Hemorrhoids are prominent and swollen veins in the anus and lower rectum, formed as a result of exertion during the functioning of the intestine or as a result of severe pressure on these veins, such as during pregnancy.

Hemorrhoids are a very common disease even at the age of fifty, affecting about half of adults.

In most people, hemorrhoidal symptoms improve after using home remedies to treat hemorrhoids and change their lifestyle.

Types of hemorrhoids

There are four types of hemorrhoids, namely:

1. External hemorrhoids

Located directly on the anus on the surface from which the stool comes out, it is not always visible but is sometimes seen as lumps on the surface of the anus.

External hemorrhoids are not usually a serious medical problem.

2. Internal hemorrhoids

They are usually found in the rectum and cannot always be seen because they are too deep to be visible from the anus.

Internal hemorrhoids are not usually dangerous and tend to go away on their own.

3. Descending hemorrhoids

Prolapsed hemorrhoids appear when the internal hemorrhoids swell and stick to the anus, and prolapsed hemorrhoids look like swollen red lumps or bumps outside the anus.

4. Clotted hemorrhoids

Thrombotic hemorrhoid contains a blood clot within the hemorrhoidal tissue, which may appear as lumps or swelling around the anus.

Blood clots can occur in both internal and external hemorrhoids.

Symptoms of hemorrhoids

The symptoms of hemorrhoids vary from person to person, as well as according to their type.

1. Symptoms of general hemorrhoids

In the case of hemorrhoids in general, the following symptoms may appear:

  • Painless bleeding during a bowel movement, sometimes a little bright red blood can be seen on toilet paper or on the toilet bowl.
  • Itching or irritation in the area of the anus.
  • Pain or discomfort.
  • Visible and protruding hemorrhoids outside the anus.
  • Swelling around the anus.
  • Painful or very sensitive bump next to the anus.
  • Fecal leakage.

2. Symptoms of hemorrhoids depending on their type

The symptoms of hemorrhoids resulting from the different locations of hemorrhoids vary:

Symptoms of internal hemorrhoids

Symptoms of hemorrhoids inside the rectum are not seen or felt and usually do not cause discomfort.

But exertion or burning when passing through the stool may injure the delicate outer surface of the hemorrhoids causing bleeding.

Sometimes, especially when exerting effort, internal hemorrhoids may rush outward, and these are called prominent hemorrhoids, or descending hemorrhoids, and they can cause pain and itching.

Symptoms of external hemorrhoids

One of the main symptoms of hemorrhoids is their excitability and irritation which can cause itching or bleeding.

Sometimes blood may tighten the external hemorrhoids and pull them inward, forming a thrombus that causes severe pain, swelling, and inflammation.

Causes and risk factors of hemorrhoids

The veins around the anus usually tend to contract due to pressure and can swell, bulging veins may swell as a result of extreme pressure in the lower area of the rectum.

Causes of hemorrhoids

Among the causes of hemorrhoidal disease:

  • Hereditary factor.
  • Aging, because the tissues supporting the veins of the rectum and the veins of the anus weaken and contract with age.

Factors that increase the risk of infection

Hemorrhoids can be caused by one of the following factors:

Complications of hemorrhoids

Complications are rare, but if they exist, they may include:

  • Anemia: Chronic blood loss as a result of the disease can cause anemia.
  • Suffocated hemorrhoids: This occurs as a result of the cessation of blood supply to them and they suffocate, which can lead to acute pain, and eventually to the death of the tissue (Necrosis).

Diagnosis of hemorrhoids

The diagnosis varies depending on the type of hemorrhoids.

Diagnosis of hemorrhoids

The doctor makes the diagnosis through the following:

  • Diagnosis of external hemorrhoids: The proctologist can only look.
  • Initial diagnosis of internal hemorrhoids: The doctor needs to insert his finger covered with a rubber glove into the rectum.

Advanced diagnosis of internal hemorrhoids: The doctor examines the lower part of the intestine and rectum by:

  • Anuscope.
  • Proctoscope.
  • Sigmoidoscope.

These endoscopes are soft, luminous tubes that allow the doctor to look inside the anus and rectum.

Conditions requiring colonoscopy

Sometimes for diagnosis, more extensive and comprehensive examinations of all parts of the intestine by colonoscopy may be required.

The need for a colonoscopy arises in the following cases:

  • Signs and symptoms indicate another digestive system.
  • High probability of developing cancer of the large intestine.
  • The person undergoing the examination is over the age of fifty years and has not undergone a colonoscopy examination in the last ten years.

