Hemorrhoids are gavoccioli (small swellings) venous that are located near the anal sphincter. Hemorrhoids originate from the internal and external hemorrhoidal plexuses, configuring the respectively internal hemorrhoids and the external hemorrhoids, and they don't normally give symptoms details. In some conditions, however, they can swell, giving an unpleasant sensation painful during defecation or while sitting. They can also slide outward, protruding from the anal rhyme and giving rise to a prolapse hemorrhoidal. Finally, they can become complicated with bleeding of a more or less significant entity, or with venous thrombosis. Symptoms are aggravated if other anal pathologies are associated with the hemorrhoids such as fissures or small perianal fistulas. There are some conditions, such as constipation, one supply not correct, but also simply one pregnancy, which can promote the development of hemorrhoids. Fortunately, they exist care is remedies effective for hemorrhoidal disease.
What are hemorrhoids
You do not need to be a doctor to know what are hemorrhoids, since it is a fairly common problem that affects men and women of all ages without distinction. While not inherently dangerous, hemorrhoids represent one pathology annoying, if not - in some cases - even painful, since they can determine from a simple discomfort to an acute pain in the anus, especially if you face complications such as thrombosis, which we will discuss later and which represents the first cause of pain in those suffering from this pathology. Hemorrhoids manifest themselves with the typical symptoms of inflammation localized in the area of the anus and frequently accompanied by itching and burning, a feeling of heaviness and anal "bulk", but also localized pangs, mucus losses and even bleeding.
In the most serious cases, and at the most advanced stage, hemorrhoids can also trigger a real hemorrhage. In case of bleeding, or just noticing of the blood on paper hygienic when you go to the bathroom, your first thought may be that of a colorectal disease. Fortunately, in most cases, it is a very common pathology and for which there are adequate treatments and remedies. Blood from hemorrhoids is not dark - usually it is blood I live, red, since it comes precisely from hemorrhoidal formations that are located near the anus and that are affected by the passage of feces, rubbing with toilet paper and even the linen worn. Although in common parlance we speak of hemorrhoids, in reality it would be more scientifically correct to speak of disease hemorrhoidal: hemorrhoids, in fact, in themselves do not constitute any problem, since they are a part of our body. These are in fact blood vessels naturally present in the channel anal of all people.
But then because hemorrhoids come out? The problem - or pathology - arises when these blood vessels suddenly become inflamed, swelling beyond measure and triggering a very varied set of symptoms, but which invariably includes pain and discomfort during defecation and while sitting. Specifically, hemorrhoids can be defined as highly vascularized cushions, that is characterized by spongy and blood-filled tissue formed by capillaries, arteries and veins.
Difference between internal hemorrhoids and external hemorrhoids
Hemorrhoids are found inside the anal canal, or rather close to its wall, to which they are firmly attached thanks to fibrous ligaments that hold them in place. In anatomy it is usual to distinguish between internal and external hemorrhoids on the basis of the part of the anal canal in which they are located. The internal hemorrhoids are in fact located in the upper part of the canal, the external ones in the lower part, therefore they are closer to the orofice of the anus. Hemorrhoidal disease can affect both internal and external hemorrhoids, and sometimes even both. Although similar, the symptoms are a bit different: in the case of internal hemorrhoids, in fact, pain is rarely felt.
This is because the mucous membrane that covers them is thicker and more impenetrable. Conversely, in the case of hemorrhoids external it is not uncommon to suffer from pain. These can also leak from the anus and for this very reason being doubly annoying. To understand why hemorrhoids come out, it is first necessary to ascertain what their function is. These vascularized cushions have the same function as the anal sphincter: that is, they help the body to evacuate or, conversely, to retain not only the faeces, but also liquids and gases. By swelling and deflating - i.e. passing from a greater to a lower internal vascularity - hemorrhoids help the anal sphincter in its main functions of containment (when they swell) and evacuation (when they deflate, thus favoring a natural transit of waste from the inside to the outside the organism).
By emptying, in fact, the hemorrhoids favor the escape of feces and excess air and allow intestinal regularity. Normally, a healthy individual, that is, who does not present hemorrhoidal disease, absolutely does not perceive the presence of hemorrhoids. This, in fact, is felt only when the inflammatory process is in progress, which often includes severe irritation of the skin around the anal orifice. Inflammation occurs when hemorrhoids dilate and become inflamed, causing - in addition to all the symptoms we have already talked about - also prolapse and thrombosis, or the formation of internal intravascular blood clots. Anorectal bleeding is almost a constant in hemorrhoids, and can occur in either drip or splash form, but in most cases it is easier to notice specks of blood on the toilet, toilet paper and even the stool itself (in in this case the blood is deposited during the exit of the feces).
Classification of hemorrhoids
Classical medicine is used to classify hemorrhoids on the basis of their severity; this classification serves both the doctor and the patient to understand at what stage the disease is and therefore, consequently, how to treat hemorrhoids, how to intervene. The task of thoroughly investigating to understand whether it is first, second, third or fourth degree hemorrhoids (depending on the increasing seriousness of the disease in progress) is up to the proctologist, a doctor specialized in proctology, i.e. in the study and treatment of pathologies affecting the anus and the colorectal. Four main variables are considered to classify hemorrhoids:
- The dimensions
- whether it is internal or external hemorrhoids
- the extent of the bleeding
- the severity of any prolapse.
