Hemorrhoids: When to Seek Treatment and Potential Risks

Hemorrhoid issues

Hello, Director Ke.
I would like to ask: 1.
I currently have some tissue around the anal area that looks like hemorrhoids.
There is no significant swelling, pain, prolapse, or bleeding, and the sensation of a foreign body is mild.
I only experience occasional anal fissures (with minor bleeding and pain).
Is active treatment necessary? 2.
Does the size of the hemorrhoids and the degree of prolapse influence the need for treatment? Is there a risk of continued deterioration or long-term complications such as rectal prolapse, anal prolapse, or damage to the sphincter muscle?

Nìmíng, 20~29 year old female. Ask Date: 2022/12/22

Dr. Ke Fangxu reply Surgery

1.
Surgery is not necessary for hemorrhoids if there is no persistent bleeding, severe pain, or significant prolapse; most cases can be improved through lifestyle modifications and changes in bowel habits.

2.
Hemorrhoids do not progress to rectal prolapse or rectal prolapse.
If the size of the prolapse requires manual reduction after bowel movements or if it protrudes during walking or squatting, surgical removal is recommended to prevent interference with daily activities.

Reply Date: 2022/12/22

More Info

Hemorrhoids, commonly referred to as piles, are swollen veins in the lower rectum and anus that can cause discomfort, pain, and bleeding. Understanding when to seek treatment and the potential risks associated with hemorrhoids is crucial for maintaining good health and preventing complications.

1. When to Seek Treatment: In your case, you mentioned that you have observed some tissue resembling hemorrhoids around the anal area, but you do not experience significant pain, protrusion, or bleeding, aside from minor anal fissures. While it is reassuring that you do not have severe symptoms, it is still advisable to consult a healthcare professional for a thorough evaluation. Even if the symptoms are mild, they can sometimes indicate underlying issues that may require treatment. Regular check-ups can help monitor the condition and prevent it from worsening.

2. Size and Prolapse: The size of hemorrhoids and the degree of prolapse (the extent to which they protrude from the anal canal) are indeed important factors in determining the need for treatment. Larger hemorrhoids or those that prolapse can lead to more significant discomfort and complications. If left untreated, hemorrhoids can potentially worsen over time, leading to chronic symptoms and complications such as rectal prolapse or damage to the anal sphincter muscles.
3. Potential Complications: Chronic hemorrhoids can lead to several complications, including:
- Thrombosed Hemorrhoids: This occurs when a blood clot forms in an external hemorrhoid, leading to severe pain and swelling.

- Anemia: Chronic bleeding from hemorrhoids can lead to anemia, characterized by fatigue and weakness.

- Infection: Prolapsed hemorrhoids can become irritated and infected, requiring medical intervention.

- Fissures: As you mentioned, anal fissures can occur due to straining during bowel movements, which may be exacerbated by hemorrhoids.

4. Preventive Measures: To manage and potentially prevent the worsening of hemorrhoids, consider the following lifestyle changes:
- Dietary Adjustments: Increase fiber intake through fruits, vegetables, and whole grains to promote regular bowel movements and reduce straining.

- Hydration: Drink plenty of water to help soften stools.

- Regular Exercise: Physical activity can help stimulate bowel function and reduce pressure on the veins in the rectal area.

- Avoid Straining: When using the bathroom, avoid prolonged sitting and straining, which can exacerbate hemorrhoids.

5. Treatment Options: If your condition does require treatment, options may include:
- Conservative Management: This includes dietary changes, topical treatments, and over-the-counter medications to relieve symptoms.

- Minimally Invasive Procedures: If conservative measures fail, procedures such as rubber band ligation, sclerotherapy, or infrared coagulation may be recommended.

- Surgical Options: In severe cases, surgical intervention may be necessary to remove the hemorrhoids.

In conclusion, while your current symptoms may not seem severe, it is essential to monitor your condition and consult a healthcare professional for personalized advice. Early intervention can prevent complications and improve your quality of life. Regular check-ups and lifestyle modifications can also play a significant role in managing and preventing hemorrhoids.

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