What do Hemorrhoids look like? It all depends on the type of hemorrhoid. What hemorrhoids look like also depends largely on the current stage your hemorrhoids are in.  Hemorrhoids are swollen blood vessels that populate in and around the anus. These blood vessels can stretch under pressure. They are similar to varicose veins in the legs. Common factors that can cause hemorrhoids are, straining to move a bowel, sitting too long on the toilet, diet, lack of exercise and very little fresh air. Hemorrhoids are either inside the anus (internal hemorrhoid) or under the skin around the anus (external hemorrhoid).

Although many people have hemorrhoids not all experience symptoms. The most common symptoms of internal hemorrhoids is bright red blood covering the stool or inside the toilet or blood on the toilet paper after wiping.

However, an internal hemorrhoid may protrude through the anus outside the body making it more irritated and painful. This is known as a protruding hemorrhoid.

Symptoms of external hemorrhoids may include painful swelling or a hard lump around the anus that results when a blood clot forms. This condition is known as a thrombosed external hemorrhoid. In addition, excessive straining, rubbing or cleaning around the anus may cause irritation with bleeding and/or itching, which may produce a vicious cycle of symptoms. Draining of mucus may also be the cause of additional itching.

Hemorrhoids are very common in both men and woman. More than half of the adult population will have hemorrhoids by age 50. Hemorrhoids are also common with pregnant woman when the pressure of the fetus is on the abdomen, as well as hormonal changes that  cause  hemorrhoidal vessels to enlarge. These vessels are also placed under severe pressure during childbirth. For most woman, however, hemorrhoids caused by pregnancy are a temporary problem.  Please refer to some of the other articles on H.I.C. if you wish to view more images of what hemorrhoids look like.

written by,

David Gilbert

© 2009 Hemorrhoid Information Center

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

Many people suffer in silence that have hemorrhoids because they are too embarrassed to see a  doctor. Social taboos are associated with this part of our body and we are conditioned to keep any problems with bathroom habits to ourselves. The fear of being ridiculed for having hemorrhoids is enough to keep this condition in our own personal closet forever.  Yet, if you suspect that you have hemorrhoids, you do need to get a diagnosis from your doctor. Remember that doctors are not there to embarrass you, and they routinely perform these examinations all the time.  There are many other conditions that could be causing your symptoms, such as rectal cancer or anal fissures.  Your life is too valuable to gamble with, so always go to your doctor to make sure what you are dealing with is a hemorrhoid. It is one thing to be embarrassed, and quite another thing to have a different disease which could be life-threatening.

Even though you may feel uneasy, seeing a doctor is the right choice!

The doctor will be able to visually identify prolapsed and external hemorrhoids, and then, will examine the interior of the rectum. If you have  internal hemorrhoids they usually can be felt by a digital rectal exam. With this exam, the doctor will insert a gloved lubricated finger into the rectum where they can feel any abnormalities. If the doctor needs to examine the inside of  the rectum visually, they will use an anoscope. An anoscope is a hollow lighted tube useful for viewing internal hemorrhoids.

To rule out any other causes of gastro-intestinal bleeding, the doctor may have you return for a more complete examine of the rectum and colon. A sigmoidoscopy or colonoscopy are diagnostic procedures that involve the use of lighted, flexible tubes inserted through the rectum. These two exams would not be done on your first visit, unless you have gone through the pre-op care required beforehand. Your digestive system would need to be cleansed of all fecal matter for these exams. A sigmoidoscopy can exam half the colon for abnormalities, and it is usually done in the doctor’s office.  In contrast, a colonoscopy exams the whole length of the colon, and is performed in a hospital or outpatient surgical setting.

written by Joy Seeman

© Hemorrhoid Information Center 2009 / H.I.C. Digestive Health

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

Over 75 million Americans suffer from a painful condition that no one really wants to talk about –hemorrhoids. These swollen, inflamed veins and capillaries around the anus are linked to constipation, straining at the stool, pregnancy, dehydration, and certain vitamin and nutrient deficiencies. They are caused by a diet consisting of low fiber, few nutrients, and too many refined foods.

