Do I need treatment for hemorrhoids? Do internal hemorrhoids hurt?

There is a saying among the people that "nine out of ten men have hemorrhoids" and "ten out of ten women have hemorrhoids". Although it is a bit exaggerated, hemorrhoids do cause serious troubles to people. According to statistics from the National Institutes of Health of the United States, about 75% of people will suffer from hemorrhoids at some stage in their lives.

What are hemorrhoids actually?

Hemorrhoids are actually a type of anorectal disease caused by congestion and varicose veins at the lower end of the rectal mucosa and under the skin of the anal canal, which then form a blood vessel mass.

At the junction of the anal canal skin and the rectal mucosa, there is a serrated line called the anal dentate line. Based on this line, hemorrhoids can be divided into internal hemorrhoids, external hemorrhoids and mixed hemorrhoids according to the different locations of occurrence.

Internal hemorrhoids: Internal hemorrhoids generally occur above the dentate line of the anal canal (the last part of the large intestine). Simple internal hemorrhoids are painless but there is a feeling of heaviness and swelling, and blood may drip after defecation.

External hemorrhoids: Moles that occur below the dentate line of the anal canal are called external hemorrhoids. It grows outside the anus and is a small, protruding lump visible to the naked eye. It is often swollen and painful, and may bleed after defecation.

Mixed hemorrhoids: Mixed hemorrhoids grow across the serrated line of the anus, mostly due to internal hemorrhoids not receiving timely and effective treatment. Mixed hemorrhoids can either prolapse out of the anus or be incarcerated by the sphincter, forming incarcerated hemorrhoids.

What causes hemorrhoids?

Anish Sheth, a gastroenterologist at Princeton University in the United States, said that continuous pressure on the anal connective tissue affects venous blood circulation and is one of the main causes of hemorrhoids, mainly including the following:

Taking too long to defecate: Whether you are distracting yourself by playing with your phone while on the toilet, or straining even though you are constipated and don’t feel anything, as long as you spend more than 10-15 minutes on the toilet, it is likely to cause tension, sensitivity and inflammation of the anal connective tissue, which can lead to hemorrhoids over time.

Standing or sitting for a long time: Maintaining a posture for a long time will affect the blood circulation of the veins under the lower end of the rectal mucosa and the skin of the anal canal, causing the venous plexus in this area to dilate and congestion, and form hemorrhoids.

Pregnancy: The enlarged uterus can compress the inferior vena cava, obstructing blood return, thereby increasing pressure in the vulvar and rectal veins and inducing hemorrhoids. Pregnant women are most likely to suffer from hemorrhoids after 5 months of pregnancy.

Love eating chili peppers: Capsaicin in chili peppers can promote vasodilation and cause local congestion. When it acts on the skin, it can produce a burning sensation. The dilation and congestion of the veins in the rectal mucosa and anus are the source of hemorrhoids.

Age factor: Sheth adds that the incidence of hemorrhoids can increase with age. As people get older, their blood vessels become less elastic, causing abnormal contraction and dilation, which in turn leads to hemorrhoids.

Do I need treatment for hemorrhoids?

The answer is: symptomatic hemorrhoids require treatment to eliminate or relieve symptoms. Non-surgical treatment is the main one, supplemented by surgical treatment.

This is because, on the one hand, long-term and repeated bloody stools may lead to iron deficiency anemia, and on the other hand, untreated hemorrhoids have the risk of serious complications, such as rectal prolapse (rectal prolapse), perianal abscess, infection, etc.

In addition, the severe pain and unspeakable "restlessness" caused by external hemorrhoids and mixed hemorrhoids can also bring great inconvenience to your life.

How to treat it?

Dr. Gina Sam of the Mount Sinai School of Medicine in the United States recommends using an ointment containing hydrocortisone under the guidance of a doctor to help eliminate redness and swelling and relieve pain. However, pregnant women must consult a doctor before use to avoid harm to themselves and the fetus.