The Signs and Symptoms of Hemorrhoids

Definition of hemorrhoid

Hemorrhoids (Piles) are blood vessels located in the smooth muscles of the walls of the rectum and anus. They are a normal part of the anatomy and are located at the junction where small arteries merge into veins. They are cushioned by smooth muscles and connective tissue and are classified by where they are located in relationship to the pectinate line, the dividing point between the upper 2/3 and lower 1/3 of the anus. This is an important anatomic distinction because of the type of cells that line the hemorrhoid, and the nerves that provide sensation.

Internal hemorrhoids are located above the pectinate line and are covered with cells that are the same as those that line the rest of the intestines. External hemorrhoids arise below the line and are covered with cells that resemble skin.

Hemorrhoids become an issue only when they begin to swell, causing itching, pain and/or bleeding.

What causes hemorrhoids?

While the presence of hemorrhoids is a reflection of the normal anatomy, most people and care professionals refer to hemorrhoids as an abnormal finding because they only present when they swell and cause problems.

Hemorrhoid swelling occurs when there is an increase in the pressure in the small vessels that make up the hemorrhoid causing them to swell and engorge with blood. This causes them to increase in size leading to symptoms. Increased pressure may be caused by a variety of factors:

• Low fiber diet and smaller caliber stool causes a person to strain when having a bowel movement, increasing the pressure within the blood vessels.
• Pregnancy is associated with hemorrhoid swelling and is likely due to increased pressure of the enlarged uterus on the rectum and anus. In addition, hormonal changes with pregnancy may weaken the muscles that support the rectum and anus.
• Prolonged sitting on the toilet may increase pressure within the hemorrhoid blood vessels
• Obesity
• Diarrhea, both acute and chronic
• Colon cancer
• Previous rectal surgery
• Spinal cord injury and lack of erect posture

What are the signs and symptoms of a hemorrhoid?

• Hemorrhoids are the most common cause of rectal and anal complaints. The most common complaint is painless bleeding, anal itching, pain, swelling and feeling a lump at the anus are all associated with an inflamed hemorrhoid.
• It is important to remember that rectal bleeding or blood in the stool is never normal and while it may come from a relatively benign cause like hemorrhoids, more serious causes can be life threatening. These include bleeding from ulcers,diverticulitis, inflammatory bowel disease, and tumors. If rectal bleeding occurs, it is important to contact your health care professional or seek emergency medical care. This is especially important if the person is taking blood thinning medications.
• When an internal hemorrhoid becomes inflamed, it can cause swelling. This in itself does not cause pain because there are no pain fibers attached to the veins above the pectinate line. Passing a hard stool can scrape off the thinned lining of the hemorrhoid causing painless bleeding. However, the swollen hemorrhoid can also cause spasm of the muscles that surround the rectum and anus causing pain, especially if they protrude or prolapse through the anus. A lump can be felt at the anal verge. Internal hemorrhoids can also thromboses (clot) leading to severe pain.
• The inflamed hemorrhoid can leak mucus that can cause inflammation of the skin surrounding the anus causing burning and itching, known as pruritis ani. However, other causes of itching include yeast and other skin infections and parasites like pin-worms. Most importantly, just as blood in the stool should not ignored in the stool because it mike be a sign of colon cancer, anal itching or bleeding should not be presumed to be due to hemorrhoids because it can be a sign of anal cancer tumor.
• External hemorrhoids behave differently since they are covered by “regular skin” and have pain fibers associated with them. A thrombosed external hemorrhoid occurs when an underlying vein within the hemorrhoid clots off causing intense pain from the rapid stretching of the skin covering the hemorrhoid. A hard painful lump can be felt at the anus. External hemorrhoids can also result in excess skin tags that can be felt at the anal verge and can cause difficulties with cleaning after a bowel movement, leading to secondary skin infections

What does a hemorrhoid look like?

