What are Hemorrhoids?
A hemorrhoid is a medical term that is used to explain the vascular regions in the anal canal. In general hemorrhoids are called as ‘piles’. These are cushion like structures in anal canal which help in stool control.
Piles in non technical way used to describe the disease. The hemorrhoids will turn into disease due to any kind of inflammation or infection. In diseased hemorrhoid the veins around the anus or lower rectum are swollen. At the time of hemorrhoids the walls of the vessels become thin and under stress the veins bulged out which causes irritation.
According to the studies, around 40% of the patients suffering from hemorrhoids exhibit no symptoms. All around the world, approximately 75% population is suffering from this disease and these people are above the age of 50 years. The working group people who have long hour sitting jobs are more prone to this disease. But most of the people are not taking proper medical treatment due to lack of awareness of symptoms of hemorrhoids and diagnosis.
What are the symptoms of Hemorrhoids?
The hemorrhoids in initial stages do not show any visible symptom. They can only be recognized after visible swelling and inflammation. There are few common symptoms of hemorrhoids that are observed in the patients suffering from it:
1. The most common and visible symptom of hemorrhoids is bleeding, usually painless. There might be visible redness on the toilet paper or toilet bowl. The person suffering from initial or start developing hemorrhoids does not feel any pain. The only symptom is rectal bleeding, when the person found blood in his fecal discharge then only he can identify the trouble.
2. The itching in the anal region with redness on the skin. The skin around the anus or anal canal is very sensitive and soft, at the time of hemorrhoids this skin evolve some kind of inflammation. This inflammation results in itching inside the anal canal or around the anus. Excessive rubbing on the infected area may turned the skin red and rashes can be also be seen.
3. Sometime people may observe discomfort and pain around the anus. The disruption of the vessels due to swelling may result severe pain and discomfort specially at the time of passing stool. Urination is also affected due to the discomfort.
4. Other visible symptom of hemorrhoids is swelling around the anus. Not only the internal anal swelling is responsible for the hemorrhoid but these will also create external swelling near the anus.
5. In severe conditions, there is a lump of skin that extrude out of the anal region. The hemorrhoids sometime protrude out and form a lump like structure. Also the clotting will occur due to the blockage in bleeding visible lumps are found around the anus.
6. Unwanted fecal leakage or the mucus leakage. When the hemorrhoids are swollen then they lost their basic nature of controlling the stool. This will result in unwanted fecal discharge anytime and person will not be able to control it.
7. Sometime not usually there are severe painful bowel movements, person feel to pass stool but unable due the pain and irritation. The bowel movement are also affected due to the hemorrhoids, the person may feel passing the stool and cannot do that due to the swelling. This uneasiness may cause varied bowel regulations.
8. Anemia can also be symptom for hemorrhoids because of chronic blood loss.
9. The unusual blood loss and irregular bowel movement will change the diet activities of the patient and result in abrupt weight loss.
10. A person with a history of having colon cancer is most suspicious to have the hemorrhoids in his later life.
What are different types of hemorrhoids?
Hemorrhoids are itself present in the body, but their location is only recognized at the time of inflammation. Hemorrhoids on the basis of their location in the anal canal can be classified into two- (a) internal hemorrhoids (b) external hemorrhoids.
Apart from this classification the hemorrhoids are of different types like thrombosed and strangulated. These are the modified forms of hemorrhoids’ due to the presence of any kind of external factor.
What are the symptoms of different types of hemorrhoids?
Though the hemorrhoids can be classified into following major type on the basis of their location thus they vary in their symptoms also. These symptoms of hemorrhoids are explained in the following section:
1) Internal Hemorrhoids/Piles- Internal hemorrhoids/piles are found inside the rectum. They are intact to the walls of the vessels. Though they are located on the lower parts of the rectum, they still can’t be seen but can be felt only at the time of inflammation.
These types of hemorrhoids do not cause any kind of pain to the patient as they present inside the rectum. But at the time of swelling and inflammation the patient might feel slight discomfort might be felt.
The lowest part of the rectum has a limited number of pain-sensing nerves, thus even at the time of inflammation and swelling the person does not feel extreme pain.
