All you need to know about colon and rectal diseases - hemorrhoids

Dr. Matthew Tetherley, Consultant Colorectal and Laparoscopic Surgeon at Burjeel Hospital, Abu Dhabi, answers frequently asked questions about colorectal diseases.

First, what are hemorrhoids?

Hemorrhoids are one of the most common diseases of the colon and rectum. More than half of the population will develop hemorrhoids at some point in their lives, usually after the age of thirty. External hemorrhoids consist of dilated veins under the skin at the anus, which may swell or cause pain. Sometimes it may become very painful if the blood clots (thrombosis). Internal hemorrhoids, which affect the anal canal, are characterized by bleeding without pain and protrusion during bowel movement. When hemorrhoids get worse, they may protrude.

What are the common symptoms and signs of hemorrhoids?

The most common symptom is rectal bleeding without pain. This bleeding may appear in a small amount on a tissue or in the toilet. Patients also complain of discomfort or itching in the anal area. Sometimes in the case of large hemorrhoids, prolapse from the anus occurs and is very painful. But the presence of severe pain when defecation is usually the result of another condition called anal fissure.

When should a colon and rectal surgeon be consulted?

Hemorrhoids are very common and there are many effective treatment options. Most people can recover from symptoms by making lifestyle changes and using simple medications. But if the symptoms do not go away within two weeks, a colon and rectal surgeon should be consulted. Bright red bleeding during and after a bowel movement is the most common symptom of hemorrhoids. Unfortunately, similar symptoms may occur in other diseases such as colitis and cancer. Therefore, if the bleeding does not stop with simple treatment within two weeks, it is important to visit a colon and rectal surgeon.

What are the causes of hemorrhoids?

Factors that contribute to the occurrence of hemorrhoids and that should be noted for prevention are excessive straining to have a bowel movement, prolonged sitting on the toilet (for reading or using a mobile phone), constipation or chronic diarrhea, pregnancy and genetic factors.

How are hemorrhoids diagnosed?

The simplest way to diagnose these problems is to have an examination with a colon and rectal surgeon who deals with these conditions. To confirm the diagnosis, a digital (computer) examination of the rectum is performed with a proctoscopy and sigmoidoscopy (a simple scope for examining the rectum). Sometimes a comprehensive colonoscopy is recommended if there are signs and symptoms of another colon disease, such as a change in bowel movement, or if there are risk factors for colon cancer.

How can hemorrhoids be avoided?

Prevention is better than cure! The easiest way to prevent hemorrhoids is to keep stools soft to pass without straining. It is also important not to sit for long periods on the toilet and not to strain during a bowel movement. Ideally, go to the bathroom only when there is a strong need to open the bowels and do not sit for more than 3 to 4 minutes while passing stools the consistency of toothpaste.

What is the treatment of hemorrhoids?

It helps in the beginning changing the diet and increasing fluids. Keeping the area dry and clean is also important. Soak the area in warm water for 10 to 15 minutes two to three times daily, especially after opening the intestines. When drying use a towel and pat rather than wipe. If these measures do not improve the condition, you may need medication, usually a laxative or a laxative, to soften the stool. If hemorrhoids cause pain or itching, a local anesthetic or a steroid cream may relieve symptoms, but they should only be used for a short time. With the use of these treatments, the symptoms of hemorrhoids may disappear within a week or two. If the condition does not improve, a colon and rectal surgeon should be consulted.

The colon and rectal surgeon has many ways to deal with hemorrhoids, including procedures that are done in the clinic, such as a rubber band ligation or injection that leads to shrinkage of hemorrhoids. There are also a number of surgical procedures that can be performed, such as ligation of the veins, open excision of the hemorrhoid or stapled hemorrhoidectomy. The surgeon determines the appropriate treatment and surgery according to the type of hemorrhoids that the patient suffers from.