{Colon cancer and Crohn’s disease or ulcerative colitis has some of the same symptoms as haemorrhoids}

Normal hemorrhoidal tissue cannot be seen since it must first swell and become inflamed or develop a clot to cause symptoms. One can see swollen external hemorrhoids or internal prolapsed hemorrhoids exposed outside the anus but internal hemorrhoids cannot be seen because they remain inside the anus.

Thrombosed hemorrhoids will appear as a lump at the anal verge, protruding from the anus, and will be dark bluish because of the blood clot contained inside the swollen blood vessel. Non-thrombosed hemorrhoids will appear as a rubbery lump.

Often more than one swollen hemorrhoid appears at the same time.

Hemorrhoid swelling occurs when there is an increase in the pressure in the small vessels that make up hemorrhoids causing them to swell and engorge with blood. This causes them to increase in size leading to symptoms. Increased pressure may be caused by a variety of factors:

• A low-fiber diet and smaller caliber stool cause a person to strain when having a bowel movement, increasing the pressure within the blood vessels.
• Pregnancy is associated with hemorrhoid swelling and is likely due to increased pressure of the enlarged uterus on the rectum and anus. In addition, hormonal changes with pregnancy may weaken the muscles that support the rectum and anus.
• Prolonged sitting on the toilet may increase pressure within the hemorrhoid blood vessels.
• Obesity
• Diarrhea, both acute and chronic
• Colon cancer
• Previous rectal surgery
• Spinal cord injury and lack of erect posture.

• Usually, the first haemorrhoid symptom is blood in/on the stool.
• Itching in the anal area.
• Pain in the anal area, especially when sitting.
• Painful bowel movements.
• One or more hard, painful lumps/polypi around the anus.

Colorectal cancer might not cause symptoms immediately, but if it does, these could be some of the symptoms:

• A change in bowel habits, such as diarrhoea or constipation, that lasts for more than a couple of days
• Blood in the stool, which might make the stool look dark brown or black
• Cramping or stomach pain
• Heavy rectal bleeding with bright red blood.
• Need to relieve your bowel but not have a bowel movement.
• Unintended weight loss.
• Weakness and fatigue.

Crohn’s disease or ulcerative colitis Crohn’s disease is a type of inflammatory bowel disease (IBD), which can lead to abdominal pain, severe diarrhoea, fatigue, weight loss and malnutrition. Inflammation caused by Crohn’s disease involves different areas of the digestive tract/intestine that’s why it is also called “Kangaroo disease“.

Causes of Hemorrhoids :

• Chronic constipation.
• Diarrhoea.
• Low-fibre diets.
• Lifting heavy objects.
• Sitting or standing for long periods.

Portal hypertension refers to a condition where there is an increase in the blood pressure within the veins of the portal venous system.

The veins coming from the spleen, stomach, pancreas, and intestines merge into the portal vein, which travels through the liver. In case of any complication due to which blood cannot flow properly through the liver, high pressure develops in the portal system. This pressure can cause the development of large, swollen veins in the stomach, oesophagus, and rectum. As a result, haemorrhoids may develop in the anal area.

For external haemorrhoids, examine the area surrounding the anus, and for internal haemorrhoids, perform a digital rectal exam through an anoscopy/colonoscopy, or a rigid proctosigmoidoscopy.

According to allopathic theory, hemorrhoids are a lifelong condition to be controlled and not cured.

Diet and lifestyle changes are compulsory.

• Consuming more fibre can make bowel movements easier and put less stress on the rectal muscles.
• Avoid straining during bowel movements.
• Wash anus properly after each bowel movement.

Medicines: Grade one hemorrhoids are treated symptomatically. There can be some spasms of the anal muscles. Warm sitz baths, sitting in a warm tub for 20 minutes, two or three times a day may be helpful. Avoiding spicy food may also prevent anal itching. Over-the-counter medications may be helpful.

To control symptoms advise the following:

• Softening the stool
• Decreasing the inflammation of the hemorrhoids
• Treating the pain

Stool softeners work by increasing the water and fat content within the stool allowing it to be passed more easily.

