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Hemorrhoids are generally defined as a health condition that occurs when the veins in the anal region become enlarged. Also known as piles, this condition can negatively affect patients’ daily lives. It occurs when the veins in the rectum and anus, located at the end of the large intestine, form pouch-like structures. It is a very common condition and can be seen in nearly half of the population. We will also discuss how hemorrhoids are treated and their causes, but first, let’s review the symptoms.
What Are the Symptoms of Hemorrhoids?
First, it should be noted that hemorrhoid symptoms can vary from patient to patient. Symptoms differ depending on the type of hemorrhoid, and their severity may also vary.
Examples of external hemorrhoid symptoms include:
- Severe itching and discomfort around the anus
- A painful lump or swelling near the anus
- Increased pain while sitting
- Blood in the stool
Rubbing the area or prolonged cleaning may increase pain. Sitting for long periods can also worsen discomfort.
Symptoms of internal hemorrhoids include:
- Bright red blood in the stool
- Protrusion of hemorrhoids from the anus
Prolapsed hemorrhoids usually cause pain, while non-prolapsed ones rarely do. These symptoms should not be ignored, and medical consultation is recommended.
What Causes Hemorrhoids?
Chronic constipation is one of the leading causes of hemorrhoids. Frequent constipation should be investigated and treated to prevent hemorrhoid formation. Spending long periods in the toilet and straining during bowel movements are also major causes. These factors negatively affect blood flow in the area, leading to vein enlargement over time. Pregnancy is another common cause due to increased pressure from the uterus.
Types of Hemorrhoids
Hemorrhoids are generally classified into four categories:
- Internal
- External
- Prolapsed
- Thrombosed
This classification is based on location and symptoms. Internal hemorrhoids occur in the rectum and are less sensitive to pain. External hemorrhoids occur outside the anus and may cause itching and discomfort. Prolapsed hemorrhoids extend outside the anus, and thrombosed hemorrhoids involve blood clots.
Stages of Hemorrhoids
Internal hemorrhoids are graded from 1 to 4:
Grade 1
Hemorrhoids are present but do not protrude outside the anal canal. Bleeding may occur.
Grade 2
They protrude during bowel movements but return spontaneously.
Grade 3
They protrude during activity and must be manually pushed back.
Grade 4
They remain prolapsed and cannot be repositioned.
How Are Hemorrhoids Diagnosed?
Many patients delay visiting a doctor due to embarrassment. However, early diagnosis is important. External hemorrhoids can be diagnosed through physical examination, while internal ones may require rectal examination. In some cases, further tests such as colonoscopy may be needed.
How Are Hemorrhoids Treated?
Treatment depends on severity. Mild internal hemorrhoids may be treated with medication, while advanced cases may require surgery. External hemorrhoids without symptoms may not need treatment.
Medications aim to relieve symptoms rather than cure the condition. These may include creams, suppositories, or oral drugs.
Surgical Treatment of Hemorrhoids
Closed Surgery (Longo – Stapled Hemorrhoidopexy)
- A technique developed by Antonio Longo in 1997
- Introduced in Turkey in 1999
- Low pain and high long-term success rate
Laser Hemorrhoidectomy
- Uses laser to treat hemorrhoidal tissue
- Suitable for Grade 1–2 hemorrhoids
Band Ligation
A rubber band is placed around the hemorrhoid, cutting off blood supply and causing it to fall off.
Ligasure Hemorrhoidectomy
Uses heat to remove hemorrhoids but may cause burns and prolonged healing.
Ferguson Hemorrhoidectomy
Hemorrhoids are surgically removed and the wound is sutured.
Parks Procedure
A submucosal technique with superficial suturing.
Milligan-Morgan Hemorrhoidectomy
Hemorrhoids are removed and the wound is left open.
Whitehead Hemorrhoidectomy
All hemorrhoidal tissue is removed, but this method is rarely used due to complications.
Ultrasonic (Harmonic Scalpel)
Uses ultrasound to reduce blood supply to hemorrhoids, but is less commonly used due to cost.
What Helps Hemorrhoids?
Lifestyle and dietary changes are essential:
- Consume olive oil-based meals
- Eat fiber-rich foods
- Drink 2–3 liters of water daily
- Avoid prolonged sitting
- Limit red meat consumption
- Avoid high-carb foods
- Do not delay bowel movements
- Avoid spicy foods
Hemorrhoids During Pregnancy
Increased abdominal pressure and hormonal changes during pregnancy can lead to hemorrhoids. Constipation also contributes. This condition is most common in the last trimester and usually resolves after childbirth.
Post-Surgery Recovery
Recovery depends on the surgical method. Closed surgery typically causes minimal pain, while open surgery may involve more discomfort and bleeding initially.
Hemorrhoids and Nutrition
A fiber-rich diet and adequate hydration are essential. Avoid spicy, processed, and high-fat foods. Balanced nutrition helps prevent and manage hemorrhoids while improving overall health.
