Hemorrhoids, also called "piles" are swollen, inflamed veins in the anus and rectum. Anatomically, the word hemorrhoids refers to "cushions" of blood vessel filled tissue at the junction of the anus and the rectum. In popular use, however, the term refers to varicose veins of the rectum and anus.
Hemorrhoids can be caused by long periods of sitting, by straining while moving the bowels, and by constipation. People with hypertension - particularly of the portal vein (the vein in the abdominal cavity that drains blood from the spleen and gastrointestinal tract) are more prone to hemorrhoids due to the connection between the portal vein and the vena cava, which occur in the wall of the rectum. Obesity, poor muscle tone, and poor posture can also result in excess pressure on the rectal veins. Pregnancy is another condition that can dispose a person to hemorrhoids.
Poor diet contributes to the conditions favorable for development of hemorrhoids. For example, excessive lactic acid in the stool accompanying excessive consumption of dairy products, can cause an increase in hemorrhoids, and reduction of dairy products may provide relief. Insufficient vitamin E has also been associated with the development of hemorrhoids.
There are two main types of hemorrhoids: external and internal. External hemorrhoids can be painful, and can be accompanied by irritation and swelling. If there is itching, it is usually due to skin irritation. External hemorrhoids are prone to development of a blood clot. This process is called thrombosis.
Internal hemorrhoids occur inside the rectum. Because this area lacks pain receptors, internal hemorrhoids usually don't hurt. People may not even be aware of them unless bleeding occurs. Internal hemorrhoids left untreated can lead to complications including prolapsed and strangulated hemorrhoids. Prolapsed hemorrhoids are distended enough that they are pushed outside the anal opening. Spasms of the anal sphincter can trap a prolapsed hemorrhoid outside the anus, cutting off the blood supply, and resulting in a strangulated hemorrhoid.
The measures for prevention of hemorrhoids are generally practices that are beneficial to overall health: adequate water intake, adequate fiber intake, better posture, and regular exercise. There are some experts who believe that wearing tight fitting clothing and underwear can contribute to irritation in the region and promote the development of hemorrhoids. Adequate hygiene can alleviate some of the swelling caused by hemorrhoids.
Treatments for hemorrhoids vary greatly by culture and may be simple, complicated, and non-intrusive to very intrusive. They range from hydrotherapy to cold compresses to pain relievers. Topically applied vasoconstrictors like phenylephrine, or topically applied astringents such as witch hazel are sometimes used. Over-the-counter hemorrhoid treatments often contain a mixture of ingredients in one topical ointment. Severe cases may require surgery for relief.
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