The symptoms of a Prolapsed hemorrhoids are as follows: a second degree Prolapsed Hemorrhoid retracts of its own accord, a third degree Prolapsed Hemorrhoid is one that can be manually reinserted, while a fourth degree Prolapsed Hemorrhoid is one that remains externalized and cannot be reinserted.  In the most extreme cases, a fourth degree Prolapsed Hemorrhoid becomes either Strangulated or Thrombosed, in addition to its resistance to being manually reinserted into the anus, after which it spontaneously remerges.

Prolapsed Hemorrhoid Symptoms may include mild itching or burning, slight to temperate bleeding, or in more extreme cases, produce severe pain by virtue of its becoming an inflamed mass of externalized tissue.  Other common prolapsed hemorrhoid symptoms include either red blood in the stool or residual red blood on toilet paper, or an inability to complete a bowel movement.  It should be noted that blackened stool or actual pain caused by the act of defecating is not typically symptomatic of a hemorrhoidal condition.  In the presence of these last two symptoms, a doctor should examine the individual suffering the symptoms forthwith.  Essentially, all masses of tissue that are externalized outside of the anus are regarded as external hemorrhoids, with the exception being the prolapsed hemorrhoid, which originate as an internal condition but extend outside of the rectum as they progress.  Prolapsed Hemorrhoids have a variety of causes.  Straining during bowel movements (caused by either diarrhea or constipation) is a typical culprit, as is hypertension, obesity,  pregnancy, and cigarette smoking.  Each of the foregoing causes has specific explanations, which are as follows:

Straining during a bowel movement places pressure on the walls of the anus, thereby weakening the rectal tissue of the anus and making it susceptible to a hemorrhoidal breach.

Constipation during pregnancy is often the result of water retention, which can induce strenuous bowel movements and thus weaken the walls of the anus, in addition to causing hypertension, which is not an uncommon condition during pregnancy.

Obesity can be a factor in causing Hemorrhoids due to an increase in the amount of pressure exerted on rectal veins, in addition to attending symptoms such as reduced muscle tone and poor posture, all of which also put additional stress on rectal veins.

Cigarette smoking during bowel movements have been linked to not only an increased risk in producing Hemorrhoids, but are also believed to be responsible for causing severe bleeding of the veins in the anus and the rectal area.

Causes and Prevention of Prolapsed Hemorrhoids

Prolapsed Hemorrhoids are caused by a myriad of reasons, and thus their prevention varies.  However, there are standard preventative measures that are typically suggested as a means for either reducing the risk of developing them, or treating them should they occur.  These measures include consuming more fluids and dietary fiber (fruits, vegetables, cereals or muffins that are high in fiber, in addition to taking fiber supplements).  The consumption of fiber and fluids reduces the strain that occurs during bowel movements, which in turn act as agitating factors that can either cause or prolong the condition.  Reducing the time and duration of a bowel movement is also a means of reducing the risk of developing Prolapsed Hemorrhoids, and is a practice that can also assist in the healing process.  Elsewhere it has been suggested by doctors, and reported by patients, that tight undergarments can be a contributing factor to irritating the condition, as can the presence of weak muscle tone in the anal region.  Additionally, women frequently report an increase in the development of Hemorrhoids, or Hemorrhoidal irritation during periods of menstruation, which may be alleviated by washing the affected area with cool or warm soapy water, which can also assist in reducing itching and irritation, and possibly stave off a general worsening of symptoms.

Prolapsed Hemorrhoid Treatment

Prolapsed Hemorrhoids, which are distinguished by an external lump of inflamed tissue protruding from the anus, can be treated with a variety of interventions, depending on their severity.  Inflammation can be reduced by bathing in warm water, which assists the blood vessels in the rectal area to relax.  Steady use of medicated ointments and creams during the initial onset of symptoms can also achieve some relief, and may be a deterrent against increased inflammation or a worsening of the condition.

Prolapsed Hemorrhoid Treatment is typically handled surgically because of the inherent severity of the condition and the nature of its symptoms. In such cases, where the hemorrhoid has externalized, a Hemorroidectomy may be performed.  The procedure consists of surgically excising, or removing, the hemorrhoid, and is noted for the long duration of its recovery time and the severity of pain that accompanies it.  The hemorroidectomy is only recommended for grade IV Hemorrhoids, and has been linked with cases of incontinence later in life.  A Stapled Hemorrhoidectomy is a procedure whose objective is to resect the tissue that is in proximity to what is referred to as the dentate line (the dentate line is the region in the anal canal  that resides above the area where an individual experiences pain).  The Stapled Hemorrhoidectomy works by reducing blood flow to the inflamed tissue, thereby starving the hemorrhoid.  It is a less painful procedure than a Hemorrhoidectomy, and is favored treatment by doctors and patients because of the shorter recovery time that is necessary to otherwise treat a Prolapsed Hemorrhoid.