Normal hemorrhoidal tissue cannot be seen since they must first swell and become inflamed or develop a clot to cause symptoms. One can see swollen external hemorrhoids or prolapsed internal hemorrhoids exposed outside the anus but internal hemorrhoids cannot be seen because they remain inside the anus. A thrombosed hemorrhoid will appear as a lump at the anal verge, protruding from the anus and will be dark bluish in color because of the blood clot contained inside the swollen blood vessel. A non-thrombosed hemorrhoid will appear as a rubbery lump. Often more than one swollen hemorrhoid appears at the same time.

How are hemorrhoids treated?

Regardless of the size or swelling of a hemorrhoid, no treatment is required if symptoms do not exist.

Prevention is perhaps the most effective treatment. Diet and adequate hydration are very important to maintain normal bowel movements. Hemorrhoid symptoms can occur with the passage of hard stool and constipation, as well as diarrhea and frequent bowel movements. For patients with constipation, high fiber diet, adequate hydration and stool softeners may be required. For those with too frequent bowel movements, antidiarrheal medications and diet adjustments may be required. These preventive measures decrease the amount of straining that is required to have a bowel movement, thus decreasing the pressure within the blood vessels to prevent swelling.

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Once hemorrhoid symptoms develop, a variety of treatment options exist, depending upon the situation and severity of the hemorrhoids.

Internal hemorrhoids are graded by the degree of prolapse below the pectinate line into the anal canal.

• Grade 1:the internal hemorrhoid bulges into the canal but does not prolapse or fall completely into it. These may bleed.
• Grade 2:the hemorrhoid protrudes past the anal verge with straining for a bowel movement or passage of flatus, but spontaneously return to their original internal position once the straining has subsided.
• Grade 3:the hemorrhoid may protrude past the anal verge without any straining and requires the patient to push them inside manually.
• Grade 4:the internal hemorrhoid always stays protruded or prolapsed and is at risk for thrombosis or strangulation should the anal muscles go into spasm.

How to know if you are suffering from Indigestion

Indigestion is often a sign of an underlying problem, such as gastroesophageal reflux disease (GERD), ulcers, or gallbladder disease, rather than a condition of its own.

Also called dyspepsia, indigestion is a term used to describe a feeling of fullness or discomfort during or after a meal. It can be accompanied by burning or pain in the upper stomach.

What Are the Symptoms of Indigestion?

The symptoms of indigestion include:

• Bloating (full feeling)
• Belching and gas
• Nausea and vomiting
• Acidic taste
• Growling stomach
• Burning in the stomach or upper abdomen
• Abdominal pain

These symptoms may increase in times of stress.

People often have heartburn (a burning sensation deep in the chest) along with indigestion. But heartburn is caused by stomach acids rising into the esophagus.

Who Is at Risk for Indigestion?

People of all ages and of both sexes are affected by indigestion. It’s extremely common. An individual’s risk increases with excess alcohol consumption, use of drugs that may irritate the stomach (such as aspirin), other conditions where there is an abnormality in the digestive tract such as an ulcer and emotional problems such as anxiety or depression.

What Causes Indigestion?

Indigestion has many causes, including:

Diseases:

• Ulcers
• GERD
• Stomach cancer (rare)
• Gastroparesis (a condition where the stomach doesn’t empty properly; this often occurs in diabetics)
• Stomach infections
• Irritable bowel syndrome
• Chronic pancreatitis
• Thyroid disease

Lifestyle:

• Eating too much, eating too fast, eating high-fat foods, or eating during stressful situations
• Drinking too much alcohol
• Cigarette smoking
• Stress and fatigue

Swallowing excessive air when eating may increase the symptoms of belching and bloating, which are often associated with indigestion.

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Sometimes people have persistent indigestion that is not related to any of these factors. This type of indigestion is called functional, or non-ulcer dyspepsia.

During the middle and later parts of pregnancy, many women have indigestion. This is believed to be caused by a number of pregnancy-related factors including hormones, which relax the muscles of the digestive tract, and the pressure of the growing uterus on the stomach.

