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HEMORRHOIDS Did
you know... Hemorrhoids are one of the most common ailments known. More
than half the population will develop hemorrhoids, usually after age 30.
Millions of Americans currently suffer from hemorrhoids. The average person
suffers in silence for a long period before seeking medical care. Today's
treatment methods make some types of hemorrhoid removal much less painful.
WHAT
ARE HEMORRHOIDS? Often
described as "varicose veins of the anus and rectum", hemorrhoids are
enlarged, bulging blood vessels in and about the anus and lower rectum. There
are two types of hemorrhoids: external and internal, which refer to their location.
External (outside)
hemorrhoids develop near the anus and are covered by very sensitive skin. If a
blood clot develops in one of them, a painful swelling may occur. The external
hemorrhoid feels like a hard, sensitive lump. It bleeds only if it ruptures. Internal
(inside) hemorrhoids develop within the anus beneath the lining. Painless bleeding
and protrusion during bowel movements are the most common symptom. However, an
internal hemorrhoid can cause severe pain if it is completely "prolapsed"
- protrudes from the anal opening and cannot be pushed back inside. 
WHAT CAUSES
HEMORRHOIDS? An
exact cause is unknown; however, the upright posture of humans alone forces a
great deal of pressure on the rectal veins, which sometimes causes them to bulge.
Other contributing factors include: Aging Chronic constipation or diarrhea
Pregnancy Heredity Faulty bowel function due to overuse of laxatives
or enemas; straining during bowel movements Spending long periods of time
(e.g., reading) on the toilet Whatever the cause, the tissues supporting
the veins stretch. As a result, the veins dilate; their walls become thin and
bleed. If the stretching and pressure continue, the weakened veins protrude. WHAT
ARE THE SYMPTOMS? If
you notice any of the following, you could have hemorrhoids: Bleeding during
bowel movements Protrusion during bowel movements itching in the anal
area Pain Sensitive lump(s) DO
HEMORRHOIDS LEAD TO CANCER? No.
There is no relationship between hemorrhoids and cancer. However, the symptoms
of hemorrhoids, particularly bleeding, are similar to those of colorectal cancer
and other diseases of the digestive system. Therefore, it is important that all
symptom are investigated by a physician specially trained in treating diseases
of the colon and rectum. Do not rely on over-the-counter medications or other
self-treatments. See a colorectal surgeon first so your symptoms can be properly
evaluated and effective treatment prescribed. HOW
ARE HEMORRHOIDS TREATED? Mild
symptoms can be relieved frequently by increasing the amount of fiber (e.g., fruits,
vegetables, breads and cereals) and fluids in the diet. Eliminating excessive
straining reduces the pressure on hemorrhoids and helps prevent them from protruding.
A sitz bath - sitting in plain warm water for about 10 minutes - can also provide
some relief With
these measures, the pain and swelling of most symptomatic hemorrhoids will decrease
in two to seven days, and the firm lump should recede within four to six weeks.
In cases of severe, persistent pain, your physician may elect to remove the hemorrhoid
containing the clot with a small incision. Performed under local anesthesia as
an outpatient, this procedure generally provides relief. Severe
hemorrhoids may require special treatment, much of which can be performed on an
outpatient basis.
Ligation - the rubber band treatment - works effectively on internal hemorrhoids
that protrude with bowel movements. A small rubber band is placed over the hemorrhoid,
cutting off its blood supply. The hemorrhoid and the band fall off in a few days
and the wound usually heals in a week or two. This procedure sometimes produces
mild discomfort and bleeding.
Injection
and Coagulation can also be used on bleeding hemorrhoids that do not protrude.
Both methods are relatively painless and cause the hemorrhoid to shrivel up. Hemorrhoidectomy
- surgery to remove the hemorrhoids - is the best method for the permanent removal
of hemorrhoids. It is necessary when (1) clots repeatedly form in external hemorrhoids;
(2) ligation fails to treat internal hemorrhoids; (3) the protruding hemorrhoid
cannot be reduced; or (4) there is persistent bleeding. A hemorrhoidectomy removes
excessive tissue that causes the bleeding and protrusion. It is done under anesthesia
any may, depending upon circumstances, require hospitalization and a period of
inactivity. Laser hemorrhoidectomies do not offer any advantage over standard
operative techniques. They are also quite expensive, and contrary to popular belief,
are no less painful. Other
treatments include cryotherapy, BICAP coagulation and direct current. Cryotherapy,
popular 20 years ago, consists of freezing hemorrhoidal tissue. It is not recommended
for hemorrhoids because it is very painful. BICAP and direct current are methods
that shrink the hemorrhoid. None of these t reatments have gained widespread acceptance.

Rubber
Band Ligation of Internal Hemorrhoids:
A. Bulging,
bleeding, internal hemorrhoid B.
Rubber band applied at the base of the hemorrhoid C.
About 7 days later, the banded hemorrhoid has fallen off leaving a small scar
at its base (arrow)
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The
executive office of the 1,800-member American Society of Colon and Rectal Surgeons
is located in the Chicago suburb of Arlington Heights. Board-certified colon and
rectal surgeons complete a residency in general surgery, plus an additional year
in colon and rectal surgery. They also pass an intensive examination conducted
by the American Board of Colon and Rectal Surgery administered after successful
completion of written and oral examinations conducted by the American Board of
Surgery. For
additional information or a list of colorectal surgeons in your area, contact:
American Society
of Colon and Rectal Surgeons 85 W. Algonquin Rd., Suite 550 Arlington
Heights, IL 60005 (847)290-9184 or (800)791-0001 Email: ascrs@fascrs.org
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