What are Hemorrhoids: Symptoms, Causes and Treatments

Hemorrhoids are an enlargement of the veins in the anal area (anus and rectum) and the tissue surrounding them, a phenomenon similar to the varicose veins that can appear on the legs. A Frenchman over 50 will be a victim of it in his lifetime. As embarrassing as it is frequent, this very intimate problem is too often the object of taboos. Doctissimo returns to the causes and symptoms of hemorrhoids. 

Produced by venous dilatations whose size varies from one individual to another, hemorrhoids can be internal (inside the anus) or external (around the anus), depending on their location. They are normal anatomical structures and only take on a pathological appearance when they progress to a hemorrhoidal disease (i.e. when the vessels are exteriorized, forming a “ball” at the level of the anus).

Symptoms of hemorrhoids

Itching, irritation, and bleeding during or after bowel movements are typical symptoms of hemorrhoids. Other rarer symptoms may also be associated with it.

Itching, burning and pain in the anal area

Whether internal or external hemorrhoids, itching and pain may appear; although very bothersome, these symptoms should not cause you to scratch. This would only aggravate the inflammation and, therefore, the pain.

Pain during defecation

In the case of internal hemorrhoids, defecation is painful, and an internal burning sensation can be felt. Not visible, internal hemorrhoids do not allow an obvious self-diagnosis. Pain is not an element that necessarily accompanies hemorrhoidal diseases. Still, it generally accompanies their complications, which can be internal or external thrombosis, depending on the location of the affected vessels. Treated effectively, hemorrhoids are not dangerous from a medical point of view, but the thrombosis can ulcerate and bleed after a few days.

Bleeding during or after bowel movements

Bleeding is usually light and hardly noticeable on underwear or toilet paper. In the event of bleeding, please inform your doctor, who will be able, thanks to a local examination (with an anoscope ), to classify the hemorrhoids according to their anatomical position. Very often, your practitioner will not be satisfied with this observation and will prescribe other complementary examinations because this type of bleeding can also be the first sign of rectal cancer.

The sensation of inflammation in the rectum

Again, this sensation can reflect inflammation related to internal hemorrhoids. 

Discharge of mucus from the anus

A pinkish or bright red discharge may indicate the presence of internal hemorrhoids. But beware, oozing from the anus can have many origins: hemorrhoids, ulcerative colitis, ulceration of the rectum, colon tumors, atrophy of the intestinal mucosa…

Exit through the anus of sensitive protuberances

Unlike internal hemorrhoids, external hemorrhoids form small lumps of variable size and shape but can be identified at the exit of the anus. 

Advanced forms of internal hemorrhoids can be externalized. Thus, there are three degrees of internal hemorrhoids:

1st-degree hemorrhoids: The anal canal is normal

2nd-degree hemorrhoids: There is a beginning of prolapse of internal hemorrhoids, still reducible. The hemorrhoid comes out of the anus at the time of defecation before returning to its normal position.

3rd-degree hemorrhoids: Internal and external hemorrhoids come together. The hemorrhoid must be replaced manually after defecation.

4th-degree hemorrhoids: Hemorrhoids remain more or less constantly externalized. It causes discomfort, oozing and bleeding. It is not possible to replace them manually.

How long does a hemorrhoidal attack last?

The hemorrhoidal crisis lasts from 2 to 4 days. It is accompanied by pain and bleeding from the anus.

In hemorrhoidal disease, the hemorrhoidal pads slide down towards the anus (exit out of the anus of internal hemorrhoids). This is called hemorrhoidal prolapse.

The hemorrhoidal crisis can also be complicated by hemorrhoidal thrombosis, characterized by clot formation in the hemorrhoidal tissues.

The causes of hemorrhoids

It is normal for the veins in the recto-anal region to dilate slightly during defecation. On the other hand, when this dilation becomes persistent, it is problematic, and we then speak of hemorrhoids. There are several possible causes for the appearance of these hemorrhoids. They can be favored by:

• A genetic predisposition
• Natural pregnancy and childbirth
• Over weight
• Frequent constipation
• Sitting too long and very repeatedly
• Sedentary lifestyle
• Certain sports, such as horse riding or cycling
• Carry heavy loads daily
• The practice of sodomy

Hemorrhoids: People at risk

• People with a close relative with hemorrhoids
• Pregnant women
• Women who have given birth vaginally
• People who have cirrhosis of the liver;
• Constipated people

Hemorrhoids Treatments

The treatment of hemorrhoids is based on pain medication (paracetamol or ibuprofen) and cortisone-based creams prescribed for a short time.

Ligation of the hemorrhoids, radiofrequency or sclerosis of the hemorrhoidal vessels (consisting of an injection of a sclerosing product) can be considered. A surgical operation can also be proposed if necessary.

Prevention of hemorrhoids

1. Foods that help prevent constipation and the formation of hemorrhoids are fresh vegetables, fruits, raw vegetables and legumes;
2. Drink enough water ( 1.5 liters to 2 liters per day);
3. A healthy diet rich in fiber and low in fat, salt and pastries is recommended;
4. Avoid meats, spicy dishes, alcohol, coffee and tea. The ideal is to opt for a vegetarian diet until the symptoms disappear.

Generally, simple treatments can treat hemorrhoids effectively, reducing pain and inflammation. Care should also be taken to regulate intestinal transit by fighting against constipation. Finally, particular attention must be paid to the hygiene of the anal region without however going overboard, as soap can irritate it.