How Is Indigestion Diagnosed?

If you are experiencing symptoms of indigestion, make an appointment to see your doctor to rule out a more serious condition. Because indigestion is such a broad term, it is helpful to provide your doctor with a precise description of the discomfort you are experiencing. In describing your indigestion symptoms, try to define where in the abdomen the discomfort usually occurs. Simply reporting pain in the stomach is not detailed enough for your doctor to help identify and treat your problem.

First, your doctor must rule out any underlying conditions. Your doctor may perform several blood tests and you may have X-rays of the stomach or small intestine. Your doctor may also use an instrument to look closely at the inside of the stomach, a procedure called an upper endoscopy. An endoscope, a flexible tube that contains a light and a camera to produce images from inside the body, is used in this procedure.

What should be known about Gall Bladder Diseases

Gallbladder disease is a term for several types of conditions that can affect your gallbladder, a small pear shaped sac located under the liver. Your gallbladder’s main function is to store the bile produced in your liver and pass it along to the small intestine.

The majority of gallbladder diseases are caused by inflammation due to irritation to the gallbladder wall (cholecystitis). This occurs when gallstones obstruct the ducts leading to the small intestine and may eventually lead to necrosis or gangrene. Other diseases of the gallbladder include biliary enteric fistulas, sclerosing cholangitis, gallbladder polyps, and gallbladder cancer.

What are the Types of Gallbladder Disease?

• Gallstones

  

  Gall Bladder Stone

Gallstones are the most pressing of all gallbladder diseases. They develop when substances in the bile (such as cholesterol, bile salts, and calcium) form hard particles that block the passageway to the gallbladder.

In addition, stones tend to form when the gallbladder doesn’t empty completely or often enough. They vary in size from as small as a grain of sand to as large as a golf ball.

Numerous factors contribute to your risk of gallstones. These include:

• being overweight or obese
• eating a high-fat or high-cholesterol diet
• having diabetes
• being age 60 or older
• taking medications that contain estrogen
• having a family history of gallstones
• being a women

Cholecystitis

Cholecystitis is the most common type of gallbladder disease. It presents itself as either an acute or chronic inflammation.

Acute Cholecystitis

Acute cholecystitis is generally caused by gallstones, but may also be the result of tumors or various other illnesses. It may present with pain in the upper right side or upper middle part of the abdomen. The pain can come right after a meal and range from sharp pangs to dull aches that may often radiate to the right shoulder. Fever nausea, vomiting,jaundice, and different colored stools are also a result of acute cholecystitis.

Chronic Cholecystitis

After several attacks of acute cholecystitis, the gallbladder will shrink and lose its function of storing and releasing bile. Abdominal pain, nausea, and vomiting may follow.

Choledocholithiasis

Gallstones may become lodged in the neck of the gallbladder or in the bile ducts. When the gallbladder is plugged in this way, bile cannot exit. This may lead to the gallbladder becoming inflamed or distended. The plugged bile ducts will further prevent bile from traveling from the liver to the intestines. Choledocholithiasis produces extreme pain in the middle upper abdomen, fever, chills, nausea, and vomiting.

Acalculous Gallbladder Disease

Acalculous gallbladder disease (biliary dyskinesia) occurs without the presence of gallstones. It can be chronic or acute and may result from the gallbladder muscles or valve not working properly. Symptoms include abdominal pain on the right side of the body, radiating to the shoulder. Eating high fat foods often triggers this. Related symptoms may include nausea, vomiting, bloating, and loose stools.

What is Obesity?

Obesity is a condition where a person has accumulated so much body fat that it might have a negative effect on their health.

If a person’s bodyweight is at least 20% higher than it should be, he or she is considered
obese. If your Body Mass Index (BMI) is between 25 and 29.9 you are considered overweight. If your BMI is 30 or over you are considered obese.

Why do people become obese?

