Hemorrhoids (or hemorrhoidal disease) are anal conditions related to dilated veins in (called internal hemorrhoids) or around the anus (called external hemorrhoids).
The expression "having hemorrhoids" is a misnomer since everyone has anatomically hemorrhoids; in case of symptoms, we should speak of "hemorrhoidal crisis." Internal hemorrhoids (deep part of the anus) are purple and are not visible; you need a device (anoscope) to see.
Risks and health issues hemorrhoids
Hemorrhoidal disease is a common condition in adults (one in two people in life), responsible for a large number of medical consultations. The frequency is the same for both sexes, but men seem to complain earlier. This frequency increases with age with a maximum after 70 years. Some risk factors have been identified but remain controversial: alcohol, coffee, obesity ...
Causes and mechanisms of hémarroïdes
Hemorrhoids are vessels normally present at the anus. Anatomically, there are external hemorrhoids and the internal hemorrhoids, deeper.
The cause of the haemorrhoidal expansion is still unclear. Hemorrhoids often appear to support an increase in abdominal pressure (constipation ...) which interferes with venous return and lead to venous dilatation. In fact, several factors are probably involved as a relaxation of the supporting tissues related to age and / or encouraging terrain.
Symptoms and signs of hemorrhoids
The output of hemorrhoids outside the anus causes symptoms of discomfort, itching, pain and bleeding rectal called. Such bleeding are related to the erosion hemorrhoidal packets; blood is red, occurring at the end of defecation (he tries toilet paper, splashes bowl ...).
A possible complication is the local formation of a clot causing an external hemorrhoidal thrombosis most often. One then notes a bluish swelling with a more or less intense pain until elimination of the blood clot.
The other complication is related to the loss of blood and iron, which can in extreme cases lead to an iron deficiency anemia (iron deficiency).
With what should we be confused?
Rectal bleeding should not always be attributed to hemorrhoids. Other diseases such as tumors must be removed first before bleeding.
Moreover, anal fissure, ulceration thermometer, inflammatory bowel disease (colitis, proctitis ...) can also give bleeding and pain. Their treatments are specific.
Will it possible prevention?
There are no preventive measures to avoid completely the hemorrhoidal attacks. Local hygiene, without excess, and physical activity to fight against physical inactivity are recommended.
The fight against constipation is an axis of treatment with use of mucilage and / or increasing the daily intake of dietary fiber. Foods to eat are whole wheat bread, fresh fruits and vegetables, legumes (lentils, split peas), grains (oats, bran, wheat).
Alcohol and spices are good contributing factors as well as prolonged sitting: When is prone to hemorrhoids, it is best to avoid them.
The ointment application can also relieve symptoms.
When to consult?
The occurrence of bleeding from the anus should lead to a medical consultation urgently to eliminate gastrointestinal bleeding and / or tumor. If necessary, an exploration through a colonoscopy will list possible causes and to take samples.
What is the doctor?
The doctor makes the diagnosis by questioning and clinical examination. The latter includes an examination of the anus and, if possible, a digital rectal examination.
The doctor may refer you to a specialist colleague (proctologist, gastroenterologist) for additional tests: Anoscopy explores the anus, proctosigmoidoscopy back in the digestive tract (rectum, sigmoid) and colonoscopy shows almost full. A blood test may help verify the absence of anemia.
The proposed treatments for hemorrhoids are of three types: medical, surgical and instrumental. The effectiveness of drugs is controversial veinotonic; correction of bowel dysfunction (fight against constipation or diarrhea), however, is unanimously recognized.
The drugs against pain (analgesics) are effective on pain of internal and external hemorrhoidal thrombosis, as well as nonsteroidal anti-inflammatory.
Instrumental techniques (coagulation) are reserved for surgical or medical treatment failures.
If thrombosis, incision under local anesthesia relieves symptoms.
How to prepare my next appointment?
Identify triggers or relieve seizures allows to establish appropriate therapeutic strategies. Furthermore, hemorrhoids can manifest as prolapse (externalization) Intermittent: note the frequency of prolapse.
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