DUBAI - Hemorrhoids are normal vascular structures in the anal canal which help with stool control but they become piles when swollen or inflamed, said Dr Wadhah Shaker, Specialist Surgeon at Zulekha Hospital, Dubai.
“The symptoms of pathological hemorrhoids depend on the type present. Internal hemorrhoids usually present with painless rectal bleeding while external hemorrhoids present with pain in the area of the anus,” he explained.
Recommended treatment consists of increasing fiber intake, oral fluids to maintain hydration, analgesics, stiz baths and rest. Surgery is reserved for those who fail to improve following these measures.
A number of factors may lead to the formations of hemorrhoids including irregular bowel habits (constipation or diarrhea), no exercise, nutrition (low-fibre diet), spicy food, increased intra-abdominal pressure (prolonged straining), pregnancy, genetics, absence of valves within the hemorrhoidal veins, and aging.
Other factors that can increase the rectal vein pressure resulting in hemorrhoids include obesity and sitting for long periods of time. During pregnancy, pressure from the fetus on the abdomen and hormonal changes cause the hemorrhoidal vessels to enlarge. Delivery also leads to increased intra-abdominal pressures. Surgical treatment is rarely needed, as symptoms usually resolve post delivery.
The best way to prevent hemorrhoids is to keep stools soft so they pass easily, thus decreasing pressure and straining, and to empty bowels as soon as possible after the urge occurs.
Exercise, including walking, increased fibre in the diet and reducing spicy food help reduce constipation and straining by producing stools that are softer and easier to pass. Spending less time attempting to defecate and avoiding reading while on the toilet are also recommended.
Surgical techniques may be used if conservative medical management fails.
Anal fissure is a crack or tear in the skin of the anal canal. Anal fissures may be noticed by bright red anal bleeding on the toilet paper, sometimes in the toilet.
If acute, they may cause severe periodic pain after defecation but with chronic fissures, the pain intensity is often less.
In infants, frequent nappy/diaper change can prevent anal fissure. As constipation can be a cause, it’s important to make sure that the infant is drinking enough fluids.
Non-surgical treatment is recommended as first-line treatment of acute and chronic anal fissures. Customary treatments include warm stiz bath, topical anesthetics, high-fibre diet and stool softeners.