Hemorrhoids

Hemorrhoids are a common, but usually harmless, problem. It can bleed, itch and sting around the rectum. It can also leak a bit of mucus or stool and you may feel something bulging at the rectum opening. Hemorrhoids often get better by themselves, but you may need medicines that relieve them.

Symptoms of hemorrhoids

A common symptom of hemorrhoids is that you bleed from the rectum, for example, some red blood may appear on the paper when you dry yourself after a toilet visit or blood splashes in the toilet seat. The blood is usually not mixed with feces.

You may also have one or more of the following symptoms of hemorrhoids:

  • It can itch and sting around the rectum.
  • It can leak gases and feces or mucus without hindering it.
  • It can hurt when you poop.
  • You can feel something bulging at the rectum opening.

The fact that it is burning maybe because the intestinal mucosa next to hemorrhoid has become irritated and that small cracks have formed. The leak can occur because the hemorrhoids are covered by a mucous membrane that secretes mucus, and that the rectum opening does not close tightly.

When you tick off, hemorrhoids can appear and they can be felt with your fingertips. Sometimes it is possible to push the hemorrhoids in again. Large hemorrhoids can be difficult or impossible to push back at the same time as they can hurt if they become inflamed.

When and where should I seek care?

Most people who get hemorrhoids do not need to seek care as the problems usually go away by themselves.

Contact a health care provider if you have any of the following symptoms of hemorrhoids:

  • You bleed from the rectum.
  • You have pain in or around the rectum.
  • It has been itching around the rectum for more than a week.
  • It leaks mucus or feces.
  • The trouble does not go away, despite treatment for two to three weeks.

If it is a weekend, you can wait until it is every day. You can contact many receptions by logging in.

If it’s in a hurry

If you are bleeding profusely or have a lot of pain, contact a health care center or an on-call reception immediately. If closed, seek care at an emergency room.

What can I do for myself?

Constipation increases the trouble for those who already have hemorrhoids. If you have easy constipation, it is good to avoid things that cause a severe bowel movement. Among other things, food and drink affect the stool’s texture.

Stopping food can cause stools. Examples of stuffing foods include food products that contain a lot of white flour-like pasta and light bread. Some drugs can also cause hard stools.

You can reduce your discomfort through regular physical activity.

Eat more fiber

To avoid constipation it is good to eat more fiber-rich foods such as muesli and coarse bread. Wheat bran is also rich in fiber and can be mixed in porridge or other dishes.

Other things you can do are the following:

  • Replace salad, tomato, and cucumber that do not contain so much fiber to beans, peas, potatoes, broccoli, and cauliflower.
  • Drink an extra glass of water at every meal.
  • Try to go to the bathroom every day, and preferably at the same time, for example after breakfast.

If you find it difficult to get fiber with you in the food, there are fibers in powder form, a so-called bulk agent that the doctor can print. They are also available to buy prescriptions at pharmacies.

You should take bulk fluid with plenty of fluid. The bulk agent binds fluid in the large intestine. If the stomach is sluggish the effect is that the intestinal contents increase in volume and the intestine gets more to work with. All liquid also gives the intestinal contents a softer and smoother texture. In this way, the passage through the intestine is facilitated and the stool is easier to get out.

Bulk agents and foods containing fiber often produce gases in the stomach, but also the gases help to facilitate bowel emptying. You can temporarily reduce the amount of fiber if gas formation becomes too difficult.

Endure – it takes at least six weeks

Increase fiber intake for at least six weeks. Then the hassles of the hemorrhoids usually disappear, but they can come back if you get constipated again.

Relieve the trouble

You can relieve the trouble with non-prescription drugs if you are sure you have hemorrhoids. Then it is important to wash the skin around the rectum with lukewarm water after pooping, as well as morning and evening.

Just wash with water. Soap can irritate the skin further. Dry gently by patting dry with the towel, instead of rubbing.

You can also try to push back the hemorrhoids, but that should not hurt.

What are hemorrhoids?

In the lower part of the rectum is the anal canal which leads into the rectum opening. There are small pillows consisting of connective tissue and blood vessels, so-called anal pads. They can be enlarged and swollen up, and even slide down so that they come out through the anal opening. This is what is called internal hemorrhoids. 

Outer hemorrhoids form in the skin of the anal opening that forms flaps. Often, internal and external hemorrhoids occur simultaneously.

An explanation for increasing swelling may be increased tension in the muscle that regulates how the rectum opening is closed and opened.

Harmless and ordinary

Hemorrhoids are common and usually harmless. It is very uncommon for them to turn into something serious.

You can often treat the hemorrhoids yourself if you have had hemorrhoids before and recognize the symptoms. Hemorrhages that change should always be examined by a doctor. For example, the blood may become darker and more blended with the poop.

The biggest risk with hemorrhoids is that they can hide a more serious illness, as both can cause blood in the stool. Therefore, always contact a health center for blood for the first time.

What is it?

It is common for pregnant women to have hemorrhoids. On the one hand, pregnant women have a larger amount of blood in the body, and on the other hand, the growing uterus presses the large blood vessels in the abdomen, which in the long run makes it a little harder for the blood to circulate. This leads to higher pressure in the blood vessels of the rectum and hemorrhoids to form more easily. They usually disappear after childbirth.

Hormone changes in pregnancy can also cause constipation.

Some drugs may contribute to constipation and thus cause greater problems with hemorrhoids. This applies, for example, to the following drugs:

  • Iron preparations.
  • Some painkillers.
  • Some drugs for mental illness.
  • Some medicines for high blood pressure.
  • Some medicines for the acidic stomach.

