Hemorrhoid FAQ

What are hemorrhoids?

Hemorrhoids are enlarged veins in the walls of the lower rectum and the tissues surrounding the anus. They usually occur when the muscles around the anorectal area can no longer massage the veins. As a result, there is a slowing of blood flow back to the heart and stagnant blood backs up into the veins, creating hemorrhoids.

Sometimes hemorrhoids may develop as a result of straining during a bowel movement or due to other factors that cause the tissue to become stressed such as: pregnancy, chronic constipation or diarrhea, the aging process, or hereditary factors.

The root cause is that the pelvic region and anorectal area is overstressed. The best way to eliminate this problem is to improve the health of the muscles of the region through exercise and a healthy diet. Increasing muscle tone to the anorectal area can be achieved through consistent use of High Island Health's Peristal®.

What are the types of hemorrhoids?

Hemorrhoids can develop inside the anal canal (internal hemorrhoids) or near the anal opening (external hemorrhoids). Both types can occur at the same time. The symptoms, progression, and treatment differ depending on where the hemorrhoids are.

Internal hemorrhoids have four degrees of severity. Bleeding may occur with any of these.
Degree/Grade Description Peristal Use?
1 The hemorrhoid does not stick out from the anus. There may be annoying itching or pain in the area. Mild distention (enlargement); Some anal bleeding noticed, probably indirect in stool or on toilet paper. Peristal Compatible
2 Prolapsed (bulge out) with bowel movement, spontaneously reduce (go back into rectum) Peristal Compatible
3 Prolapsed with bowel movement, must be manually reduced (pushed back in) Peristal Incompatible
4 Prolapsed, cannot be pushed back in and the hemorrhoid becomes a permanent protrusion. The rectal mucosa (inner lining) also starts to prolapse. Peristal Incompatible

Fourth-degree hemorrhoids also include hemorrhoids that are thrombosed (containing blood clots) or that pull much of the lining of the rectum through the anus. There hemorrhoids are Peristal® incompatible.

The Peristal® is designed for external hemorrhoids and internal hemorrhoids within the first to second degree of severity.

What are the symptoms of hemorrhoids?

Actually, some people who have hemorrhoids do not present any symptoms at all. However, the most common symptom of internal hemorrhoids is bright red blood - generally found on the stool, on toilet paper, or in the toilet. Other common symptoms include fissures, abscesses, irritation and itching, but these symptoms are sometimes indications of other conditions as well.

Usually, hemorrhoids are not dangerous or life threatening, and can often be treated at home. However, if an internal hemorrhoid protrudes outside the body, it is likely to become irritated and painful.

Internal hemorrhoids. Rectal bleeding is the most common symptom of internal hemorrhoids. There may be bright red streaks of blood on toilet paper or bright red blood in the toilet bowl after having a normal bowel movement. There may even be blood on the surface of the stool. Internal hemorrhoids can range from small, swollen veins in the wall of the anal canal to large, sagging veins and tissue that bulge out of the anus all the time.

External hemorrhoids. External hemorrhoids often cause painful swelling and blood clots around the anus. If a hard lump develops outside the anus, the hemorrhoid is known as a thrombosed external hemorrhoid. Any additional straining, rubbing or cleaning of the area may cause further irritation, bleeding or itching, which then exacerbates the problem.

How common are hemorrhoids?

Hemorrhoids are common in both men and women and affect both sexes equally. In 2003, Hemorrhoids was the most commonly reported digestive disorder. By age 50, about half the population will have hemorrhoids. Of these cases, over 10 to 20% of hemorrhoid suffers will require some form of surgery.

In addition, hemorrhoids are common among pregnant women. Hormonal changes, as well as the pressure that the fetus exerts upon the abdomen, cause the hemorrhoid vessels to enlarge. The strain of childbirth also causes more severe pressure on the vessels that cause hemorrhoids. Fortunately for many women, hemorrhoids caused by pregnancy are often only temporary.

How are hemorrhoids diagnosed?

Although the appearance of blood is a common indicator of hemorrhoids, anytime this occurs for more than a couple of days, you should consult your physician because it could also be a symptom of other digestive diseases, including colorectal cancer.

To determine if you have hemorrhoids, the physician will examine the anus and rectum to look for swollen blood vessels that indicate the presence of hemorrhoids, and they will probably perform a digital rectal exam (DRE) as well, in order to check for other abnormalities. Your doctor may also use an anuscope or proctoscope for closer inspection.

What are the treatment options for hemorrhoids?

Several treatment options are available, with surgery being required in some severe cases. In addition, most medical treatments of hemorrhoids are aimed at relieving symptoms such as the application of hemorrhoidal cream or suppository to the affected area. However, most of these treatments are either extremely invasive or ineffective. An excerpt from WedMd's Emedicine, Hemorrhoid Treatment explains:

Stool softeners play a limited role in the treatment of routine hemorrhoidal symptoms. Oral fiber intake and fiber supplements almost always cure constipation and straining. Remember that hemorrhoidal symptoms are due to prolapse, thrombosis, and vascular bleeding; therefore, creams and salves have a small role in treating hemorrhoidal complaints. Suppositories, except for providing lubrication, have a small role in the treatment of hemorrhoidal symptoms. Topical hydrocortisone can sometimes ease internal hemorrhoidal bleeding. The author rarely recommends typical medications (eg, suppository, cream, enema, foam) in the treatment of hemorrhoids. Submucosal veins do not get smaller with anti-inflammatory medications.

Bathing in tubs with warm water universally eases painful perianal conditions. Relaxation of the sphincter mechanism and spasm is probably the etiology.

The Peristal® is revolutionary in that it is a one-of-a-kind device that is modeled after the idea of muscle relaxation to help sooth your body. It trains your body's own PC-Sphincter muscles to create a relaxing environment, generating peristaltic motions to help massage hemorrhoids.

To learn more about the Peristal®.


Hess, Christopher, Hemorrhoids, HealthBanks, www.healthbanks.com/PatientPortal/Public/ArticlePrint.aspx?ArticleID=HW5hw213495

MacKay, ND. Hemorrhoids and Varicose Veins: A review of Treatment Options, Alternative Medicine Review, Volume 6, Number 2, 2001

National Digestive Diseases Information Clearinghouse, NIH Publication No. 02-3021 February 2002

Rectal Problems, The American College of Gastroenterology, www.gi.org/patients/women/rectal.asp

Thornton, Scott C, MD, Associate Clinical Professor of Surgery, Yale University School of Medicine; Director, Colorectal Teaching, Bridgeport Hospital; Private Practice, Colon and Rectal Surgeons, Hemorrhoid Treatment, WebMd, Nov., 20, 2007, http://www.emedicine.com/med/topic2821.htm#section~Treatment