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>> What are Piles?
>> Can Dehydration Cause Hemorrhoids?
>> Proper dieting to Reduce Hemorrhoids
>> Can Constipation Cause Hemorrhoids
>> Sitz Bath for Hemorrhoid Relief
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Prolapsed Hemorrhoids

Hemorrhoids are a condition where the blood vessels around the anal and rectal region become engorged due to excessive straining or pressure. Hemorrhoids are classified into two main types, external and internal.

Internal hemorrhoids develop on the inside of the anal canal. Sometimes, due to excessive pressure, internal hemorrhoid slips down the anus and protrude from the anal opening. These hemorrhoids are known as prolapsed hemorrhoids. They generally appear as red lumps of tissue which are spongy in nature. Though they might not pain, they do bleed.

Degrees of Prolapsed Hemorrhoids

Prolapsed hemorrhoids are classified on the basis of their severity:

  • The uterus and the fetus are both growing, putting more pressure on the veins in the lower pelvic area
  • Hormones released during pregnancy results in the enlargement of blood vessels.
  • Excessive pressure on the hemorrhoidal vessels during childbirth.
  • Increase in blood circulation in the abdominal area results in the engorgement of the blood vessels
  • Women frequently suffer from constipation during pregnancy, which increases the straining and pressure on blood vessels during bowel movement.

How to Prevent Hemorrhoids during Pregnancy

Here are some steps to minimize or prevent hemorrhoids during pregnancy:

  • First degree: This is the least severe and occurs when the hemorrhoid has not yet protruded outside the opening of the anal canal.

  • Second degree: These protrude from the anus while passing stools. They, however, retract to their original position inside the anal canal on their own.

  • Third degree: The prolapsed hemorrhoid protrudes from the anal opening while passing stools, but does not return to its original position on its own. It needs to be inserted back manually.

  • Fourth degree: This is the most severe of all, where the protruding hemorrhoid cannot be re-inserted back into the anal canal manually.

Prolapsed Hemorrhoids: Prevention and Treatment

Prolapsed hemorrhoids are treated, depending on their severity. They are treated using preventive remedies or surgical methods:

  • High fiber diets: High fiber content in the diet enables softening of stools, which prevents constipation, and helps in easy bowel movements without straining the anorectal veins. Avoiding processed foods also helps. Processed foods are very low in fiber content and vital nutrients, and lead to the formation of dry and hard stools. Too much consumption of processed foods is also one of the major reasons for constipation.

  • Proper fluid intake: Regularly drinking water also helps in softening stools, and helps in proper bowel movements. Lack of water causes the feces to dry up and harden, needing one to strain during bowel movements. Also, we should avoid drinking too much alcohol or caffeinated drinks, such as coffee, tea or soft drinks, because they act as diuretics. Diuretics cause the body to lose more water, again leading to constipation.

  • Sphincterotomy: In this procedure, a part of the sphincter is removed to reduce the pressure being applied in the anal region by the prolapsed hemorrhoid. But this procedure may also affect the control of bowel movements later in life.

  • Doppler ligation: In this procedure, doctors identify the artery feeding the affected hemorrhoid. Doctors can then tie this artery with a string, blocking the blood supply to the affected region, causing the hemorrhoid to dry up and fall off.

  • Rubber band ligation: In severe conditions, the prolapsed hemorrhoid is held with forceps while a rubber band is slipped around it, thus cutting off the blood supply to the tissue. The hemorrhoid then gradually shrivels up and falls off within a few days while passing stools.

  • Hemorrhoidectomy: In this procedure, the prolapsed hemorrhoid, which has slipped out of the anal opening, is excised or removed surgically, using a scalpel. The patient is usually given an anesthetic for the procedure. Some doctors stitch the area after the surgery with absorbable stitches, while others choose to leave the wound open to prevent any kind of infection. The recovery time is generally long and painful. This surgery might cause incontinence later in life, and hence recommended only for IV degree prolapsed hemorrhoids.

  • Stapled hemorrhoid surgery: In this procedure doctors use a specially designed stapler. A suture is made in the sub-mucosal and mucosal layers, above the dentate line. The dentate line is that area in the anal canal above which the patient feels pain. The stapler is slowly placed and excess hemorrhoidal tissue is carefully drawn out into the stapler. The stapler is triggered which resects the excess hemorrhoidal tissue, just above the dentate line. This causes the resection of the affected hemorrhoidal tissue and blocking of the blood supply to the hemorrhoidal tissue from above.

Awareness about the factors and symptoms leading to hemorrhoids can help prevent the development of this painful condition.