There are many products out there that look promising, and if you suffer from this debilitating condition they probably sound too good to be true. One of the most well-known is the topical cream that starts with Preparation and ends with “H,” as this company’s advertisements have saturated TV and print ads for as long as most of us can remember. While a topical ointments like Preparation H may be soothing – if you have this condition you probably know that, while for some it may be a temporary solution at best – it’s not the cure for hemorrhoids. As a clinical nutritionist and technical writer for the dietary supplement industry, I can tell you that the only approach that will actually work in the long run to support the body in healing from and preventing future hemorrhoid attacks is one that addresses diet and lifestyle, and gives you the nutrients your body needs both internally and topically. Except, perhaps, in the temporary case of pregnancy and the rapid change in body chemistry and weight, hemorrhoids is not a condition I ever see in people who eat a healthy diet. This article will give you the information your doctor or the Preparation H package probably will not. This article will tell what dietary changes you need to make to solve your hemorrhoid problem.

Juli Keene, B.S.c, CN

Constipation is almost always part of the equation when talking about hemorrhoids. In order to get rid of constipation, the diet must change. Using laxatives is not a long-term solution. Drinking plenty of pure water is paramount to having healthy elimination. I recommend half a person’s body weight in ounces of water per day. Drinking small amounts throughout the day is better than drinking it all at once. It’s almost cliché these days, but I have to say it anyway: fiber is so important in a healthy diet. And I don’t mean cheerios or other refined cereals or bran products. I mean fiber from fruits and vegetables and whole grains eaten in as close to their natural state as possible. Vegetables with at least three meals or snacks each day is ideal. Eating smaller amounts of food more often, like every four hours will also help your digestive system to break down foods, help avoid obesity and liver exhaustion, and help prevent constipation. In cases where constipation is not found in hemorrhoid sufferers, chronic diarrhea caused by too many laxatives and antacids is. Either way, the body is out of balance and diet is the key.

Eating the right amounts of the right kinds of fats is a very important to proper digestion and elimination. Many people are told not to eat too many fats when experiencing hemorrhoids. This is only half true. You definitely want to eliminate the unhealthy fats, but you also must increase the healthy or nourishing fats.

Unhealthy fats are fats that cannot be digested, assimilated, or used by the body for anything other than empty calories. They can also be very damaging. Any foods that are fried in oils should be avoided. Exposure to high heat for long periods causes food enzymes and essential fatty acids to be broken down. Since these fats are basically not digestible without their enzymes, they hang around in the body clogging blood vessels and weakening circulation. Since hemorrhoids are inflamed veins and capillaries around the anus, this is probably one of the worst things to do for this condition.

Any undigested food blocking up the intestine and colon, including fats will contribute to constipation. Hydrogenated fats and oils which are found in most packaged foods like cookies, crackers, breads, chips etc…and which are probably all over your kitchen right now is one of the worst things you can put in your body. These fake food products have been chemically changed so that the shelf life is basically forever. This is great for the grocer who can have it sitting on his shelf for decades without technically going bad, but they are poison for your body. Besides clogging your digestive system and causing more inflammation in the body – where do you think these indigestible fats go after we eat them? They are probably stored in your liver, fat tissue and cardiovascular system. Yuk!

