Hemorrhoids are very common today, with around 50% of people having them by the time they turn 50. While hemorrhoids are seen in both sexes, they are especially common among women because they often develop during pregnancy. However, hemorrhoids during pregnancy are usually temporary and resolve after the baby is born.
If a patient experiences rectal bleeding or bloody stools, they're usually evaluated for hemorrhoids and digestive diseases, such as colorectal cancer. The physician does a visual examination of the anus and rectum to search for enlarged blood vessels indicating hemorrhoids. Additionally, the doctor does a digital exam of the rectum using a gloved and lubricated finger. This allows the doctor to feel abnormal swelling or growths. To make a hemorrhoids diagnosis, particularly in the case of internal hemorrhoids, an anoscope may be used to light up the interior of the rectum so it can be viewed more closely. In some cases, a proctoscope exam, which allows for a full exam of the whole rectum, is used to make the diagnosis.
Internal hemorrhoids can be treated in several different ways. Infrared coagulation (IRC) is the leading outpatient treatment for hemorrhoids. This non-surgical treatment uses infrared light exposure to coagulate the blood vessels that feed the hemorrhoid. Over the next few weeks, the hemorrhoidal tissues gradually shrink and recede. In a rubber band ligation, a rubber band cuts the blood supply to the hemorrhoid internally, which makes it wither. In sclerotherapy, a special chemical solution is injected directly into the blood vessels to force the hemorrhoid to shrink. In cases where none of these solutions are effective, especially when the patient has severe hemorrhoids, a surgical procedure called hemorrhoidectomy is performed.
Patients can do several things to help prevent hemorrhoids. Keeping stools soft is important, as it means less pressure and straining. This can be accomplished through eating plenty of fiber and using a fiber supplement. The doctor may also recommend a bulk stool softener. The bowels should always be emptied as quickly as possible when the urge occurs, but patients should be mindful of heavy straining.
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