hemorrhoid surgery method is chosen specifically for the patient. Some problems may be encountered frequently after surgery.

Remaining breast: The small skin protrusions left behind can be interpreted by the patient as hemorrhoids. Physiological defecation difficulty seen after surgery passes within 1-2 days. If it persists, laxatives called stool relaxants can be used.

Ectropion (whitehead deformity): If excess tissue is removed from the rectum (the area where the intestine meets the anus) during surgery and if it is not detected appropriately, healing occurs outside the anus. The patient has a mucous discharge and skin irritation and itching. In the surgery of large hemorrhoids, if most of the rectum is removed or stitches are placed on the lower part of the anus, scarring and stenosis may be seen in the advanced stages of wound healing. If rectal stenosis develops, enlargement can be performed 6-8 weeks after surgery.

Continuation of breech prolapse: Surgery If enough tissue is not removed, a bulge may occur. You can find detailed information about anal fissure at this address.

Anal fistula anal fistula): In some cases, fistula formation in the rectum may be encountered. You can find detailed information about anal fistula at this address.

Rectovaginal fistula: In female patients, a canal may form between the anus and the vagina and stool may come from the vagina. The reason for this is that it usually covers the adjacent vagina as a result of the deep passage of the suture placed in the breech canal.

In addition to these, problems such as petrification of the stool (fecal impaction) due to insufficient defecation, urinary tract infection due to urinary catheter, difficulty urinating, and stool and gas incontinence can also be seen after hemorrhoid surgery.

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