• Docusate sodium is the most often recommended drug in this class.

Inflammation can be controlled with over-the-counter creams or suppositories.

• Some brand ingredients (Preparation H) include low-dose topical anesthetics to help with symptoms.
• Others (Anusol, witch hazel) contain astringents that help shrink the swollen tissues.
• Both may contain low-dose steroids (hydrocortisone) to decrease inflammation.
• Patients with diabetes should check with their pharmacist or health care professional before using OTC hemorrhoid treatments. If the medication contains a vasoconstrictor (for example, phenylephrine HCI, ephedrine, or epinephrine) it may elevate blood sugar levels if absorbed in large amounts.
• Prescription-strength lidocaine or hydrocortisone may be offered by the health care professional.

Grade 2 and 3 hemorrhoids are initially treated the same way, using techniques to destroy hemorrhoids. These include:

• Injecting the hemorrhoid vein to make it sclerose or harden
• Using rubber bands to choke off the blood supply and make the hemorrhoidal tissue shrivel
• Other procedures that cause the mucosa to shrivel and die

Patients who have failed conservative therapy or who have grade 4 hemorrhoids will be advised for surgery to remove the swollen hemorrhoids and the larger external hemorrhoid skin tags. Options include:

• Hemorrhoid removal with laser surgery or hemorrhoidectomy (ectomy=removal) using a scalpel.
• Another alternative is stapled hemorrhoidectomy, where a special staple gun is positioned to remove hemorrhoids and surround the tissue with a ring of staples to close the area as well as control the bleeding.

A thrombosed external hemorrhoid indicates that a clot has formed in hemorrhoids causing significant pain.

• Treatment involves cutting into hemorrhoids to remove the clot and reduce the swelling.

Prognosis with allopathic treatment

Hemorrhoids will recur after nonsurgical treatment about 80% of the time, while the recurrence rate after surgery is 65%.

Homeopathic treatment for Hemorrhoids

In Homeopathy, there lot of medicines for hemorrhoids and their cause(s); Here I (Dr Qaisar Ahmed MD, DHMS) will explain few of them:

Aloe Socotrina:

Haemorrhoids that are swollen and protrude “like grapes bunch” and are soothed by cold soaks or compresses may be helped with this remedy. Haemorrhoids, alternate with diarrhoea, and a lot of flatulence.

Graphites:

Constipation without urges, very large and dry stools, hard, knotty and scanty, with the feeling of heaviness in the lower abdomen, and often associated with anal itching and burning and haemorrhoids. painful piles that get worse during sitting. Cutting pains and swelling with cracks.

Muriatic Acid:

Piles that are intensely painful, sore and protrude outside the anus. The haemorrhoids are very swollen and look bluish. Pain may get worse while passing stools. Stitching pain that gets worse on touch, gets better from warm-washing.

This medicine is also used to treat cases where the soreness in the haemorrhoids worsens during menses/periods.

Nitricum Acidum:

Piles and anal fissure when there are tearing pains while passing stools. The stool can be hard or soft but is passed with difficulty and may also bleed. There may be splinter-like pains in the anus.

Ratanhia Peruviana:

Piles were a burning sensation after defecation, strain to pass stool. Darting – Knives like stitching pains or the feeling of a sharp splinter of glass.

Collinsonia Canadensis:

Piles accompanied by constipation. The stool is lumpy, dry and is passed with a lot of strain, aching and burning at the anus, the sensation of sharp sticks in the rectum, anal itching and a constricted sensation in the anus.

Aesculus Hippocastanum:

Piles with sharp, shooting pains where the stools are knotty, dry and hard. This medicine is used to treat external, blind and bleeding piles.

Sepia Succus:

Piles that develop during pregnancy or after the delivery. The stools are very hard and large, protrusion of piles during stool, Itching at the anus and rectum

Kalium Carbonicum:

Piles that develop post-childbirth, extremely tender to touch, stitching, smarting, pricking and tingling sensation at the anus along with sharp pain. Constipation lasting for days along with hard stool, white mucus after bleeding from piles may also be present.

