Hemorrhoids, also known as piles, are the swollen blood vessels that are located in the smooth muscle walls of the rectum and anus. They are cushioned by smooth muscles and connective tissue. The blood vessels of the rectum become swollen due to increased pressure within them. Hemorrhoids are common in human beings and occur at some stage during their lives. They to occur more frequently during old age due to weakening and stretching of vein tissues in the rectum.

Generally, minor hemorrhoids do not cause much discomfort and heal after some time. They become an issue only when they begin to swell and expand and cause irritation, pain, and bleeding. Treatment and prevention of hemorrhoids involve prescription of ointments, home remedies and change in lifestyle. However, if the condition persists for a longer duration, it is necessary to visit a doctor for diagnosis and treatment. In some cases, a minor surgery needs to be done.

Types of hemorrhoids
Hemorrhoids are classified on the basis of their location with respect to the pectinate line. They are mainly categorized into two types – Internal hemorrhoids and external hemorrhoids.

Internal hemorrhoids are swollen blood vessels arising from within the rectum above the pectinate line. They usually do not cause any problem unless their surface gets damaged during the bowel movement. The straining can sometimes push hemorrhoid through the anal opening which results in a protruding or prolapsed hemorrhoid. This can cause severe pain and irritation.

External hemorrhoids are swollen blood vessels arising from blood vessels that surround the anus beyond the pectinate line. They do not cause much discomfort unless blood gets accumulated in the vessels and form a clot. The clot rapidly expands and causes severe pain, swelling, and inflammation.

Causes of hemorrhoids
Hemorrhoids are primarily caused due to increase in pressure within the blood vessels of the rectum. This leads to swelling of blood vessels and increases in their size resulting in pain and other symptoms. An increase in pressure may be due to various factors which include:

• Prolonged sitting at a place, especially on the toilet
• Straining during bowel movements
• Chronic constipation or diarrhea
• Low fiber diet
• Pregnancy
• Obesity
• Maintaining poor posture or spinal cord injury
• Anal intercourse

Symptoms of hemorrhoids
Signs and symptoms of hemorrhoid include:

• Discomfort and pain during sitting
• Swelling around the anus
• Irritation during bowel movement
• Irritation around the anal region
• Presence of blood in stool
• Formation of lumps around the anal region, which are painful

How to diagnose it
External hemorrhoids can be diagnosed with a visual inspection performed by the physician for any unusual growth or masses.  Internal hemorrhoids cannot usually be diagnosed just by seeing. The various tests carried out to diagnose external hemorrhoids are shown below:

• Physical examination is performed that involves a rectal examination in which the doctor inserts a lubricated gloved finger into the rectum to feel for abnormal lumps.
• The medications and past medical history of the patient are often taken into account to recommend further testing or not. It includes focussing on associated symptoms such as constipation, hard bowel movements, and straining while going to the toilet.
• If the symptoms (especially rectal bleeding) cannot be explained by hemorrhoids, then anoscopy may be considered. Anoscopy is a procedure in which a lighted tube, known as anoscope, is inserted to get the view of the anal canal and rectum.
• If the signs and symptoms suggest any other digestive system disease or colorectal cancer, then, colonoscopy or sigmoidoscopy may be considered.

How to treat hemorrhoids
A majority of hemorrhoid conditions can either be treated naturally or with some ointments. But, in the case of severe situations, it is essential to consult a doctor, who might give medications or recommend surgery.

Home treatment methods for hemorrhoid relief

• Warm bath : Soaking the anal region by sitting in warm water for 10-15 minutes 2-3 times a day may help in reducing the inflammation of the hemorrhoids.
• Stool softeners : Using stool softeners will assist in easy passage of stools.
• Dietary changes : Increase in fluid intake and dietary fiber will reduce the chances of constipation and reduce pressure on rectal blood vessels. Thus, it helps to decrease further swelling and bleeding.
• Ice packs : Applying ice packs on the affected region can provide relief from swelling.

Medical treatment for hemorrhoid relief

• Medication : Use of oral medication (such as paracetamol) and ointments (such as hydrocortisone) can provide temporary relief from inflammation and irritation.
• Laser or Infrared Coagulation : It is a type of heat treatment which causes hemorrhoid to harden and subsequently crumble.
• Hemorrhoidectomy : It involves removal of hemorrhoids with the help of a laser or scalpel.
• Hemorrhoids stapling : It involves removal of hemorrhoid using a special staple gun. During this procedure, staple rings are inserted into the anus to close the wound and prevent bleeding.

Prevention
The following steps can be undertaken to prevent occurring of hemorrhoids or controlling symptoms of existing hemorrhoids

• Eating high fiber diet
• Staying well hydrated
• Getting sufficient exercise
• Avoid sitting at a place for long periods
• Trying to have bowel movement as soon as possible after the urge arises
• Avoiding straining during toilet
• Using fiber supplements

It’s always a good option to consult your doctor before undergoing any treatment to get hemorrhoid relief.