Treatment of hemorrhoids

Fortunately, there are many effective ways to treat the disease, the treatment of hemorrhoids is divided into several types as follows:

1. Medications

If you only have hemorrhoids that cause discomfort, your doctor may prescribe over-the-counter medications, such as creams, ointments, or suppositories.

These drugs contain substances such as hydrocortisone and lidocaine that relieve pain and itching, even temporarily.

Do not use a steroid-containing cream sold without a prescription for more than a week unless advised by your doctor, as doing so can cause thinning of the skin in the area.

2. Eradication

If your external hemorrhoids cause painful clotting, your doctor will most likely eliminate this clotting by making an incision to drain the clot, known as a thrombectomy.

This procedure is highly effective if applied within 72 hours of thrombus formation in the area.

3. Simple actions

If your hemorrhoids are accompanied by bleeding and pain, your doctor may advise you to use one of the minimally invasive procedures, which can be applied in the doctor's office without the need for anesthesia, and these options are:

Treatment of hemorrhoids with an elastic band

The doctor places one or two rubber bands around the base of the internal hemorrhoid to prevent blood from flowing to it to fall within only one week, this treatment may cause bleeding that may begin 2-4 days after the operation, but it is rarely severe.


During this treatment mechanism, the doctor injects a chemical solution into the hemorrhoidal tissue in order to reduce it, and although this injection does not cause any pain, it may be less effective than a rubber band.

Treatment of hemorrhoids with coagulation

Coagulation techniques rely on the use of lasers, heat, or infrared light, which can lead to internal hemorrhoid hardening and then wilting.

This procedure is associated with some side effects and the chances of re-emergence of hemorrhoids are greater compared to treatment with a rubber band.

4. Surgeries

If previous treatments did not work and the size of the hemorrhoid is large, your doctor may advise you to use available surgeries, including:

Hemorrhoidectomy (Hemorrhoidectomy)

In this operation, the surgeon removes the excess tissue that causes bleeding, and the surgeon may use local anesthesia associated with sedation, this is the most effective operation that helps in treating hemorrhoids completely.

The operation may cause difficulty in emptying the bladder completely and infections in the urinary tract.

Shortening hemorrhoids

This operation is aimed at blocking blood flow to the hemorrhoidal tissue and is used only in case of internal hemorrhoids.

The pain associated with this operation is less than the previous one, and unfortunately, the chances of developing hemorrhoids again are greater.

The process may cause bleeding, pain, and urinary retention.

5. Treat hemorrhoids at home

You can treat hemorrhoids that are not accompanied by great pain at home ways, and these procedures include the following:

  • Focus on eating high-fiber foods: Eat more fruits, vegetables, and whole grains to soften stools.
  • Warm baths: Make warm baths for 10-15 minutes three to four times a day.
  • Keep the area clean: Always make sure to clean the area and its surroundings with warm water and do not forget to dry it well.
  • Avoid using dry toilet paper: Replace it with damp toilet paper that does not contain alcohol or perfume.
  • Cold source placement: Apply it to the area where the hemorrhoid appears to relieve swelling.

Information about other treatments depending on the type of hemorrhoids

The doctor may resort to treating hemorrhoids in different ways depending on the type, as follows:

1. Treatment of external hemorrhoids

In general, there is no need or recommendation for treatment with invasive procedures or surgeries for patients with external hemorrhoids unless thrombosis occurs.

In general, patients who are examined within 72 hours of thrombosis usually remove blood with a simple surgical procedure such as opening, to significantly relieve pain.

On the other hand, some doctors in this field believe that there is a preference for surgery to remove these hemorrhoids to prevent recurrent thrombosis.

2. Surgical treatment of internal hemorrhoids

If other procedures don't work for hemorrhoids and don't produce the desired results, or if the hemorrhoids are large, your doctor will likely recommend surgery for treatment.

Some surgeries can be performed on an outpatient basis, while others require an overnight hospital stay, including:

  • Closed hemorrhoidectomy.
  • Open hemorrhoidectomy.
  • Hemorrhoidectomy by stapling.
  • Hemorrhoidal artery ligation guided by Doppler ultrasound.
  • Lateral internal sphincterotomy.

Prevention of hemorrhoids

The best method of prevention is to take care that the stool is loose so that it can pass easily.

In order to prevent or alleviate the symptoms of hemorrhoids, it is preferable to follow the following measures:

Alternative therapies

There is no way to treat hemorrhoids with herbs, but some plants and other natural materials may help relieve the symptoms of hemorrhoids, the most important of which are:

  • Honey.
  • Coconut oil.
  • Aloe vera gel.
  • Apple cider vinegar.

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