Enlarged Hemorrhoids 101

Hemorrhoids are normal blood filled cushions that everyone has, but not often what patients are talking about when they refer to having hemorrhoids. When patients talk about having hemorrhoids, they are usually referring to the bothersome, symptomatic condition that occurs when hemorrhoids become enlarged.

Since there is a stigma associated with hemorrhoids, many patients are hesitant to discuss the condition. But, having enlarged hemorrhoids shouldn’t be something to be ashamed about. Enlarged hemorrhoids aren’t often dangerous, but they can cause a lot of unwanted symptoms for patients. While you might not want to go to a doctor and divulge all the details, it’s important to report your symptoms if you can’t get them under control.

Do you suffer from enlarged hemorrhoids? Here’s everything you have to know about the condition and how to find the right treatment for your specific case!

Types of Enlarged Hemorrhoids

When hemorrhoids become enlarged, they can fall into one of two categories. The two types of hemorrhoids are internal and external. Internal hemorrhoids often go unidentified because they exist in a part of the anus that is free of pain-sensing nerves. Therefore, the most common symptom is painless bleeding. When internal hemorrhoids progress, they become more severe. Internal hemorrhoids are classified by grades depending on their severity. The grades of hemorrhoids are:

• Grade 1: The earliest stage of hemorrhoids are classified as grade 1 hemorrhoids. Grade 1 hemorrhoids are slightly enlarged, but can’t be seen from outside the anus.
• Grade 2: The second stage are larger hemorrhoids and can come out of the anus. When passing stool or during physical activity, grade 2 hemorrhoids protrude outside the anus, but spontaneously retract on their own.
• Grade 3: These hemorrhoids come out of the anus during a bowel movement or with exertion. They do not spontaneously retract, but they can be manually pushed back into the anus.
• Grade 4: These are the most serious grade of hemorrhoids. The protrude out of the anus, but cannot be pushed back inside. Instead, they generally need hemorrhoid surgery to staple the hemorrhoid back to the wall of the anal canal.

External hemorrhoids are more bothersome. They may come out of the anus and can be seen as soft lumps of tissue around the opening of the anus. As they become bigger or irritated, external hemorrhoids can be painful, uncomfortable, and come with severe itching.

Symptoms of Enlarged Hemorrhoids

When hemorrhoids become enlarged, they can be accompanied by a variety of symptoms. These symptoms are what make hemorrhoids particularly difficult to deal with, and lead patients to seek more information about the condition. The most common symptoms of enlarged hemorrhoids are:

• Itching
• Pain
• Burning Sensation
• Mucus Discharge
• Blood in the stool, toilet bowl, or on the toilet paper after wiping after a bowel movement
• Feeling of Fullness
• General Discomfort

If your hemorrhoids are accompanied by blood, it’s important to contact a medical professional to rule out any more serious medical conditions.

Causes of Enlarged Hemorrhoids

Enlarged hemorrhoids come from an increase in pressure on the anal canal. There are several factors that might make this happen. These factors include:

• Obesity
• Chronic Constipation
• Chronic Diarrhea
• Exertion
• Pregnancy
• Sitting for Prolonged Periods
• Poor Diet
• Age

Diagnosing Enlarged Hemorrhoids

While self-diagnosis for enlarged hemorrhoids is common, the only way to truly diagnose the condition is to see your medical provider. While many patients have an idea in their mind that the first appointment with a doctor to discuss hemorrhoids is torturous, you would be surprised. Your doctor will discuss your condition, ask about your symptoms, and talk about any other medical conditions you may have.

In some cases, your doctor can diagnose your condition through a series of questions. They may prescribe a pharmaceutical grade medication to treat the condition. A basic examination may also be necessary. Your doctor will be able to identify hemorrhoids if they are external or protruding.

For more severe cases, like if there is blood in your stool, your doctor may order a series of tests. The most common is a colonoscopy. During a colonoscopy, a small camera will be inserted into the bowel to visualize the issues. Most of the examinations for hemorrhoids do not hurt. Although they may be unpleasant, and even embarrassing, your doctor has performed countless exams. Do your best to relax and be comfortable.

Another common exam is a digital rectal examination. During this exam, your doctor will insert a finger into your anus with a lubricated glove. This gives your doctor the chance to feel inside the anal canal and examine the sphincter muscles and the membranes lining the anus. While grade 1 enlarged hemorrhoids are still not often felt with this exam, a digital rectal exam can rule out other medical conditions. The final most common medical exam is called a proctoscopy. If your doctor feels that you have enlarged hemorrhoids, they may insert a short tube with a light and lens on it into the rectum. This will allow your doctor to get a closer look at the enlarged hemorrhoids, identify how big they are, and find their immediate location.

Treatment for Enlarged Hemorrhoids

The treatment option that works best for your hemorrhoids truly depends on the severity of your case and the size and type of hemorrhoid you have. If your hemorrhoids are slightly enlarged and aren’t bothering you to the point that you can’t function, over-the-counter medications, at-home remedies, and lifestyle changes may be the best treatment options. You can use hemorrhoid creams or sitz baths for effective at home treatment. Changing your diet and your bowel habits are lifestyle changes that can help alleviate the symptoms of enlarged hemorrhoids.

If your symptoms continue to be unpleasant or affect your quality of life, talk to your doctor about the best treatment option. If over-the-counter or at-home remedies don’t do the trick, your doctor may prescribe a pharmaceutical strength medication. Suppositories, creams, ointments, and medicated wipes could be prescribed at higher strengths. In many cases, the higher strength is enough to do the trick to relieve the symptoms of hemorrhoids.

If prescription strength medications don’t work, it might be time to consider a more aggresive treatment. There are several non-invasive procedures that can be used to treat hemorrhoids. These include:

• Rubber Band Ligation which places a small rubber band at the base of the enlarged hemorrhoid to cut off the blood supply, causing the hemorrhoid to die off. This procedure is performed in a doctor’s office without anesthesia.
• Sclerotherapy is similar to the rubber band ligation in the idea that is performed in a doctor’s office without the need for anesthesia. The sclerotherapy procedure involves injecting a chemical solution into the hemorrhoid to reduce the blood supply. The chemical injection also causes the hemorrhoid to die off and shrink.

In addition to non-invasive procedures, some severe cases of hemorrhoids require surgical treatment. There are two common types of hemorrhoid surgery that patients undergo. They are:

•  Hemorrhoidectomy which is performed in a surgical center or hospital setting. The hemorrhoidectomy places a small incision in the hemrorhoid to remove the vein and cure the hemorrhoid. After the swollen vein is removed, the incision is closed with a few stitches and the patient is sent home for recovery. Recovery times may vary but generally takes a week.
• Hemorrhoidopexy is another type of hemorrhoid surgery that is also known as stapling. This is most commonly used to treat internal hemorrhoids. During a hemorrhoidopexy, a surgical staple is used to secure the hemorrhoid back in place. The stapling cuts off the blood supply to the hemorrhoid, and causes it to shrink. The skin will eventually return to normal and shrink back into the lining of the wall of the anal canal.

 Although enlarged hemorrhoids may seem like a serious condition, hemorrhoids are common and can be easily treated. Whether at-home remedies, over-the-counter treatments, lifestyle changes, or more advanced medical treatment do the trick, you can be sure that there is a resolution for your enlarged hemorrhoids. If you think you may be suffering from enlarged hemorrhoids, talk to your medical provider about how to alleviate your symptoms and effectively treat the condition so you can be on the road to better health.