Due to the swelling at the lowest region of the canal the opening get reduced in size and thus, there is a little straining or irritation at the time of passing stool. This straining may disrupting the walls or the surface of the hemorrhoids and this disruption may result in bleeding. This bleeding is the only symptom of internal hemorrhoids.
The rectal bleeding is the most common symptom for the internal hemorrhoids and are the only visible feature which can be consider for the further diagnosis.
2) Prolapsed Hemorrhoids- The internal hemorrhoids due to several factors like pregnancy stress, enlarged hemorrhoids will cause the vessels to weaken and prolapsed out of their place. This condition in which the walls will protrude out is known as protruding of prolapsed hemorrhoids.
These protruding hemorrhoids may automatically revert back to their position; otherwise they can also be manually inserted back.
This protruding hemorrhoid causes severe pain and irritation.
The structural presentation of internal hemorrhoids’ with several stages of protruding internal hemorrhoid is given below. The blue lining of the walls is representing the protruding internal hemorrhoids.
3) External Hemorrhoids/Piles- The external hemorrhoids/piles are the type of hemorrhoids that are present outside the anus. These are visible and can be felt by touching.
The anus is surrounded by numerous pain-sensing nerves in comparison to the internal hemorrhoids. These will result in the severe pain that is felt by the patient. The pain is more severe in the external hemorrhoids than in internal type.
Since, the external piles/ hemorrhoids are on the skin surface thus they are more prone to infections. The size of hemorrhoid may also affect the conditions of the patient, as large size external hemorrhoids may cause hygienic issues for the patient.
The presence of the hemorrhoids on the surface may result in excessive itching due to the in contact between the skin and the clothes. The excessive itching or irritation is one of the major symptom of external hemorrhoid.
The bleeding is a common symptom for both the type of hemorrhoids, but the only difference in the two is that the bleeding in external hemorrhoids is extremely painful and in the internal hemorrhoids there is painless bleeding.
The third and most prominent symptom of hemorrhoids is swelling in the anal region which is due to the inflammation.
The picture given below shows the external hemorrhoid at the outer surface of the anal opening. This can be visualize as a clump of skin sometime bluish-red in color.
4) Thrombosed Hemorrhoids/Piles- The external hemorrhoid when exhibit the condition of prolapsed hemorrhoid and blood pools out into this results in the formation of blood clot (thrombus). Thus, known as thrombosed hemorrhoid/piles. The minor thrombosed hemorrhoids may heal on its own, but the severe one may require proper treatment.
The thrombosed hemorrhoid will cause severe pain to the patient; even it is in minor state. The other symptoms for thrombosed piles/hemorrhoids are visible swelling and inflammation. The thrombosed hemorrhoids as formed due to the blood clotting can be seen on the skin near anus red hard lump of skin.
The hemorrhoids after inflammation turn out to b the most painful. The pain felt by the patient are of several degrees. By taking the severity of the hemorrhoid/piles, they are divided into four grades and then they are given the listing of their symptoms. The grading of the hemorrhoids is done in the following manner-
• First Degree Pile/Hemorrhoids- The symptoms shown by the first degree hemorrhoids are that they does not cause any kind of pain but exhibit only the visible symptom of painless bleeding.
• Second Degree Pile/Hemorrhoids- Patient suffering from the second degree piles may not feel any pain but may feel some discomfort or irritation. The painless bleeding is also a symptom for these grade hemorrhoids.
• Third Degree Pile/Hemorrhoids- Piles under this degree cause minor pain in the anal canal as well as in the bowel region. Mucus or fecal discharge along with excessive bleeding is also a major symptom.
• Fourth Degree Pile/Hemorrhoids- Fourth degree piles are the most severe in nature. Patient will have to bear severe pain, excessive painful bleeding, sometime clotting and strangulation.
In the pregnancy there is excessive volume of blood in the vessels which results in the dilation of veins. These dilated veins may cause swelling in the anal region and when strain is exerted this will result in hemorrhoids.
Hemorrhoids can also be found in some teenagers and the people below the age of 40 years. They will exhibit the same symptoms for all the conditions.
The hemorrhoids/piles may follow the family line, meaning they can pass as genetic disease from generation to generation.
Hemorrhoid is not a disease with no cure, people need a extensive awareness on symptoms of hemorrhoids and the hygienic steps to be followed when seen.