What are haemorrhoids? Are they dangerous? How do we know we are having a hemorrhoidal disease? Those are common questions asked by the public. Haemorrhoids or hemorrhoidal disease is a condition in which the hemorrhoidal plexus is distended and bulge into the anal canal and cause bleeding following defecation. The hemorrhoidal disease can cause chronic blood loss, itchiness of the anal canal, prolapse of the hemorrhoidal cushion, and pain. Scratching will not stop haemorrhoids from itching. Treatments as listed later in this article are required to solve all the symptoms of this disease. Ask Questions to DoctoronCall to understand more about this condition.
Hemorrhoidal disease is peaked among people from 45 years old to 65 years old. Patients with this disease can develop symptoms or remain asymptomatic. Data from a study in America shows that the percentage of new cases was 4.4%. Symptomatic hemorrhoidal disease is very rare before the age of 20. There are three types of hemorrhoidal disease. The types are:
- External haemorrhoids
- Internal haemorrhoids
- Mixed haemorrhoids
External haemorrhoids have no grading, while internal haemorrhoids have a grading to determine the extent of the disease. The risk factors for the symptomatic hemorrhoidal disease are:
- Advance in age
- Pregnancy
- Diarrhoea
- Tumours in the pelvis
- Straining during defecation
- Prolonged sitting
- Long-standing constipation
- Patients who are taking anticoagulation medications
- Patients who are taking antiplatelet medications
Around 40% of patients who are suffering from the hemorrhoidal disease are asymptomatic. Most of the patients who seek treatments are symptomatic. The faeces are usually coated with blood and appear to be bright red. The blood may also drip into the toilet bowl. Straining will worsen the bleeding. Bright red blood indicates that the blood is fresh following bleeding from a nearby structure to the anus. Long-standing blood loss will later lead to a condition known as iron deficiency anaemia. The symptoms of iron deficiency anaemia are headache, irritability, weakness, fatigue, and exercise intolerance.
The clinical features of the hemorrhoidal disease are:
- Hematochezia
- Bleeding per rectum
- Pain (mixed or external hemorrhoidal disease)
- Perianal itching
- Faecal incontinence
- Fullness sensation on the perianal region
- Discharge of mucus
- Irritation of the perianal region
Similar to other diseases, to formulate a diagnosis of hemorrhoidal disease, a complete history taking, physical examination, and investigations are required. If patients are found to have symptoms like fever, unintentional weight loss, night sweats, and abdominal pain, they are more likely to suffer from a malignancy or chronic infection instead of hemorrhoidal disease. The investigations to confirm a diagnosis of hemorrhoidal disease is:
- Anoscopy
- Lab investigations
- Colonoscopy
- Sigmoidoscopy
The conditions that may mimic hemorrhoidal disease are:
- Rectal prolapse
- Polyps
- Anal fissures
- Solitary rectal ulcer syndrome
- Proctitis
- Colorectal cancer
- Anal cancer
- Anal abscess
- Fistula
The interventions that can be done by patients with the hemorrhoidal disease are:
- Consume more fibre or psyllium or methylcellulose
- Stop straining
- Exercise regularly
- Reduce the intake of alcohol and fatty food
The treatments for the hemorrhoidal disease are:
- Painkillers
- Topical corticosteroids
- Sitz bath
- Antispasmodic medications
- Rubber band ligation
- Sclerotherapy
- Infrared coagulation procedure
- Laser photocoagulation
- Cryosurgery
- Surgical excision (Hemorrhoidectomy)
Ask Questions to DoctoronCall that can help you to have a better knowledge of the hemorrhoidal disease or other diseases that you may be suffering from. Please take good care of your health and get an immediate medical opinion if you are experiencing any symptoms. Do not self-diagnose and self-treating your condition as that may do more harm.
