Saturday, March 2, 2013

External and Internal Hemorrhoids

External and Internal Hemorrhoids
Hemorrhoids or piles, as they are usually called, are one of the very painful and embarrassing constipation side effects. They are caused by applying excessive pressure on the veins in the pelvic and rectal areas.

External and Internal Hemorrhoids

This is exactly what happens in a constipated person. Constipation makes the stool compact, dry and hard, difficult to expel. You apply more pressure to expel fecal matter. You spend more time in the toilet. Even if the stool is soft, because of other reasons like improper peristaltic movement of the colon muscles, presence of less fiber in the stool etc, you end up straining a lot to expel stool.

All this causes pressure on the veins in the areas of pelvis and rectum. The tissues inside the rectal area are filled with blood veins. When you strain at stool, these veins swell and stretch. Such repeated stretching results in internal hemorrhoids.

When the severity of internal hemorrhoids increases, the swollen and stretched veins protrude from the anus. The anal canal becomes narrow and causes pressure on the anal tissues when you try to pass compacted hard stool. This causes external hemorrhoids.

If the swelling and rupture of veins is inside the anal canal, they are internal hemorrhoids. If the swelling is near the anus opening, they are external hemorrhoids. Usually, untreated internal piles lead to external piles but need not be the case always.

Since the main reason for hemorrhoids and anal fissures is constipation, you need to get rid of constipation for permanent relief from piles. However, you can try a few things for temporary relief.

Hemorrhoids – symptoms
Prolapsed Internal Hemorrhoids
  •  Internal hemorrhoids

    • Normally don’t cause pain.
    •  Rectal bleeding. Stool has streaks of blood.
    • Stool may be covered with mucus.
    • If severe or untreated, they become prolapsed – swell and stretch and protrude out of the anus during evacuation and go back inside after evacuation. In much more severe cases, they remain protruded permanently.
    •  Fecal incontinence – involuntary excretion and leakage.
External Hemorrhoids
  • External hemorrhoids

    • Pain in and around anus.
    •  Watery discharge that results in itching.
    • Inflammation.
    • Bloody discharge - Blood in stool as well as blood without stool.
    • Painful swelling and lump inside and outside the anus.
    • Fecal incontinence – involuntary excretion and leakage.

External and Internal Hemorrhoids – Causes
  •  Chronic constipation, irregular bowel habits, aging.
  •  Pregnancy – during the last 6 months due to pressure on the pelvic tissues. Straining during delivery makes it worse. Normally gets relief after delivery.
  • Overweight and obesity.
  • Sitting for long periods.
  • Anal intercourse.
Immediate relief

  • Internal hemorrhoids are treated with pain killers and inflammation controlling drugs. Some ointments are available to stop itching.
  •  Stool softeners make evacuation less painful.
  • Avoid straining. The lesser, the better.
  • Take good amount of rest.
  • You need to go for surgery in very severe cases of extreme pain.
Note: Colorectal cancer can also cause rectal bleeding. Once you notice rectal bleeding, approach the doctor to make sure of the cause.

Permanent cure and prevention

The same factors that cause hemorrhoids also show you the direction of prevention and cure. Once you got immediate relief, you start working on the cure and prevention.

  1. During the initial treatment for immediate relief, make some diet and lifestyle changes.
    • Drink lots of water. There are so many benefits of drinking water. It is very important to know how much water to drink, how and when to drink water.
    • Stop eating junk food and low fiber diet. Add high fiber foods into your daily intake.
    • Reduce non-veg food. It has zero fiber. If you can stop non-veg food completely, it is much better.
    • Have reasonable amount of physical exercises. Mild exercise like walking won’t hurt your hemorrhoids. Once it gets better, you can try other exercises like jogging, cycling, playing games etc.

  2.  Because of chronic constipation, your colon is filled with hard, dry and compacted stool. As a second step, clean your colon. Colon cleansing enema with plain water is the best. You have to do it for 6 to 7 days to remove the dry stool sticking to the walls of the colon.
  3. See that you pass stool regularly. 3 times a day is best, twice a day is good, at least daily once is not bad. Each time, your evacuation must be satisfactory. External and internal hemorrhoids heal themselves since there is no pressure on the tissue.
  4. If you are pregnant, follow the suggestions given in Constipation in Pregnancy.
  5. Avoid sitting for long periods continuously. Have a five minute interval. Get up from the seat wander around.
  6. Never hold stool for a long time. You will run the risk of getting constipation again.
  7. Stop the practice of taking news paper, books, cell phone etc to the toilet. Keep your mind on your colon immediately before and during evacuation.
  8. Avoid anal intercourse and anal stimulation. It’s not natural. Don’t misuse your body. Anal sex causes not only anal tissue rupture, but also you run the risk of disease transmission.

Hemorrhoids or piles become very painful, if neglected. Internal hemorrhoids lead to external hemorrhoids. If identified early, they are easy to treat. Constipation happens to be the main culprit for piles. If you are free from constipation, in all probability, hemorrhoids won’t touch you.


  1. It was painful to sit and go to the toilet. I registered with a doctor. Inspection confirmed thrombosed hemorrhoid. Be careful with health.