Hemorrhoids, Fissure and Fistula are the common anorectal problems in men and women. Normally people blame all the rectal problems as "Hemorrhoids". However, they are due to a variety of conditions such as fissures, fistulae, perianal abscess and so on. About half the population has hemorrhoid by their middle age.

What are Hemorrhoids?

HemorrhoidsHemorrhoids are swollen but normally present blood vessels in and around the anus and lower rectum that stretch under pressure. It is similar to varicose veins in the legs. The increased pressure and swelling may result from straining to move the bowel. Contributing factors include pregnancy, ageing and chronic constipation or diarrhea.

Hemorrhoids are either inside the anus called "internal piles" or under the skin around the anus called "external piles."

What are the symptoms of Hemorrhoids?

Pain and bleeding are the key symptoms of Hemorrhoids. In addition, excessive straining, rubbing or cleaning around the anus may cause irritation with bleeding or itching, which may produce a vicious cycle of symptoms. Excessive production of mucus may also cause itching.

Many anorectal problems including fissures, fistulae, abscesses or irritation and itching have similar symptoms and are incorrectly referred to as hemorrhoids.

The most common symptom of internal hemorrhoids is bright red blood covering the stool, that "splashes the toilet bowl" at the end of the bowel movement. However, an internal hemorrhoids may protrude through the anus as bunch of grapes and recedes back. Sometimes the mass gets prolapsed and protrudes always outside the anus.

Hemorrhoids are also common among pregnant women. The pressures of the foetus in the abdomen, as well as hormonal changes, cause the hemorrhoid vessels to enlarge. These vessels are also placed under severe pressure during childbirth. For most women, hemorrhoids are caused by pregnancy which are temporary problem.

Symptoms of external hemorrhoids may include painful swelling or a hard lump around the anus that results when a blood clot forms known as Thrombosed external hemorrhoid.

What is Fissure?

The classical symptoms of a fissure are those of pain and bleeding with a bowel movement of very hard stool. This pain may persist for many hours after a bowel movement. The fissure is caused by a tear in the lining of the anal skin often noticed by the victims as "streaks of blood" in the faeces.

What is Fistula?

FistulaA fistula is a form of infection around the rectum. It is an abnormal, thin tunnel that connects the inside of the rectum with the outside through a small hole that is located to the side of the rectum. A fistula will usually leak blood-stained pus because, as mentioned, it is a form of mild infection. There is usually some discomfort, but this condition isn't really painful. When the openings of the fistula become plugged with infection "Perianal Abscess" will be formed.

How are these Diagnosed?

Diagnosis is made by the clinical symptoms and rectal examination. It is performed with a gloved, lubricated finger to feel the abnormalities.

How to prevent?

Prevention of recurrence of hemorrhoids is aimed at changing conditions associated with the pressure and straining of constipation. Constipation is corrected by increasing fiber in the diet. Eating the right amount of fiber results in softer, bulkier stools. A softer stool makes emptying the bowels easier and lessens the pressure on hemorrhoids caused by straining. Eliminating straining also helps to prevent the hemorrhoids from protruding. Good sources of fiber are fruits, vegetables and whole grains.

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