The rectum is the final portion of the large intestine. It empties stool from the body through the anus. Hemorrhoids are "cushions" of tissue filled with blood vessels at the junction of the rectum and the anus. These cushions normally act to prevent the leakage of stool from the anus. These vascular cushions can become swollen and inflamed, usually due to increased intra-abdominal pressure, such as straining when constipated or during pregnancy. Such swelling causes pain, bleeding, and itching.
Hemorrhoid removal is recommended when non-surgical treatment (fiber rich diet, laxatives, stool softener, suppositories, medications, or warm baths) does not provided adequate relief from:
- persistent itching
- anal bleeding
- blood clots (thrombosis of the hemorrhoids)
The hemorrhoid is bound (ligated) at the base to prevent bleeding from blood vessels within it. Then it is removed surgically. Some surgeons simply apply a rubber band around the base of the hemorrhoid (banding), depriving it of its blood supply. The hemorrhoid will then simply fall off and be passed into the stool. Some surgeons inject the base of the hemorrhoid with a sclerosing agent (sclerotherapy), which also destroys the vessels in the hemorrhoid, causing it to fall off and be passed into the stool. More than 90% of hemorrhoid cases are successful. There is considerable pain after surgery as the anus tightens and relaxes, but medications are available to alleviate this. To avoid straining, stool softeners are used. Avoid any straining during bowel movement or urination. Soaking in a warm bath also provides additional comfort. Expect complete recovery in about two weeks.