Silicea Terra:

Piles and anal fistula. The piles tend to protrude during the passage of stool, stool is hard and tends to recede into the rectum several times during defecation. Burning in anus after passing hard stools, foul-smelling discharge of pus or serum from the anal fistula.

Sedum Acre:

Painful piles that worse after a few hours of passing stool, pain is constricting. Anal fissure with pain that worsens a few hours after passing stool.

Ammonium Carbonicum:

Piles that get worse during the menses/periods. The piles tend to bleed during menses, feels better upon lying down.

Merc Solubilis:

Piles along with diarrhoea. There is an urge to pass stool, more frequently during the night. The stools in most cases smell sour and with undigested bits of food. Burning while passing stools, protrusion of piles during defecation, exhaustion, and chilliness with shivering and nausea.

Baryta Carbonicum:

is it a medicine used to treat piles that protrude during urination? Other symptoms that indicate the need for this medicine include an urgent need to pass stools, and an itching, burning, soreness and shooting pain in piles.

Lachesis Mutus:

Piles that protrude during a cough or sneeze, stitching pain and a throbbing sensation in the piles. Piles during menopause.

Nux vomica:

Blind piles with pronounced burning and itching around the anus. Constant desire to pass stools. Haemorrhoids are caused by a sedentary lifestyle, overeating and drinking, especially spicy and rich foods and alcohol.

Phosphorus:

Internal piles where there is bleeding during stool. Excessive exhaustion, an urgent need to empty bowels and rectal tenesmus (desire to evacuate the bowels).

Causticum:

Large, swollen piles hinder the passage of stool from the anus. The patient needs to pass stool by straining hard in a standing position. The piles are hard, painful and constant and get worse upon sitting, standing and walking; pressing and sticking pain in the anus along with a burning, stinging sensation.

Pulsatilla:

Itchy and uncomfortable, with sticking pains. Protrude, with improvement after lying down. Warmth often aggravates the symptoms. Haemorrhoids that appear during pregnancy or around the menstrual period.

Sulphur:

Itching, burning, oozing haemorrhoids accompanied by a feeling of fullness and pressure in the abdomen. The anus is inflamed and red and may protrude significantly. The patient may feel worse from warmth and bathing, flatulence with a strong offensive odour.

Alumina

A very general condition corresponding to this medicine is dryness of mucous membranes and skin, and tendency to paretic muscular states. Stool hard dry, knotty; no desire. Rectum sore, dry, inflamed, bleeding. Itching and burning at anus. Even a soft stool is passed with difficulty. Great straining.

Paeonia Officinalis

The rectal and anal symptoms are most important. Chronic ulcers on lower parts of body, leg, foot, toe, also breast, rectum. Biting, itching in anus; orifice swollen. Burning in anus after stool; then internal chilliness. Fistula ani, diarrhoea, with anal burning and internal chilliness. Painful ulcer, oozing offensive moisture on perineum. Haemorrhoids, fissures, ulceration of anus and perineum, purple, covered with crusts. Atrocious pains with and after each stool. Sudden, pasty diarrhoea, with faintness in abdomen.

Arnica montana:

Sore, bruised feeling haemorrhoids, especially when straining or over-exertion (for instance, childbirth or heavy lifting) has brought on the haemorrhoids.

Calcarea Fluorica:

Haemorrhoids with bleeding and itching in the anal region, or internal haemorrhoids causing soreness in the very low back and sacrum. The patient may also have flatulence and constipation.

Hamamelis virginiana:

Improves venous circulation and relieves haemorrhoids that are painful with the slightest contact and bleed easily.

Ignatia:

Haemorrhoids are accompanied by spasms and stabbing pain in the rectum, especially if the patient is sensitive and emotional. Stitching pains can be felt in the rectal area when coughing. Bleeding and pain are often worse when the stool is loose, and rectal prolapse sometimes follows bowel movements.

Lycopodium Clavatum:

Piles in cases where there is a rectal prolapse. The piles may be swollen and painful, and the pain gets worse upon touching and sitting. Chronic constipation with a scanty stool, painful constriction at the anus and excessive flatulence and bloating in the abdomen may also be present.