Hemorrhoids - Symptoms, causes and treatment

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Hemorrhoids - Symptoms, causes and treatment
Hemorrhoids - Symptoms, causes and treatment

Piles or hemorrhoids are swelling or inflammation of the blood vessels at the end of the large intestine (rectum) and anus. This condition is caused by increased pressure in the blood vessels around the anus. One of them is pushing too hard

Piles, also known as hemorrhoids, are conditions that generally do not cause symptoms and can improve in a matter of days. However, in severe conditions hemorrhoids can cause pain, itching, and bleeding after defecating.

Hemorrhoids - Alodokter

Hemorrhoid Causes

The exact cause of hemorrhoids is not known, but this condition is thought to occur when pressure on the abdomen or legs increases. This increased pressure then causes the blood vessels around the anus to become swollen and inflamed.

Some factors that can increase the risk of hemorrhoids, namely:

  • Constipation or prolonged constipation due to lack of fiber intake from food
  • Often lifting heavy weights
  • Habit of sitting for a long time
  • Prolonged diarrhea
  • Habit of straining when defecating
  • Cough and vomiting that lasts a long time
  • Obesity or overweight
  • Pregnancy
  • History of hemorrhoids in the family
  • Anal sex

In addition, several medical conditions are also suspected of causing hemorrhoids, namely:

  • Inflammatory bowel disease, such as Crohn's disease and ulcerative colitis
  • Accumulation of fluid in the abdominal cavity (ascites)
  • Rectal prolapse
  • Spine Injury
  • Colon cancer

Hemorrhoid Symptoms

Signs and symptoms that appear due to hemorrhoids depend on the type of hemorrhoid experienced. Here is the explanation:

External hemorrhoid

This type of hemorrhoid is characterized by swollen blood vessels outside the anus so that it can be seen from the outside. Symptoms that can appear on external hemorrhoids are:

  • Itching or irritation, pain, and swelling around the anus
  • Pain when touching the lump hanging outside the anus
  • Bleeding during defecation

Internal hemorrhoid

Internal hemorrhoids occur when swollen blood vessels are inside the anus so that hemorrhoids are not visible or palpable from the outside. Symptoms that can be found in this type of hemorrhoid are:

  • Bleeding when defecating without pain
  • Pain when straining, if hemorrhoids cause lumps coming out of the anus (prolapse)
  • Itching in the anus

When to see a doctor

See your doctor if you experience the symptoms of hemorrhoids as previously mentioned, or if your symptoms do not improve after 7 days of self-care. Also check with your doctor if the above complaints are accompanied by symptoms of a more serious illness or condition, such as:

  • Changes in stool color and consistency
  • Changes in bowel patterns that have been going on for a long time
  • Heavy bleeding
  • Dizzy
  • Fainted

Hemorrhoid Diagnosis

In determining the diagnosis of hemorrhoids, the doctor will first ask about the symptoms and complaints felt, as well as the patient's medical history. After that, the doctor will perform a physical examination to see if there are lumps, swelling, or irritation in the area around the anus.

Furthermore, the doctor will perform several other examinations, namely:

  • Digital rectal examination, to check for abnormalities in the blood vessels in the rectum and rectum
  • Anoscopy, to see the lining of the anus and rectum using a lighted tube equipped with a camera
  • Sigmoidoscopy, to view the inside of the large intestine and rectum using a long tube with a camera
  • Colonoscopy, to find out if the cause of hemorrhoids comes from disorders of the digestive system
  • Biopsies, to examine samples of colon or rectal tissue further in the laboratory

After the examination is complete, the doctor will classify hemorrhoids based on their size and severity, namely:

  • Grade I: small swelling appears inside the anal wall, but is not visible from outside the anus
  • Grade II: larger swelling that comes out of the anus during defecation (BAB), but goes back on its own after a bowel movement
  • Grade III: there is one or more small lumps hanging from the anus, but can be pushed back in
  • Grade IV: there is a large lump hanging from the anus and cannot be pushed back

Hemorrhoid Treatment

Although generally hemorrhoids can recover on their own in a few days, treatment must still be done to reduce the complaints felt. Some methods of hemorrhoid treatment that can be done are:


One of the methods that can be used to treat hemorrhoids is with drugs. These drugs can be obtained at pharmacies or with a doctor's prescription. Some of these drugs include:

  • Osted medication

    Osted medication can be used to relieve swelling and itching due to hemorrhoids. Hemorrhoid ointments are available in the form of creams, ointments, and suppositories.

  • Corticosteroids

    To relieve inflammation that occurs inside or outside the anus, the doctor will prescribe a corticosteroid cream to the patient.

  • Patients with pain relief

    Patients can take pain relievers, such as paracetamol, to relieve pain and swelling due to hemorrhoids.However, first consult with your doctor regarding the right type of pain medication to avoid worsening symptoms.

  • Laxatives (laxatives)

    If hemorrhoids are caused by constipation, the doctor will prescribe laxatives to help smooth bowel movements.

Non-surgical medical procedures

Some of the non-surgical medical procedures that can be used to treat hemorrhoids are:

  • Hemorrhoid binding (ligation)

    In this procedure, the doctor will tie the hemorrhoid using an elastic cord so that the blood flow to the hemorrhoid can be cut off.

  • Sclerotherapy injection

    In sclerotherapy, the doctor will inject special drugs into the veins around the hemorrhoid. This injection works to shrink hemorrhoids without pain.

  • Coagulation

    Coagulation is a procedure of burning hemorrhoid tissue using infrared. This procedure also serves to cut off blood flow so that the hemorrhoid can shrink.


If hemorrhoids still can't be cured with medication and simple procedures, the doctor will recommend surgery to treat hemorrhoids. Operation procedures that can be performed include:

1. Hemorrhoidectomy

Hemorrhoidectomy surgery procedure is done by cutting the hemorrhoids through open surgery. During the operation, the doctor will give local anesthetic so that the patient does not feel pain.

2. Stapled hemorrhoidopexy

Stapled hemorrhoidopexy is a surgical procedure that uses a special stapler tool on the rectum, to stop blood flow to the hemorrhoids while shrinking the hemorrhoids.

Hemorrhoid Complications

Hemorrhoids can last a long time and cause chronic pain. In addition, in rare cases, hemorrhoids can cause complications such as:

  • Anemia due to bleeding
  • Twisted hemorrhoid
  • Blood clots in swollen veins
  • Infection of external hemorrhoids
  • Skin damage

Hemorrhoid Prevention

Some ways that can be done to prevent hemorrhoids are:

  • Consumption of foods rich in fiber.
  • Increase the intake of body fluids.
  • Don't delay defecation.
  • Avoid excessive straining.
  • Avoid sitting too long.
  • Do exercise regularly.

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