Dr. Rami Hamed Medical Blog

Main cause of hemorrhoids

Written by Dr. Hassan M.Hashem Alshater | 12-Apr-2022 13:07:19

What is the main cause of hemorrhoids?

Swelling in the veins of the lower rectum results in hemorrhoids. Hemorrhoids are classified into two types, internal hemorrhoids, and external hemorrhoids. Internal hemorrhoids do not cause pain but may cause bleeding whereas, external hemorrhoids usually cause intense pain. Hemorrhoids treatment includes having a high-fiber diet such as fruits, taking oral pain killers, and using topical solutions to reduce pain. Conditions that cause hemorrhoids include, chronic constipation or diarrhea, straining during bowel movements, and increased lower bowel or rectum pressure. The main cause of hemorrhoids is chronic constipation or diarrhea. Hemorrhoid problems can also be caused by sitting for a longer duration in the toilet.

 

Are hemorrhoids dangerous? What do hemorrhoids look like?

Pregnant ladies, obese individuals, with a family history of hemorrhoids, chronic constipation or diarrhea, or those who sit for a longer duration in the toilet are most likely to get hemorrhoids. Though hemorrhoids are not dangerous they cause you extreme pain and discomfort. Hemorrhoids look like small lumps in the anal canal that arise from the anal canal. They have a dark bluish-black appearance.

Hemorrhoids are a condition when the blood vessels surrounding the anal canal or rectum get swollen. This irritates me as well. Hemorrhoids can be painful (external hemorrhoids) or maybe painless (internal hemorrhoids). The condition is also known as Piles and is common in both genders. People above age 50 are most likely to get hemorrhoids. 

Main causes of hemorrhoids:

There are certain cases in which people are most likely to have hemorrhoids, such as pregnancy, chronic constipation, chronic diarrhea, age more than 50 or people having family history of hemorrhoids.

  • Pregnancy:

Pregnant women are most likely to get hemorrhoids or piles because of having excess pressure from carrying the baby in the uterus. The weight of the baby can produce pressure on the vessels of the pelvic region. Straining of bowel movement during childbirth is also a major cause of hemorrhoids in women.

  • Chronic diarrhea or constipation:

A condition in which a person passes loose watery stools more than 3 to 4 times in a day is called diarrhea. The condition can be treated with Loperamide or Bismuth subsalicylate. Acute diarrhea is of a shorter duration almost 1 to 2 days. Only chronic diarrhea can cause hemorrhoids. However, diarrhea left untreated can cause hemorrhoids. A condition in which the stools become dry, lumpy, or difficult to pass is called constipation. Having fewer than 3 bowel movements in a week is termed constipation. Constipation can be treated with oral laxatives or a high fiber diet but chronic constipation is the main cause of hemorrhoids.

  • Obesity:

Obesity is a complicated illness including a high measure of muscle or body fat. Obesity does not involve increased body weight but is associated with complex medical conditions. The clinical concern develops other health-related problems, for example, coronary artery disease, lethargy, diabetes, hypertension, and tumors. Obese individuals are more likely to get hemorrhoids as well. This is because people observing obese and sedentary lifestyles can get their veins downwards due to increased pressure. High pressure can cause hemorrhoids. In addition to this, increased body weight also puts high pressure on the rectum veins.

  • Family history:

Most diseases such as diabetes and hypertension can occur due to genetics and family history. Hemorrhoids are also one. Different hereditary characters play a vital role in getting the disease.

  • Age above 50:

It has been noted that hemorrhoids are caused by ages between 45 years to 65 years. However, hemorrhoids can be observed in young adults and children as well to a lesser extent. The main cause of hemorrhoids in elderly people is due to the weakening of connective tissue present between the rectum and anus. This weakening of the connective tissue is the major cause of getting hemorrhoids.

Constipation is also common in elderly people which is the difficulty to pass stools. High pressure to pass stools can also be a significant factor in causing hemorrhoids in elderly patients.

  • Weight lifting:

Individuals often hold their breathing and strain as they lift huge weights. Straining and holding your breath during strenuous exercise or gym will compel the air down into your lungs. This will create increased pressure on the organs such as the kidneys, pelvis, and abdominal region. Increased pressure on the pelvis makes the blood vessels swell around the rectum causing hemorrhoids. 

  • Sitting on a toilet seat for longer durations:

Like weight lifting sitting on the toilet seat also creates high pressure in and around the anal canal. The pressure on the rectum is also raised. While sitting on the toilet seat, the rectum is lowered than other body parts. Due to the action of gravity, the blood flows downwards and clots small veins which cause them to swell. Pushing and straining to add up to having hemorrhoids.

Diagnosis of hemorrhoids:

External hemorrhoids are visually inspected by the physician whereas internal hemorrhoids are inspected by examination of the rectum and anal canal. Colonoscopy is a technique through which the entire colon is analyzed for the presence of hemorrhoids. The diagnosis can be made through digital or visual inspection. The visual inspection is further classified as anoscopy, proctoscopy, or sigmoidoscopy.

Complications:

Anemia can be rarely caused due to prolonged blood loss through the anal canal and rectum. Red blood cell count is reduced that causing anemia. Chronic hemorrhoids may lead to blood clotting that is not dangerous but causes extreme pain. It is known as thrombosed hemorrhoids. Strangulated hemorrhoid is another complication associated with hemorrhoids. IT occurs when the internal hemorrhoid blood supply is cut off.

Hemorrhoids treatment:

Treatment options for hemorrhoids include various remedies such as eating a high-fiber diet. Having vegetables, fruits and grains makes the stool easier to pass which reduces pressure on the rectum. Soaking the anal area in warm water can also provide relief from the hemorrhoids. Hemorrhoid creams and suppositories are available that include hydrocortisone and numbing agents. Topical solutions are also present in the form of pads.

Medications used for hemorrhoids:

Oral pain killers such as aspirin, ibuprofen, ketoprofen, or acetaminophen are used to reduce pain temporarily. Steroidal creams are available for topical application to reduce discomfort. Suppositories and ointments having lidocaine, witch hazel, or hydrocortisone are applied to reduce pain.

Surgical treatment for hemorrhoids:

Surgical treatment involves two processes:

Hemorrhoid removal is also known as hemorrhoidectomy can also be performed by medical professionals. The surgery is performed by giving spinal or general anesthesia to the patient and is considered a one-day case surgery. Excisions are made for hemorrhoidal bundles through scalpels and scissors. Absorbable sutures are used for stitching the wound. Excessive tissue bleeding is observed after surgery. Hemorrhoid stapling is a useful treatment option that includes blocking the blood supply to the hemorrhoids. However, relapse may occur due to the technique.

Some less invasive treatment options involve:

  • An injection is also known as sclerotherapy
  • Rubber band ligation
  • Coagulation is usually done by infrared, bipolar, or laser therapies

Hemorrhoids prevention:

Hemorrhoids can occur due to several reasons but the exact cause is still unknown. Hemorrhoids can be prevented by having high fiber diets such as oranges, grapefruit, vegetables, and grains. Drinking plenty of water and juices makes the stools softer and easier to pass which reduces the risks of hemorrhoids. Fiber supplements can be added to the dietary regime for people who do not take enough fiber through their diets.

The supplements contain 20 to 30 grams of fiber. Methylcellulose and psyllium are some important examples. Heavy weight lifting, straining, and holding breath should be avoided to reduce the risk of getting hemorrhoids. Exercise also prevents hemorrhoids by reducing the risk of having constipation. Exercise makes you fit and active which prevents hemorrhoids.