Hemorrhoids

We all have hemorrhoids, which are essentially blood vessels located in the final part of the large intestine and the rectum.


Among other things, they control bowel movements and separate solids, liquids, and gases. When these blood vessels are stretched and dilated excessively, a condition of inflammation, thrombosis, or rupture occurs, resulting in significant suffering.



Prominent symptoms:

Fresh blood appearing on the stool or toilet paper - Itching, discomfort, or pain in the anal area - Swelling or a bulge outside the anus.


Types of hemorrhoids:

**External hemorrhoids**: Located at the anus and outside of it, contain nerve cells, are usually more painful, and bleed less.


**Internal hemorrhoids**: Located inside the anus and in the lower part of the rectum, contain fewer nerve cells, and therefore are less painful and bleed more.


Degrees of hemorrhoids:


1. **Grade 1**: Internal hemorrhoids that are not felt.

2. **Grade 2**: Hemorrhoids that protrude outside the anus during a bowel movement and return to their place on their own.

3. **Grade 3**: Hemorrhoids that protrude during a bowel movement and do not return on their own, requiring manual repositioning.

4. **Grade 4**: Hemorrhoids that protrude and cannot be pushed back in.



Causes of hemorrhoid formation:

- Effort due to constipation during bowel movement - Prolonged sitting in the bathroom - Pregnant women and childbirth due to the increased pressure exerted by the fetus on the rectum and the anal sphincter - Impaired liver function affecting the drainage of hemorrhoids - Significant heart failure affecting the condition of hemorrhoids due to drainage problems - Lack of physical activity - A state of stress.

Age and heredity: As people age, the risk of hemorrhoid prolapse increases due to degeneration, weakness, or loss of muscle tone. - Slow metabolism or medication use may increase the risk of constipation and thus the formation of hemorrhoids.


Diagnosis:

If the hemorrhoids are external, the diagnosis is usually simple and involves a direct inspection. If the hemorrhoids are internal, the diagnosis is made by a proctologist using an endoscope.

Warning lights:

Hemorrhoids in themselves do not pose a health risk but can cause suffering and a decline in quality of life. There are various causes of rectal bleeding besides hemorrhoids, so it is important to report such bleeding to a family doctor for further investigation to rule out other diseases like colitis, Crohn's disease, or colon cancer. Light bleeding on toilet paper usually indicates low severity of hemorrhoids (it could also be a fissure), while heavier bleeding, clearly visible in the toilet, indicates a higher grade of hemorrhoids that may cause anemia.

Hemorrhoid treatment:

In many cases where the severity is Grade 1 or 2, lifestyle changes, dietary adjustments, and correcting improper habits can resolve the issue.


Recommendations:

- Maintain a diet rich in soluble and insoluble fibers, such as fruits, vegetables, whole grains, legumes, various seeds, and nuts. The goal is to have a soft, sponge-like stool that can be expelled easily and comfortably. - The World Health Organization recommends a fiber intake of 25-35 grams per day, varying by gender and age. - When consuming a high-fiber diet, ensure adequate water intake to avoid constipation. Women should aim for about 2.7 liters of water per day, and men about 3.7 liters, noting that food and beverages contribute around 20% to daily water requirements. - Approximately, this translates to 9 cups (about 2.2 liters) for women and 13 cups (about 3 liters) for men. - Monitor hydration by checking urine color: light and clear indicates adequate hydration, while dark urine suggests the need for increased fluid intake. - Daily fluid intake can be impacted by additional factors such as weight, climate, and daily activity level.