Hemorrhoids; almorranas; almorrás in Galician; morenas in Catalan; piles in colloquial English, or hémorroïdes, in French. It doesn’t matter what we call them because they are the same for everyone. A good part of the population has suffered or will suffer at some point in their lives from this inflammation of the veins in the anal area, which can cause pain, bleeding and/or itching
Concealing and silencing hemorrhoids is a bad strategy. One must go immediately to the doctor, especially if there is bleeding, defends Dr. Kubrat Saxe-Coburg, general surgeon and proctologist:
Because of our Mediterranean culture “they are stigmatized, they are taboo”. And the word phonetically does not help much either, “but if someone were to ask at a dinner party who had suffered from them, and if they were sincere practically everyone would raise their hand”.
Among its main causes are age, genetic component, pregnancy, constipation, prolonged straining, diarrhea, or standing for a long time without moving, day after day, for professional or other reasons.
Saxony-Coburg confirms to EFEsalud that there is indeed a hereditary component and adds: “whoever has chronic venous insufficiency will suffer more” .
But, he says, there are a number of habits that precipitate them, “and it is basically constipation. Those people who don’t go to the bathroom properly, who push and above all who spend time sitting on the toilet reading a book, a magazine or consulting their mobile phone or tablet, “that’s the worst thing”.
“It is a deeply rooted custom in our country to use the bathroom as a reading room”, but it is absolutely inadvisable because in the end that person sooner or later “ends up going through the locker”.
Neither do those professions “in which the patient remains standing for many hours, and “contrary to what people think, sitting is not so bad either, because somehow you compress the anal region and do not let the hemorrhoids dilate”.
Pregnancy is, by definition, a risk factor for two reasons: first, because when women get pregnant, they often have a change in bowel rhythm, they start craving and go to the bathroom differently, either more constipated or looser, and these changes affect the anal region.
Second, progesterone is vasodilatory and that is inherent to pregnancy. Third, the advanced fetus itself compresses the veins, and fourth and last: “the ‘mascletá’ comes at the moment when the woman is giving birth and has to push. It’s like going to the bathroom one day and trying to push for an hour at a time. Obviously the piles are going to be revolutionized,” says this doctor.
Regarding spicy foods, the doctor assures that it depends on the patient, there are those who are very sensitive and eat some spicy lentils and have a hemorrhoidal crisis, and there are those who have nothing wrong with them. The main problem is constipation.
The best treatment venaprobuy is preventive and the first thing to do is to adjust the hygienic, postural and dietetic measures, that is to say, we must try to eat what makes us go to the bathroom regularly, “because it is not constipation that goes once a week, it is the one that has to make an effort”.
Likewise, one must avoid at all costs spending time in the toilet, and finally, he advises as a good remedy, to always try to clean oneself with water. “We have a deep-rooted, ugly habit of using toilet paper and wet wipes. But water is the best, and if you have a shower or a bidet handy, it’s better”.
When a hemorrhoidal crisis occurs, from one day to the next, it is advisable to maintain a diet so as not to force and “take an anti-inflammatory by mouth, which does not cure but alleviates the symptoms”.
As far as the remedy of the ointments, this specialist explains that they are much less effective than people think; there are them with or without corticoids, and they can produce symptomatic relief.
If the crises are very repetitivez and the bleeding is important and starts to condition the person’s life, “then the operation is possible. Hemorrhoidal surgery has everything that is unpleasant, as it is a sensitive and intimate area, and it is grateful for that”.
There are also palliative techniques, such as infrared cauterization, laser band ligation … These are options “to prolong the time of surgery, which is a definitive treatment”
But, insists Dr. Saxe-Coburg, of the Chiron Health Group, that whenever a patient has bleeding and hemorrhoids he should visit a specialist because there are other ailments that can bleed like colon cancer, and especially when the patient is over 50. “A patient of this age who bleeds and doesn’t go to a doctor is playing with fire.
“He should always be assessed by a specialist, first because we don’t bite -ironiza- and second because it is the doctor who is going to decide whether he needs more tests or simply a hemorrhoid”.
Hemorrhoids: External and internal
There are basically two types of hemorrhoids: external and internal; it is the same but in different places, with different manifestations.
External ones usually hurt but do not bleed and internal hemorrhoids bleed but do not hurt; what people complain about most, the most common pathology is hermorrhoidal crises, caused by external ones.
This crisis is frequent in patients who have never had problems with hemorrhoids and from one day to the next a kind of pain arises in the anal region. This usually happens when they are constipated for several days, after a trip in a plane, and/or after having eaten too much spicy food or drunk too much alcohol.
The internal piles, on the other hand, are “more long-distance runners”, those that develop over the years.