People can become obese for many different reasons. Lets look at some of the most common ones:

1) Consuming too many calories.

These days people are eating much more food than in previous generations. This used to be the case just in developed nations – however, the trend has spread worldwide.

Despite billions of dollars being spent on public awareness campaigns that attempt to encourage people to eat healthily, the majority of us continue to overeat. In 1980 14% of the adult population of the USA was obese; by 2000 the figure reached 31% (The Obesity Society).

In the USA, the consumption of calories increased from 1,542 per day for women in 1971 to 1,877 per day in 2004. The figures for men were 2,450 in 1971 and 2,618 in 2004. Most people would expect this increase in calories to consist of fat – not so! Most of the increased food consumption has consisted of carbohydrates (sugars). Increased consumption of sweetened drinks has contributed significantly to the raised carbohydrate intake of most young American adults over the last three decades. The consumption of fast-foods has tripled over the same period.

Various other factors are also said to have contributed to America’s increased calorie and carbohydrate intake:

• In 1984 the Reagan administration freed up advertising on sweets and fast foods for children – regulations had previously set limits.
• Agricultural policies in most of the developed world have led to much cheaper foods.
• The US Farm Bill meant that the source of processed foods came from subsidized wheat, corn and rice. Corn, wheat and rice became much cheaper than fruit and vegetables.

2) Leading a sedentary lifestyle

With the arrival of televisions, computers, video games, remote controls, washing machines, dish washers and other modern convenience devices, people are commonly are leading a much more sedentary lifestyle compared to their parents and grandparents.

Some decades ago shopping consisted of walking down the road to the high street where one could find the grocers, bakers, banks, etc. As large out-of-town supermarkets and shopping malls started to appear, people moved from using their feet to driving their cars to get their provisions. In some countries, such as the USA, dependence on the car has become so strong that many people will drive even if their destination is only half-a-mile away.

The less you move around the fewer calories you burn. However, this is not only a question of calories. Physical activity has an effect on how your hormones work, and hormones have an effect on how your body deals with food. Several studies have shown that physical activity has a beneficial effect on your insulin levels – keeping them stable. Unstable insulin levels are closely associated with weight gain.

Causes and Symptoms of Colon Cancer

Symptoms

Signs and symptoms of colon cancer include:

• A change in your bowel habits, including diarrhea or constipation or a change in the consistency of your stool, that lasts longer than four weeks
• Rectal bleeding or blood in your stool
• Persistent abdominal discomfort, such as cramps, gas or pain
• A feeling that your bowel doesn’t empty completely
• Weakness or fatigue
• Unexplained weight loss

Many people with colon cancer experience no symptoms in the early stages of the disease. When symptoms appear, they’ll likely vary, depending on the cancer’s size and location in your large intestine.

When to see a doctor

If you notice any symptoms of colon cancer, such as blood in your stool or a persistent change in bowel habits, make an appointment with your doctor.

Talk to your doctor about when you should begin screening for colon cancer. Guidelines generally recommend that colon cancer screenings begin at age 50. Your doctor may recommend more frequent or earlier screening if you have other risk factors, such as a family history of the disease.

Causes

• 

  Colon cancer

In most cases, it’s not clear what causes colon cancer. Doctors know that colon cancer occurs when healthy cells in the colon develop errors in their DNA.

Healthy cells grow and divide in an orderly way to keep your body functioning normally. But when a cell’s DNA is damaged and becomes cancerous, cells continue to divide — even when new cells aren’t needed. As the cells accumulate, they form a tumor.

With time, the cancer cells can grow to invade and destroy normal tissue nearby. And cancerous cells can travel to other parts of the body.

Inherited gene mutations that increase the risk of colon cancer

Inherited gene mutations that increase the risk of colon cancer can be passed through families, but these inherited genes are linked to only a small percentage of colon cancers. Inherited gene mutations don’t make cancer inevitable, but they can increase an individual’s risk of cancer significantly.