Hemorrhoids can occur in all genders and ages. They are caused by severe and chronic straining during bowel movements because people who are constipated have to strain hard when defecating. This causes blood to pool in the veins of the anal canal wall, resulting in the veins and tissues at the end of the intestine swelling and forming hemorrhoids. Factors contributing to the disease, besides severe straining, include chronic constipation, frequent bowel movements, prolonged sitting during defecation such as reading while defecating, pregnancy, liver cirrhosis, and aging.
There are 2 types of hemorrhoids: internal and external hemorrhoids
- Internal hemorrhoids are hemorrhoids located above the dentate line and are divided into 4 stages:
- Stage 1 No lumps protrude outside the anus
- Stage 2 Lumps protrude during straining but retract on their own
- Stage 3 Lumps protrude during straining but do not retract and must be pushed back manually
- Stage 4 Lumps protrude and cannot be pushed back manually; hemorrhoid surgery is required
- External hemorrhoids are hemorrhoids located below the dentate line outside the anus. A lump may be felt, covered by skin, often causing itching and pain. Patients usually visit the doctor with the following symptoms:
- Bright red blood during or after bowel movements, without mucus mixed in
- Lumps protruding during bowel movements or protruding all the time
- Pain in the anal area; surgery is required only in stage 4
Care and Surgery for Hemorrhoids
Doctors will consider symptoms and the severity of the disease. Stage 1 focuses on medication and self-care. Stages 2 and 3 (initially) are treated with medication, self-care, and in some cases, special rubber bands are used to ligate the hemorrhoids. Finally, large stage 3 and stage 4 require hemorrhoid surgery.
Prevention and Self-Care
- Diet: Eat foods high in fiber such as vegetables and fruits, drink at least 2 liters of water per day, avoid spicy and fatty foods, and reduce meat consumption.
- Bowel movements: Avoid straining, do not spend a long time defecating, have regular bowel habits especially in the morning, and soak the anus in warm water.
