Nearly three out of four adults suffer from hemorrhoids. The exact cause of hemorrhoids is unknown, but this condition is common due to straining when defecating or maternity.
Hemorrhoids or piles are swollen veins (varicose veins) in the rectum or lower large intestine. In the medical world, hemorrhoids are called hemorrhoids. When located in the rectum, this condition is called external hemorrhoids. While hemorrhoids are located at the end of the large intestine called internal hemorrhoids.
Hemorrhoids can be treated in various ways, either by self-medication at home or through surgery. Before talking further about the treatment of hemorrhoids, you should first identify the signs of hemorrhoids.
What are the Symptoms of Hemorrhoids?
Although sometimes it does not cause symptoms, the patient will feel pain if a blood clot forms in the hemorrhoid. Symptoms of hemorrhoids depend on the location, whether internal or external hemorrhoids. But in general, the symptoms of hemorrhoids that sufferers can feel are:
- Itching or irritation in the anal or rectal area
- Discomfort or pain in the rectal area
- Bloody stools
- Lumps and swelling in the anus
The following are symptoms that can be felt by hemorrhoid sufferers, based on the location of the formation of hemorrhoids:
hemorrhoidsinternal
At first, the patient did not feel any complaints. Because it is located inside, this type of hemorrhoid is not visible. But over time, friction by the stool during bowel movements (BAB), especially when straining and hard stools, can damage the surface of the hemorrhoids and cause bloody stools.
If internal hemorrhoids are not treated and get worse, swollen blood vessels in the last part of the large intestine will come out into the rectum. The discharge of blood vessels in internal hemorrhoids is used as a benchmark to assess the severity of hemorrhoids. Here is the explanation:
- Grade 1, if hemorrhoids have not come out into the anus or rectum.
- Class 2, when hemorrhoids that come out to the anus can come back on their own.
- Grade 3, when the hemorrhoid comes out, but can be put back in with a finger.
- Grade 4, when hemorrhoids come out and can't go back in at all.
To confirm the presence of internal hemorrhoids that have not come out, the doctor will perform a digital rectal examination. In a digital rectal examination, the doctor will insert a finger that has been smeared with lubricant into the rectum, to feel the hemorrhoid lump.
Then the doctor will carry out a follow-up examination by looking directly at the condition of the lower intestine, using a special tool called a anoscope, proctoscope, or sigmoidoscope.
External hemorrhoids
Hemorrhoids of this type will itch, and if rubbed or irritated will cause bloody stools. Swollen blood vessels will be easily seen as a lump in the rectum. Doctors can recognize external hemorrhoids simply by examining the rectal area.
In external hemorrhoids, blood can collect and form a clot (thrombus). This condition can cause intense pain and a hard lump in the anus.
How to treat hemorrhoids
Most external hemorrhoids and grade 1 and 2 internal hemorrhoids can be treated with self-care at home, namely:
- Eat foods that are high in fiber.
- Drink enough water.
- Not straining when defecating.
- Not sitting on the toilet for a long time, for example defecating while reading.
- Sit down and soak your buttocks in a tub of warm water, several times a day.
Especially for external hemorrhoids, clean the rectum carefully after defecating, because cleaning the anal area will be more difficult if there is a hemorrhoid lump outside.
In addition to carrying out the treatment steps above, you can also consult a doctor to get pain relievers, laxatives, or drugs that are inserted into the rectum to relieve hemorrhoid complaints.
Although mild hemorrhoids can be treated at home, you should immediately see a doctor if you experience bloody stools.
In external hemorrhoids that have caused bothersome symptoms, grade 3 and 4 internal hemorrhoids, or hemorrhoids that bleed heavily, the doctor will usually recommend surgery.
Some types of surgery to treat hemorrhoids are:
1. Rubber band ligation
The surgeon will tie the hemorrhoid with a special rubber material. This binding causes the hemorrhoid to lose its blood supply, so the hemorrhoid lump will shrink and eventually disappear.
2. Sclerotherapy
The doctor will inject a special chemical into the hemorrhoid, which causes the hemorrhoid to become scar tissue and shrink.
3. Laser therapy
In this procedure, the doctor will use a laser beam to shrink and harden the hemorrhoids.
4. Hemorrhoidectomy
This hemorrhoid surgery procedure is performed in the operating room and uses an anesthetic. Hemorrhoidectomy is performed by removing the entire hemorrhoid.
5. Stapled hemorrhoidopexy
This procedure is the newest surgical technique to treat hemorrhoids and is the treatment of choice for severe hemorrhoids. This operation does not remove the hemorrhoid, but instead tightens the loose tissue that supports the hemorrhoid so that the hemorrhoid does not protrude.
Treatment of hemorrhoids depends on the location and severity. In external hemorrhoids, as well as internal hemorrhoids grades 1 and 2, no surgery is necessary. Surgery should be performed on symptomatic external hemorrhoids, as well as grade 3 and 4 internal hemorrhoids.
written by:
dr. Sonny Seputra, M.Ked.Klin, SpB(Surgeon)