Hemorrhoids refer to the inflammation and swelling of veins (venous cushions) around the anus or in the lower rectum. Hemorrhoids can develop from straining during bowel movements, prolonged sitting on the toilet, chronic constipation or diarrhea, pregnancy, aging, and anal intercourse.
Hemorrhoids are located either inside the rectum (internal hemorrhoids) or under the skin around the anus (external hemorrhoids). They occur due to the congestion of internal and external venous plexuses around the anal canal.
Hemorrhoids affect approximately 80% of the population at some point, being very common in both men and women. About half of the population has hemorrhoids by the age of 50. Hemorrhoids are frequently seen in pregnant women due to the pressure of the fetus in the abdomen and hormonal changes, which lead to the enlargement of hemorrhoidal vessels. These vessels are subjected to significant pressure during childbirth.
Over two-thirds of the healthy population that undergoes medical examination is diagnosed with hemorrhoids. When hemorrhoids become inflamed, they can cause itching, pain, and bleeding. Unfortunately, the condition of hemorrhoids tends to worsen over the years rather than improve.
Internal hemorrhoids occur higher up in the anal canal and are not visible. Bleeding is the most common symptom of internal hemorrhoids and is often the only symptom in most cases.
External hemorrhoids are visible outside the anal canal. They are essentially veins under the skin that have become swollen and appear bluish. Usually, these hemorrhoids present without any symptoms. However, when inflamed, these hemorrhoids become red and tender.
Sometimes, internal hemorrhoids protrude out of the anal canal, a condition known as hemorrhoidal prolapse. It is very difficult and usually very painful to push these hemorrhoids back into the anal canal.
When a blood clot forms inside an external hemorrhoid, it usually causes sharp pain. These thrombosed hemorrhoids feel like hard peas in the anal area.
Many anorectal problems, including fissures, fistulas, abscesses, or irritation and itching (pruritus ani), have similar symptoms and are incorrectly diagnosed as hemorrhoids. Hemorrhoids are generally not dangerous and do not threaten life. Rarely, a patient may experience such significant bleeding that severe anemia or even death may occur. In some cases, hemorrhoidal symptoms may simply disappear within a few days. However, in most cases, hemorrhoidal symptoms will reappear, usually more severe than before.
Although many people have hemorrhoids, not all experience symptoms. The most common symptom of internal hemorrhoids is bright red blood covering the stool, toilet paper, or in the toilet bowl. However, an internal hemorrhoid may protrude through the anus, becoming irritated and painful. Symptoms of external hemorrhoids may include painful and hard lumps around the anus, resulting from a blood clot formation. This condition is known as thrombosed external hemorrhoids. Excessive scratching or cleaning of the anus can cause irritation, bleeding, and itching, leading to a vicious cycle of symptoms.
The best way to prevent hemorrhoids is to keep stools soft, reducing pressure. Physical exercise, including walking and increasing fiber intake in the diet, helps reduce constipation and results in softer stools that pass more easily through the intestines.
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