As a normal process of passing the stools, the anal tissue surrounding the anal sphincter gets filled with blood. While passing hard stools force is exerted on these anal tissues causing it to expand even more. Repeated expansion causes the anal tissue to prolapse in to the anal canal forming hemorrhoids. Prolapsed hemorrhoids can be either internal hemorrhoids or external hemorrhoids
Stages of prolapsed hemorrhoids
Depending on the degree of protrusion of the anal tissues in to the anal canal there are four stages of hemorrhoids.
- Stage I hemorrhoids are those that have protruded just in to the anal canal.
- Stage II hemorrhoids prolapse out of the anal canal while emptying the bowels but retract back in to the anal canal automatically.
- Stage III hemorrhoids prolapse out of the anal canal but they do not retract on their own. They have to be pushed back with the help of a finger.
- Stage IV hemorrhoids prolapse out of the canal and cannot be put back in to the anal canal even with a finger. Rarely, stage IV prolapsed hemorrhoid develops blood clots forming thrombosed hemorrhoid.
- Stage IV prolapsed hemorrhoid causes discomfort, pain and itching of the anus region. They have to be treated without delay to prevent complications such as infection and anemia due to bleeding.
Factors aggravating formation of prolapsed hemorrhoids
- Chronic constipation.
- Child labor.
Symptoms of prolapsed hemorrhoid
- Burning and itching of the skin.
- Severe pain that becomes worse with the bowel movements.
- Bleeding during passing stools.
- Feeling of fullness due to incomplete emptying of bowels.
Treating prolapsed hemorrhoids
Mild prolapsed hemorrhoids i.e. stage II hemorrhoids can be prevented from worsening by taking high fiber diet, plenty of fluids and by using hemorrhoid creams. The analgesics and vasoconstrictors present in the creams reduce the pain, inflammation and also shrink the swollen tissue. Vasoconstrictors constrict the veins and reduce the risk of bleeding. Few creams contain natural herbs such as Aloe Vera, Butcher’s broom, Horse-chestnut or Witch Hazel that soothe the irritated skin and reduce the inflammation.
Severely prolapsed stage III and stage IV hemorrhoids are often treated by performing surgery. Surgical removal of protruding hemorrhoid tissue is termed as hemorrhoidectomy. It can be performed either by conventional method that is highly painful or by stapled hemorrhoidectomy that causes comparatively lesser pain and fast recovery.
In few people, when the pain is not worse and if there are no signs of thrombosis non-surgical procedures such as rubber band ligation, sclerotherapy, laser coagulation and infrared coagulation are used. Of all these treatments laser treatment gives excellent results and the patient can resume to daily routine very quickly. But, it is an expensive procedure.
Use of home remedies such as sitz baths and placing of ice packs offers relief from prolapsed stage II hemorrhoids. These measures even help to reduce inflammation in case of severely prolapsed anal tissue.
Pain medications such as acetaminophen and non-steroidal inflammatory drugs can be used to regulate inflammation and pain.
Complications of untreated prolapsed hemorrhoids
When the hemorrhoid tissue remains out of the anus the muscles are subject to spasms. Blood and oxygen supply to these muscles will also be cut off causing death of the tissue. Tissue death initiates gangrene and infections. In few cases infections cause blood poisoning that result in death.
Preventing / precautions for prolapsed hemorrhoids
Prolapse of hemorrhoids can be prevented by taking required precaution right from the onset of the hemorrhoids.
- Taking high fiber diet such as vegetables, fruits and whole grains.
- Drinking more fluids to soften the stools.
- Avoid using tight fitting abrasive undergarments.
- Practicing exercises to strengthen the muscles. Pregnant women should practice kegel exercises to strengthen pelvic muscles.
- Emptying the bowels immediately when the urge arises without delaying until the urge vanishes.
- Consult the physician immediately if you suffer with severe constipation, inflammation of the anus, severe bleeding, pale skin and fainting.