Hemorrhoids, also known as piles, are, in fact, a normal part of the human body, and not a disease. Hemorrhoids are vascular structures located in the anal canal, in form of „cushions”, which participate in the normal functioning of the terminal section of the alimentary canal. Usually, there are three hemorrhoids in the anal canal. Along with the internal and external anal sphincters, they are responsible for sealing of the rectum, which allows for bowel control. Hemorrhoids become a cause of ailment when enlarged, inflamed and protruded. In such case, we refer to the hemorrhoidal disease, which is treated as a civilizational disease, associated with our lifestyle. The mucus covering the hemorrhoids is stretched; bleeding is observed, as well as blood retention and thrombi, which is accompanied by a local inflammatory process. The enlarged and inflamed hemorrhoids may protrude from the anal fissure.
The hemorrhoidal disease is one of the most frequently encountered proctologic diseases in the Western countries. Its prevalence in the general population reaches 36%, and it is the highest among middle-aged persons with high socioeconomic status. It is estimated that in about 50% people in the general population, symptoms of hemorrhoidal disease will occur at a certain stage of life. Moreover, the risk of this disease is particularly high in pregnant women. Its prevalence in this group ranges from 25 to 35%, and in the 3rd trimester, even 85% women may suffer from it. Elevated risk of hemorrhoidal disease is also observed in other groups of patients, such as the elderly and those with high body mass index.
The most frequently reported symptoms of hemorrhoidal disease include bleeding, secretions from the anus, pain, burning or itching sensation due to swelling and thrombosis, as well as sensation of incomplete bowel emptying. The most significant symptom, which may indicate the onset of the disease, is painless bleeding associated with bowel emptying. Even small traces of blood on toilet paper should be a signal to visit a doctor.
It should be kept in mind that the symptoms, described above, may indicate an illness other than hemorrhoidal disease. These can be more serious and include even neoplasms. Therefore, persistent anus discomfort should be definitely consulted with a doctor.
Intensification of hemorrhoidal disease is defined using the 4-stage Goligher scale. In the more advanced stages, surgical intervention is necessary; in the case of patients in the 1st and 2nd stage, who are a decisive majority (>90%) of the reported cases, conservative pharmacological treatment and a change of lifestyle are sufficient.
The initial phase of conservative treatment should include:
Prepared on the basis of:
Tribenoside and lidocaine in the local treatment of hemorrhoids: an overview of clinical evidence. Lorenc Z., Gökçe Ö. European Review for Medical and Pharmacological Sciences. 2016; 20: 2742-2751
Guzki krwawnicze i żylaki odbytu. Wałęga P. Medycyna Praktyczna Chirurgia 2012/05