A hemorrhoid is a varicose dilation of a vein of the superior or inferior hemorrhoidal plexus secondary to a persistent increase in venous pressure.
The self-reported prevalence in the United States is close to 5% of the general population, and 50% of the population declares having suffered hemorrhoids throughout their lives.
Hemorrhoids are identified in almost 40% of patients undergoing screening colonoscopy.
Greater predominance in the white population and of higher socioeconomic level.
Gender, predominantly male.
Low fiber and high fat diet
Chronic constipation and straining to defecate
Elevated anal sphincter pressures at rest
Physical findings and clinical presentation
40% of individuals are asymptomatic.
Painless bleeding with defecation.The bleeding is bright red, with stains on the toilet paper or drops in the toilet (the most common complaint in those who present symptoms).
Pressure in the perianal area.
Mucofecal stains on underwear.
Pain when sitting, standing or defecating, often associated with a thrombosed hemorrhoid.
Fiber supplements to provide volume (psyllium or mucilage extracts).
Medicinal compresses with witch hazel.
Topical hydrocortisone (1 to 3% cream or ointment.
Topical anesthesia (lidocaine).
Surgical removal during the first 72 hours from onset.
Constipation and straining when defecating must be avoided.
Prolonged sitting on the toilet should be avoided.
Diet rich in fiber (20-30g/die).
Increased fluid intake (six to eight glasses of water a day).
Cleaning with mild soap and water after defecating.
Hot soaks (15 minutes three times a day and after defecating) or ice to relieve pain.