Hemorrhoids and toilet paper

Hemorrhoids are an embarrassing health issue which affects the anal canal.

Hemorrhoids are also known as piles.

The anus is the very last part of the intestines and directly above the anus is the rectum.  The anus has two sphincters which control the passage of feces from the body and thereby maintains continence.

To learn more about fecal incontinence, visit our fecal incontinence page.

The two sphincters are known as the internal anal sphincter and the external anal sphincter.  On the wall of the anal canal are pads, or cushions, that are just inside the structure of the internal anal sphincter.  These pads are hemorrhoids.  They are always there as part of the structure of the anal canal.

We usually only think of hemorrhoids as being the swollen, painful and bleeding structures which cause discomfort and embarrassment.  They are always there but it is only when they cause us discomfort that they become a problem.

As we age, the structural integrity of these cushions lining the inside of the internal anal sphincter becomes weakened.  Due to this weakening, the pads bulge out into the lumen of the anal canal more and more.

The veins within these pads become enlarged and balloon with the loss of support from connective tissue.

Bowel movements can now cause injury to the area especially if there is constipation and straining to pass the stool.

As you can see, management of constipation and reducing straining while defecating can be very important to the prevention and treatment of hemorrhoids.  One of the easiest ways to prevent hemorrhoids is to increase dietary fiber and drink plenty of water.

If eating enough dietary fiber is difficult then supplementation with psyllium fiber can be helpful.

The number one symptom associated with hemorrhoids is rectal bleeding when defecating.

Hemorrhoids can be classified as internal or external.  They are further classified by the degree of the condition.  This ranges from 1st degree being the least bothersome to 4th degree being the most serious.

Treatments range from lifestyle changes to surgical interventions.  Commonly, piles are treated with external cream and ointments or suppositories.  These topical treatments and suppositories usually contain steriods to reduce inflammation.

You may also wish to learn about anal fissures.