Thankfully, because the diet is pretty bland without them, we do need fats. We just need the type that the human body can digest and use as nourishment. These healthy fats include olive oil, avocado, coconut oil (yes, coconut oil just not hydrogenated coconut oil), raw almonds, nuts and seeds and their butters as well as cold pressed flax seed oil, hemp seed oil, grape seed oil and Omega 3 high EPA and DHA fish oils. These oils are high in essential fatty acids and are extremely healing and strengthening to the body. They are helpful with any kind of inflammatory conditions such as hemorrhoids. If you can work these healthy fats into at least 3 of your meals or snacks a day, and take a high quality EPA/DHA supplement you will be healthier than most Americans subsisting on a diet high in the low quality fats. Omega 3’s and Omega 9’s are not nearly as prevalent in our diets as their less healthy counterparts the Omega 6’s. Most people eating a modern diet are way too high in Omega 6’s and way to low in Omega 3’s and 9’s. I have found in my private practice that changing the ratio of Omega fatty acids in the body correlates with my clients having healthier digestion, less inflammation and much less depression and anxiety. Studies confirm these correlations as well. These healthy fats also serve to lubricate the intestines and colon and soften up stools which can directly support healthy elimination.

If you can combine these high fiber, nutrient rich fruits, vegetables, grains, legumes, beans, healthy fats and plenty of water with adequate amounts of lean protein throughout the day this will go a long way toward not only getting rid of or preventing hemorrhoids but also to becoming optimally healthy. This is a general diet for good health that I have been using for years with my clients. Small amounts of lean protein, complex carbohydrate filled with high fiber and healthy fat is what your body needs every couple of hours to run smoothly. Try it and see how much better you feel.

Next time I will discuss nature’s remedies. Natural products such as herbs, vitamins and other dietary supplements that can help support your body in healing from hemorrhoids.

written by Julie Keene

© 2010 H.I.C. Digestive Health

Hemorrhoid surgery is only performed for hemorrhoids that are classified as either third or fourth stage. The third stage is where the hemorrhoids protrude (prolapsed hemorrhoids) through the anus and must be manually reinserted back into the rectum. In the fourth stage, the hemorrhoids cannot even be pushed back inside, and they contain rectal tissue which is strangulated or thrombosed (containing blood clots).

Having hemorrhoids is an embarrassing problem that most people keep to themselves for fear of ridicule. Often that leads the hemorrhoid sufferer to ignore their affliction and wait way too long before seeking medical intervention. If caught early enough, hemorrhoids can usually be cleared up in a few weeks with simple home remedies and lifestyle changes. But at some point, hemorrhoid sufferers need to consider hemorrhoid surgery if other methods have failed. Try to get your hemorrhoids diagnosed by a doctor as soon as possible.

The two types of invasive hemorrhoid surgeries.

The Hemorrhoidectomy removes the hemorrhoid completely under anesthesia, and the recuperation period can be several weeks and quite painful. This type of hemorrhoid surgery is only recommended in the severest of cases. Inability to void urine and a high infection rate can be complications from this surgery. Some studies have shown a link between this hemorrhoid surgery and a lack of bladder control later in life.

Stapled Hemorrhoidectomy or PPH surgery was developed in 1990’s as a less drastic procedure with a quicker recovery period. During the procedure, the anal canal tissue is repositioned with a circular stapler device, so that blood flow is reduced to the area, causing the hemorrhoids to shrink in four to six weeks. Usually the surgery lasts from 15-30 minutes and the patient can be back to work in a few days. Complications can be rare, but they include damage to the sphincter muscle, pelvic infection, or persistent pain. Another rare complication is rectal prolapse, where the rectum protrudes from the anus. Also, there is a chance that the hemorrhoids may return, and the procedure will need to be repeated.

Hemorrhoid Surgery is usually a last resort for people  because of the expense and recuperation period involved. Your doctor is the best judge of what stage your hemorrhoids are in, and what hemorrhoid surgery options are available for you. You may want to investigate the less invasive hemorrhoid procedures that can be done in your doctor’s office too. But you are the one who will need to make the final decision for yourself, so try to be as knowledgeable as you can be about the differences in available hemorrhoid surgery options. You also can find many more articles on hemorrhoid surgery by using the H.I.C. search engine.

Written by Joy Seeman

© 2009 Hemorrhoid Information Center