Hemorrhoids: Symptoms, Diagnosis, and Treatment Options - Surgery

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Hemorrhoids, commonly referred to as piles, are swollen veins in the lower rectum and anus that can cause discomfort, pain, and bleeding. They can be classified into two main types: internal hemorrhoids, which occur inside the rectum, and external hemorrhoids, which develop under the skin around the anus. Your description of feeling a painful, irregular lump near the anus that cannot be pushed back suggests the possibility of an external hemorrhoid or possibly a thrombosed hemorrhoid, which occurs when a blood clot forms in an external hemorrhoid, leading to increased pain and swelling.


Symptoms of Hemorrhoids
The symptoms of hemorrhoids can vary depending on their type and severity. Common symptoms include:
- Pain or discomfort: Especially when sitting, standing, or during bowel movements.

- Swelling: A lump near the anus that may be sensitive or painful.

- Bleeding: Bright red blood during bowel movements or on toilet paper.

- Itching or irritation: Around the anal region.


Diagnosis
Diagnosis of hemorrhoids typically involves a physical examination. A healthcare provider may perform a visual inspection of the anal area and may conduct a digital rectal exam to assess for internal hemorrhoids. In some cases, if the diagnosis is unclear or if there are concerns about other conditions, additional tests such as a colonoscopy may be recommended to rule out other gastrointestinal issues.


Treatment Options
Treatment for hemorrhoids can vary based on the severity of the condition. Here are some common approaches:
1. Conservative Management:
- Dietary Changes: Increasing fiber intake through fruits, vegetables, and whole grains can help soften stools and reduce straining during bowel movements.

- Hydration: Drinking plenty of water can also help prevent constipation.

- Over-the-Counter Medications: Topical treatments, such as creams or ointments containing hydrocortisone, can help relieve itching and discomfort.

2. Minimally Invasive Procedures:
- Rubber Band Ligation: A small band is placed around the base of an internal hemorrhoid to cut off its blood supply, causing it to shrink and fall off.

- Sclerotherapy: A chemical solution is injected into the hemorrhoid tissue to shrink it.

- Infrared Coagulation: A device is used to apply infrared light to the hemorrhoid, causing it to clot and shrink.

3. Surgical Options:
- If conservative treatments and minimally invasive procedures do not provide relief, or if the hemorrhoids are particularly large or painful, surgical options may be considered. This can include:
- Hemorrhoidectomy: Surgical removal of the hemorrhoids.

- Stapled Hemorrhoidopexy: A procedure that uses a stapling device to reposition and secure the hemorrhoids back into place.


When to Seek Medical Attention
It is essential to consult a healthcare provider if you experience severe pain, significant bleeding, or if the symptoms persist despite home treatment. Given your description of the painful lump and discomfort, it would be advisable to seek medical evaluation promptly. A healthcare provider can confirm whether it is indeed hemorrhoids or if another condition may be causing your symptoms.

In conclusion, while hemorrhoids can often be managed with conservative measures, persistent or severe cases may require more invasive treatments. Early diagnosis and intervention can lead to better outcomes and relief from symptoms.