Hemorrhoids are a cushion of blood vessels that prevent gases and stool from escaping from the rectum. In hemorrhoidal disease, these vessels are thickened. The cause can be excessive pressing when defecating, giving birth or a weak connective tissue. Hard stools can rupture the hemorrhoids and start bleeding. Treatment is possible with medication as well as with ointments or operations. About 80% of adults suffer from hemorrhoids.
The cause of the bulging of the hemorrhoidal vessels themselves is often a pressure load caused by strong pressure when defecating or giving birth. The portal vein hypertension caused by liver disease is rarely a possible cause. The bulging, thickened hemorrhoids extend far into the anus opening and can be an obstacle to the stool. If the stool is hard, these can then be torn open and bleed. An acute increase in blood pressure, such as occurs when pressing, can also cause the hemorrhoids to burst.
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For more information, see: Blood in the stool from hemorrhoids
There are three colors blood in stool can take. The color of blood in the stool can often tell you what the cause of the blood is:
But other intestinal diseases can also sometimes cause bleeding. Depending on the place of origin, the color can also be light red, dark red or black.
Please also read: Symptoms of hemorrhoids
The distinction between tumor and hemorrhoidal disease cannot be made with certainty based on the color of the blood alone. Most colon tumors are located in the rectum or in the sigmoid and therefore also lead to fresh bleeding. Therefore, a complete colonoscopy must always be performed, even with known hemorrhoids, in order to discover possible malignant tumors and initiate the appropriate therapy. Excluding other sources of bleeding is only possible with a colonoscopy.
$config[ads_text2] not foundConservative therapy is often sufficient for mild hemorrhoids. The chair is regulated by a certain diet and long periods of sitting are avoided. Drug treatment is also possible. Local anesthetics can reduce pain, and hemostatic drugs can help restrict the blood in the stool. Anti-inflammatory agents such as glucocorticoids can also help those affected. These can be used both in ointment form and as suppositories.
There are also some outpatient therapy options. With sclerotherapy, the hemorrhoids are fixed and cut off from the blood supply by certain drugs. It can also be achieved by locally heating the tissue with infrared light. The thrombosis then causes the hemorrhoids to shrink. Icing is also possible, but is rarely carried out because of the side effects. In a rubber band ligation, a tight rubber band is placed around the hemorrhoids and the lack of blood supply leads to the death of the hemorrhoids. In addition to outpatient treatments, classic operations are also possible. The relapse rate is very low here. These procedures are used especially in cases of severe hemorrhoidal disease.
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The standard examination of hemorrhoids is the digital rectal examination, during which the doctor scans the anal canal with his finger. Proctoscopy is necessary to see the hemorrhoids. In contrast to colonoscopy, no colon cleansing is necessary for this. A full colonoscopy should always be performed even with known haemorrhoids in order to rule out intestinal tumors and other higher-lying sources of bleeding. An advanced stage of hemorrhoidal disease may already be visible through an external inspection, as the hemorrhoids bulge out of the anus.
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$config[ads_text3] not foundThose affected often notice itching in the anal area as the first symptom. Later there is pain and blood in the stool. This is often accompanied by the feeling of not being able to empty yourself completely. At this first stage, it is internal hemorrhoids.
In the second stage, the hemorrhoids are pressed out of the anus and then move back into the anus. Hemorrhoids that are permanently outside and can only be pushed back with the fingers belong to the third degree. In the fourth stage, the hemorrhoids can no longer be pushed away.
The degree determines the method of treatment.
The duration and prognosis depend heavily on the stage of the hemorrhoids and the treatment method chosen. In the case of conservative therapy, the treatment takes a relatively long time, but there are fewer side effects. With outpatient procedures and operations, the effect can be felt immediately after the procedure. The relapse rate is lowest in the classic operation. After pregnancy, hemorrhoids can completely regress on their own after a while.
After hemorrhoid surgery, bleeding may continue for some time. This depends on the original extent of the hemorrhoids, the surgical technique and the individual healing time. Hard stool can cause surgical wounds to rupture again. With normal healing, blood should no longer be visible in the stool after a few days. If blood persists in the stool after a long period of time, the possible sources of bleeding should be checked again. The surgical wound can be spared by regulating the stool with medication.
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Pregnancy is an exceptional situation for the body. The increased pressure in the abdominal area can lead to hemorrhoids or cause existing hemorrhoids to rupture. Many women have a hemorrhoid problem after the birth of the child at the latest, as this creates high pressure through the pressing. Pregnancy hormones can also weaken the tissues and cause hemorrhoids. Women can prevent it from developing by avoiding constipation and treating it with ointments if the symptoms are slight. The hemorrhoids can recede after pregnancy.