Alternative Treatments for Prolapsed Hemorrhoids

Prolapsed Hemorrhoids can also be treated with a variety of alternative remedies, which include both preventative practices (usually dietary), as well as medicinally holistic treatment measures.  For example, consuming bulk fiber products like psyllium seed husk and plantain is believed to produce softer stool, which is easier to pass and thus less likely to induce new Hemorrhoids or inflame preexisting ones.  Adopting a squatting position when making a bowel movement is thought to ease stress to the anal walls and aid in easier defecation.  For Individuals whose poor circulation is the cause of their hemorrhoids, doctors sometimes recommend using a pillow to raise the legs while sleeping to assist in eliminating altogether the presence of external hemorrhoids. The use of soothing compounds and substances such as Witch hazel, Cranesbill, Aloe Vera and honey are advocated and favored by some patients because they are regarded as natural or more organic than compounds such as Preparation H, and provide relief for some of the symptoms associated with the condition.  Prolapsed Hemorrhoids have also been reported to respond to certain dietary interventions, such as Butcher’s Broom, Horse-Chestnut, as well as bioflavanoids.  Because compounds such as Butcher’s Broom contain naturally occurring anti-inflammatory agents such as ruscogenins, they are often sought out by patients who wish to try an organic approach to addressing the symptoms that attend Prolapsed Hemorrhoids.

Written by, David Gilbert

© 2009 Hemorrhoid Information Center

Thrombosed Hemorrhoids are external hemorrhoids that have either ruptured, or ruptured and developed a blood-clot.  In the most severe cases they can become strangulated and cause extreme pain.  Typically, an individual with a Thrombosed Hemorrhoid will report a large mass of extremely sensitive tissue protruding from the anus.  Because of the nature of the hemorrhoid’s dimensions, difficulty producing bowel movements and maintaining hygiene are common, which can in time further aggravate the condition.   In the most severe cases, in which both thrombosis and strangulation have occurred, a doctor’s care is almost invariably recommended.  The pain induced by a Thrombosed Hemorrhoid is the result of the hemorrhoid’s tissue composition.  There are two distinct kinds of nerves found in the anus: what are known as visceral nerves, which reside on top of what is called the dentate line, and somatic nerves, which are found below the dentate line.  Somatic nerves conduct pain impulses, while visceral nerves conduct a sensation of pressure or fullness.  It is for this reason that internal hemorrhoids, which reside below the dentate line, are typically painless, while external hemorrhoids, of which a Thrombosed Hemorrhoid is a severe example, are often highly excitable and very painful.

Thrombosed Hemorrhoids are amenable to variety of treatments, some of which are home-based remedies, some of which are surgical procedures that require being under a physician’s care.  Amongst the most commonly prescribed home treatments are daily sitz baths, the use of stool-softeners, making alterations to dietary habits and bowel habits, in addition to either increasing one’s psychical activities or creating an exercise regime.  Sitz baths allow one to practice more comprehensive anal hygiene, and the warm water will soothe the inflamed site and reduce some of the symptoms of pain and swelling.  In cases where strangulation has occurred, and thrombosis is pronounced (therefore making it difficult to sit), it is recommended to try squatting in warm water several times a day for up to twenty minutes at a time.  Stool softeners are frequently suggested because they will help to ensure that less straining occurs during bowel movements, which is to be avoided if possible.  In addition to using stool-softeners, eating foods that are high in grain and fiber, including bran, can provide relief by making it less stressful to produce a bowel movement.  It is also highly recommended one consume enough water to remain adequately hydrated, which aids digestion and can alleviate symptoms of constipation.  Thrombosed Hemorrhoid symptoms also respond to interventions such as ice, which can be applied to the anus and will restrict the blood supply to the hemorrhoid.  Ice is especially effective because the cold retards the blood flow to the hemorrhoid and as a result will produce numbness in the inflamed region and provide relief from the pain.  To apply the ice, wrap the ice-pack in a cloth towel, wait several minutes, and then apply directly to the anal opening.   Increasing one’s daily physical activity, even by walking for ten, twenty, or thirty minutes, can also be a factor in the reduction of hemorrhoidal symptoms because of the increase in one’s metabolism.

Thrombosed Hemorrhoids can also be treated with various surgical procedures.  Discussing with one’s physician which treatment is appropriate is essential to making an informed decision.  The most commonly performed procedures are Rubber Band Ligation, which involves tying one to two rubber bands around the base of the hemorrhoid to restrict its blood supply, causing it to fall off in approximately seven to ten days.  Sclerotherapy involves injecting a hardening agent into the hemorrhoid, which produces similar results as Rubber Band Ligation by employing a different modality of treatment: in this case, blood flow to the infected site is restricted by way of the chemical agent, rather than manually restricting it with the rubber band.  Regardless, the objective remains the same, which is to starve the hemorrhoid of its necessary blood supply.  Both Rubber Band Ligation and Sclerotherapy are known as fixative procedures.  As a last resort, in the most severe cases, a Hemorroidectomy can be performed, a surgical procedure in which the hemorrhoid is completely removed, or excised.  The procedure is invasive and frequently requires a stay in the hospital, in addition to requiring substantial time for recovery, during which it is common to experience extreme discomfort.  Whatever course of action one chooses, it is important to bare in mind that prevention is paramount, whether one is recovering from treatment, attempting to lessen a condition’s severity to better one’s treatment options, or attempting to prevent developing hemorrhoids altogether.