Hemorrhoids can be from:
- Grade I hemorrhoids
- Grade II hemorrhoids
- Grade III hemorrhoids
- Grade IV hemorrhoids
First degree hemorrhoids
The first degree hemorrhoids they are undoubtedly the least serious: they are mostly internal hemorrhoids, very often asymptomatic, which if they bleed they do so only and exclusively at the time of defecation. There is no mention of copious bleeding, but of specks or traces of blood on toilet paper. This type of hemorrhoid cannot be seen with the naked eye. To identify them, the proctologist most often has to resort to a rectal exploration with a possible anoscopy.
First degree hemorrhoids do not require special interventions other than a radical change in one's diet and lifestyle. To make the slight inflammation go away you need to eat more fibers, move more (the ideal is to walk every day at least half an hour), drink lots of water and avoid practices such as anal sex. Sometimes it is enough to simply change your diet: some foods - for example those that are too spicy - are directly brought up when it comes to how to deflate hemorrhoids, since it is enough to avoid them to already obtain significant improvements.
Second degree hemorrhoids
The second degree hemorrhoids they are more complex and sometimes require even more incisive interventions. It is in fact the first stage of external hemorrhoids: these are already beginning to show, but it is up to the doctor to decide if and how to treat them. This can be bleeding internal hemorrhoids or congested, moderately painful internal hemorrhoids. In these cases it may be necessary to have a good ointment for hemorrhoids, suppositories or a specific cream prescribed by the proctologist. Healing is often spontaneous, but these remedies pharmaceuticals can accelerate it, not to mention that they offer relief from the most annoying symptoms.
Third degree hemorrhoids
The third degree hemorrhoids are those characterized by prolapse, or by a leak. They are decidedly more serious than those of first and second degree, and therefore require manual intervention. To understand how to bring back the hemorrhoids it is good to contact your doctor, who can carry out the manual operation himself using the help of a local anesthetic and exerting a light and firm pressure on the hemorrhoids, pushing until slowly, a millimeter at a time, they do not fully fall. If you do this alone, you need to have an even firmer hand, as well as well greased with anesthetics, and above all a good degree of pain tolerance.
Fourth degree hemorrhoids
The fourth degree hemorrhoids they are undoubtedly the most serious: they are thrombosed hemorrhoids, characterized by overt mucocutaneous prolapse and by important dimensions. How are these hemorrhoids treated? And above all, how to relieve the pain and discomfort they entail? Also in this case the last word is, as always, up to your trusted proctologist, but in most cases a surgical intervention is necessary.
In all cases of hemorrhoids, the situation can also be aggravated by the presence of anal fissures. The fissure is nothing more than a small but deep skin erosion that often affects the orifices of the body, primarily the mouth and anus. Anal fissures are therefore extremely annoying cuts close to the anal orifice, which hurt especially at the time of defecation, especially in the case of hard stools (not surprisingly, one of the main causes is constipation).
Hemorrhoids: the causes
The causes of hemorrhoids are many: usually those suffering from this pathology present risk factors genetic or hormonal aggravated by socio-environmental factors, but also by behavioral and wrong eating habits.
Among the main causes of hemorrhoids are:
- a wrong diet, low in fiber and water
- a purely sedentary life, characterized by little physical movement (most of the "desk" workers are very at risk, that is, they spend most of the day sitting in front of the PC)
- the abuse of substances such as spices, tobacco and alcohol
- the pregnancy
- overly traumatic sports such as weightlifting, cycling, horseback riding, etc.
Hemorrhoids: the symptoms
As noted so far, hemorrhoids have specific symptoms that make diagnosis extremely easy, once the other diseases of the anus and colorectal are excluded. It includes:
- localized inflammation
- mucus discharge
- feeling of heaviness and discomfort
Remedies for hemorrhoids: the available treatments
Over the years, treating hemorrhoids has become increasingly easier, especially if they are detected at the first stage. The treatments are basically of three types.
In the pharmacy, by prescription or simple doctor's advice, you can find a wide range drug treatments such as ointments, creams and ointments to counteract hemorrhoids and speed up healing. These pharmacological remedies for hemorrhoids are also essential to withstand the hassles that hemorrhoids cause and to alleviate the symptoms that most hinder daily well-being.
Surgery is the last resort in the treatment of hemorrhoids, but also the most effective, especially for hemorrhoids in the fourth state. Alternatively, you can first try to retract the hemorrhoids with the manual technique.
Among the natural remedies against hemorrhoids, the most effective are plant fibers - to be used to improve intestinal transit, thus eliminating hard and bulky stools that irritate hemorrhoids -, herbal ointments based on horse chestnut, aloe gels vera, the derivative baths to be done at home with warm water and sponge and water with plums to drink in the morning, on an empty stomach.
Hemorrhoids in pregnancy
Pregnancy is also one of the main causes of hemorrhoids. In fact, pregnant women have a high risk of developing haemorrhoidal disease because, due to hormonal factors, they are more likely to suffer from constipation. In this case, however, we must pay close attention to how to intervene, and to soothe the discomfort that derives from this condition it is advisable to use exclusively natural methods, but always in agreement with your doctor.
In general, pregnant women are advised to walk more and make radical changes to their diet, and this is often enough to bring the situation within the limits of tolerability; if not, it will always be up to the doctor to decide where it is appropriate to intervene pharmacologically.