Consult with the doctor who wrote the prescription if you suspect that it is a drug that is causing constipation. Together, you have to weigh the inconvenience of constipation against what the drug can do. Sometimes the doctor may change the dose or suggest another drug, which may cause less trouble with constipation.

Investigations

Before the examination, you may be told by your doctor about your complaints, how long you have had them and how they feel. You also have to answer if you have any illnesses and if you are using any medicines.

The doctor begins the examination by looking at what it looks like around the rectum. Then the doctor feels with a finger inside and inside the rectum.

The doctor then examines the mucosa of the rectum and the lower part of the large intestine using a tubular instrument that is inserted into the intestine. The instrument is called a proctoscope. The tube is made of plastic and is eight to ten inches long. To make the instrument slide in easier, a sliding jelly is used. The doctor then looks at the intestinal mucosa through the proctoscope while slowly exiting. At the same time, you are encouraged to cruise. If you have hemorrhoids, they bulge into the proctoscope and can easily be examined.

Your doctor may also want to examine the rectum if you bleed from the rectum. It does them with the help of a so-called rectoscope. It is important to check if there is any more serious change up the bowel that causes bleeding. The doctor can also take samples from the mucosa which is then examined using a microscope.

If it is uncertain where the bleeding is coming from, the doctor can look even further up the colon using a colonoscope. You will then receive a referral to the survey, which will be done at a later date after some preparation.

If the doctor does not detect any hemorrhoids, the symptoms may be due to the following causes:

  • Cracks in the skin of the anal canal called an anal fissure.
  • A painful lump caused by a bacterial infection.
  • A fistful, which is a small opening to a channel, or connection that should not normally exist. It can occur, among other things, if you have an inflammatory bowel disease.
  • Itching around the rectum opening that can be caused by skin infections or gut in the intestine, such as a spring mask.

You can bleed from the rectum without the doctor finding any particular cause. It may then be due to the mucous membrane being damaged, for example, that it has become brittle due to inflammation or that you have dried yourself excessively.

Treatment of hemorrhoids

If the hemorrhoids are small and do not cause too much trouble, the doctor usually recommends a non-prescription drug that is available at pharmacies. The doctor may also prescribe the drug on prescription.

The drugs relieve pain and cushion the itch. Some of them contain substances that suppress inflammation, if one has them, or contract blood vessels. The drugs are available in two different forms. Partly as a stop pill that you insert into the rectum, and partly as an ointment that you grease on the hemorrhoids and around the rectum opening.

The drugs are usually used for two to three weeks. Careful instructions are included in the package of medicines.

Examples of non-prescription drugs that can be purchased at pharmacies:

  • Xyloproct and Scheriproct relieve pain, reduce bleeding and counteract itching and inflammation. The drugs are both in the form of suppositories, which are inserted into the rectum, and ointment.
  • Alcosanal relieves itching and is available as suppositories and ointment.
  • Xylocaine ointment is temporarily used if it hurts to empty the bowel. The ointment seems stunning.

Consult your doctor if the non-prescription drugs do not help. There are prescription drugs that the doctor can prescribe.

For example, for skin irritation and itching, cortisone ointment or cortisone cream can be used for a few weeks. Examples are Mildison Lipid cream and Hydrocortisone Trimb ointment and can be purchased non-prescription in smaller packages.

Sometimes surgical treatment is needed

You may need to be examined by a surgeon if it turns out that the hemorrhoids are large or that they cause severe bleeding. There are several different treatment methods to remove hemorrhoids.

Injection Treatment of Hemorrhoids

Drugs are injected with a syringe at the hemorrhoids. The agent causes the blood vessels that lead to the hemorrhoids to shrink. Thus, the blood supply is throttled and the hemorrhoids gradually decrease.

Gummibandsligering

With the help of a special device, a rubber band is drawn around hemorrhoids. As the hemorrhoids no longer receive any blood supply, they shrink and loosen after one to two weeks.

Operation

In one operation, hemorrhoids are cut off. You get back anesthesia or you are anesthetized during the operation. The wound is either sewn together again or left open and allowed to heal by itself. Other methods are to cut the hemorrhoids with a special device that also joins the mucous membrane with small staples. Or put a stitch around the hemorrhoids’ blood vessels.

There are pros and cons to all the methods. Operating the hemorrhoids is considered more effective than syringe or rubber band treatment. But there is a certain risk that the hemorrhoids will return after surgery.

It often hurts during the healing itself, but the pain usually disappears after one to two weeks. The time immediately after surgery can be a bit cumbersome and it is important that the stools are kept soft to reduce the pain. For example, it is good to drink plenty of water and eat high in fiber. There are also various non-prescription drugs in pharmacies that make it easier to poop.

Complications are rare

There may be remnants of skin flaps adjacent to the rectum opening when the hemorrhoids have receded. The tabs usually do not cause any direct inconvenience, but because they are difficult to keep clean you can get itchy. The tabs may need to be removed for that reason.

Influence and participate in your care

As a patient, you have under the Patient Act chance to affect your health.

You can seek care at any medical center or open specialist clinic you want throughout the country. Sometimes a referral to the open specialized care is required.

You should understand the information

In order for you to be involved in your care and treatment, it is important that you understand the information you receive from the healthcare staff. Ask questions if you don’t understand.

Children should also be involved in their care. The older the child, the more important it is.

You have the opportunity to get help from an interpreter. You also have the opportunity to get help from an interpreter if you have a hearing loss.

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