Thrombosed Hemorrhoids can be prevented in a variety of ways, all of which require specific lifestyle changes and modifications to one’s diet.  As discussed, modifications to one’s diet include drinking more fluids and consuming foods with higher fiber content, such as fruits, vegetables, and cereals.  Practicing better posture to alleviate undo pressure on the pelvic region is also frequently cited as a means of reducing hemorrhoidal symptoms, as is exercising and making alterations to one’s bowel habits.  Poor muscle tone is commonly linked to the development of hemorrhoids, which is why exercising can be beneficial to one’s success treating hemorrhoidal symptoms in addition to reducing the risk of developing them in the first place.  Lessening the time spent on the toilet and not straining while making bowel movements are also cited as means to reduce frequency of flare-ups and reduction of symptoms.  Individuals suffering from hemorrhoids are also frequently advised to refrain from using laxatives, and to not eat foods that might cause diarrhea.  Clothing, too, has been associated with reduction in hemorrhoidal symptoms; wearing loose-fitting clothes and under-garments can contribute to easing symptoms such as pain, irritation and swelling.  For pregnant women, who frequently develop hemorrhoids because of the pressure exerted onto the rectum and pelvic region by the fetus, what is referred to as Kegel exercises can be practiced to assist with strengthening muscle tone in the rectal area to alleviate hemorrhoidal symptoms, in addition to helping the body to retard their development.  All of the foregoing is to suggest that to some degree an individual has an impact on the trajectory of their overall health.  And while Thrombosed Hemorrhoids are considered to be some of the most severe cases, often requiring care under a doctor, it is still necessary for one to be proactive in their lifestyle choices to help prevent them from occurring.  Education and prevention are amongst the most basic and readily available means to ensuring the best possible care in the presence of Thrombosed Hemorrhoids.

David Gilbert received his BA from U.C.L.A. He is currently doing graduate work in psychology at California Graduate Institute, in Los Angeles, CA. Throughout his career in the mental health field he has worked clinically with several populations, and also contributed to academic works whose topics address both health and mental health issues.

© Hemorrhoid Information Center

Rectal Cancer occurs when a malignant tumor forms in the posterior region of the large intestines, which is called the rectum.   There are many risk factors regarding Rectal Cancer, including heredity, Ulcerative Colitis, and colorectal polyps.

Rectal Cancer is similar to Colon Cancer, but with several distinguishing traits.  The most common trait being its tendency to reoccur locally.  Following major surgical procedures the rate of relapse is approximately 15-45%.  The malignant tumors that occur as a result of Rectal Cancer begin as polyps, which may or may not initially be benign.  Early detection and treatment of the condition thus begins with polyp removal, which in the preliminary stages can produce no symptoms.  Diagnosis of Rectal Cancer is made by performing either a colonoscopy or a protoscopy, followed by a biopsy to confirm the findings.

Rectal Cancer prognosis is directly related the extent to which the rectal tumor has penetrated the wall of the anus, in addition to whether or not the cancer has spread and the lymphatic system has been compromised.   It is these two traits that define what is known as the Staging System for the condition, which in turn determines the severity of ones case.

Rectal Cancer is typically treated through a surgical procedure called mesorectal excision.  Doctors will prescribe a course of preoperative chemotherapy, which can reduce the chances of local reoccurrence, and can also reduce the adverse side-effects of postoperative chemotherapy.  The survival rate of patients who under go surgery in conjunction with a course of chemotherapy is approximately 73%.

Rectal Cancer is responsible for about 55,500 deaths annually, with approximately 136,000 new cases reported every year.  It is estimated that roughly two thirds of the reported cases are located in the colon, and the other third is located in the rectum.

Rectal Cancer Staging is performed after a diagnosis has been made.  This process includes a CT Scan (computed tomography) of the abdomen, chest, and pelvic region.  Blood work is also performed, as is tests to determine liver and kidney functionality.  The objective of the Staging procedure is to assist in creating the most effective intervention.  The Staging procedure for Rectal Cancer is similar to the Staging procedure performed for a diagnosis of Colon Cancer.

Rectal Cancer has many causes, some of which are environmental, some of which are genetic, and others which are hereditary.  Environmentally, it is believed that a diet that is rich in high-fats, and low in dietary fiber, aids in the development of rectal polyps.  Diets that are high in red meat also appear to increase one’s risk to developing Rectal Cancer or Colon Cancer.  Recent tests seem to indicate that consumption of alcohol poses a risk to developing Rectal Cancer, as does smoking or ingesting nicotine products.  A family history of Rectal Cancer is also a risk-factor that can determine one’s susceptibility and chances to developing the condition.  Additionally, the genetic disorder called Familial Adenomatous Polypsosis is often responsible for the formation of intestinal polyps, some of which can and will become malignant of they go undetected and untreated.  Ulcerative Colitis and Crohns Disease are two other preexisting conditions that contribute to Rectal Cancer.

written by David Gilbert

© H.I.C.