Hemorrhoidal veins form a network of blood vessels that sit:
- In the wall of the anal canal: internal hemorrhoids.
- Under the skin around the folds of the anus: external hemorrhoids.
All people have hemorrhoidal veins.
WHAT IS IT ABOUT ?
Hemorrhoids are a network of vessels present, in the normal state, in the rectum. There is an external network, located under the skin on the outer edge of the anus, and an internal network located deeper under the lining of the anal canal that plays a role in the continence of the anus.
In everyday language, all the disorders that can affect these vessels are called hemorrhoids.
Hemorrhoids are very common and affect both men and women. They are more common between the ages of 40 and 65. They are generally benign and transient, but can cause discomfort in daily life.
There is a hereditary ground but also several favorable factors:
- Disorders of intestinal transit and especially constipation.
- Sedentary lifestyle, in particular prolonged sitting (truck drivers, pilots, etc.).
- Certain drugs.
- In women: the premenstrual phase, pregnancy or childbirth.
Hemorrhoids are manifested by:
- Pain : it is variable from one individual to another, ranging from simple discomfort or heaviness to acute pain which makes sitting down, especially if it becomes more complicated (hemorrhoidal thrombosis, associated anal fissure). It is usually triggered by defecation or exertion.
- Typically red bleeding , often scant, but giving the impression of abundance when diluted in the water in the toilet bowl. It most often appears at the end of a bowel movement and can stain underwear. It is never a sign of seriousness.
- Prolapse corresponds to the exteriorization of a hemorrhoidal bundle outside the anus. It forms a small mass that can be felt by the sufferer.
Hemorrhoids can be complicated by thrombosis, which is the formation of a blood clot inside the hemorrhoidal bundle which is usually very painful.
Hemorrhoids can be associated with anal fissure which is a small sore in the anal margin that makes defecation very painful.
The diagnosis of hemorrhoidal disease does not require any additional examination. The doctor performs a proctologic examination (that is, an examination of the anus) with examination of the anal margin and digital rectal examination. Sometimes he can use an anoscope to see the inside of the anus. This allows the stage of the disease to be determined:
- Stage 1: the hemorrhoidal veins do not externalize.
- Stage 2: the hemorrhoidal veins exteriorize during thrusts (defecation, coughing effort) and return spontaneously.
- Stage 3: the hemorrhoidal veins externalize during relapses, must be reintegrated manually and then remain inside.
- Stage 4: the hemorrhoidal veins exteriorize during the thrusts, must be manually retracted but come out: they are exteriorized permanently.
The treatment includes above all hygieno-dietetic measures which aim to regulate the transit:
- Increase the amount of fiber in your diet by consuming more fruits and vegetables.
- Drink enough water (at least 2 liters per day).
- Drink infusions that promote circulation.
- Have moderate but regular physical activity.
- Regulation of transit by simple hygienic-dietetic rules.
- Mild laxatives.
- Healing suppositories and lubricants.
- Healing cream to be applied on the anal margin. Some contain an anesthetic that can provide effective relief when the attack is most painful.
- Painkillers like paracetamol.
- Use of a “buoy” type cushion to sit on which provides effective relief when the crisis is the most painful.