Question: I was referred to a surgeon for a consult because of my hemorrhoids. I'm concerned because he noted on the referral that I have anorectal disease. What is that?
Answer: Anorectal or anal-rectal disease, is a catch-all term for several conditions affecting the anus or the rectum. These include: hemorrhoids, anal fissures, abscesses, fistula and even cancer.
Hemorrhoids, which are swollen and inflamed veins that develop in the lower rectum (internal) or around the anus (external), are very common, affecting about 75 percent of the population, according to the National Digestive Diseases Information Clearinghouse. For some people they cause no symptoms, but for others there may be bleeding after a bowel movement.
Hemorrhoids can be caused by chronic constipation or diarrhea, straining during a bowel movement, sitting on the toilet longer than needed, or not eating enough fiber. They are also common during pregnancy when more pressure on the abdomen cause veins to enlarge in the lower rectum and anus. As we get older, hemorrhoids may also appear as the tissue in the area gets weaker.
Often changing your diet to include more fiber-rich foods and drinking enough fluid can help reduce the pain and swelling of the hemorrhoids by making the stool softer and easier to pass. The American Dietetic Association recommends 26 grams of fiber per day for women and 36 grams per day for men.
Other treatments may include taking stool softeners, drinking at least six to eight, 8-ounce glasses of fluid (non-alcoholic) each day, sitting in a warm bath (sitz bath) for 10 minutes at a time, exercising and not straining during bowel movements.
If needed, the hemorrhoids can be removed using methods that cut off the blood supply and cause them to shrink such as banding (rubber band ligation) or through the injection of chemicals (sclerotherapy).
If the hemorrhoids are large, surgical removal may be necessary. The hemorrhoid is excised and the incision is closed with sutures that will dissolve as the wound heals. Your physician will help you decide the best method from removal.
There is no guarantee that your hemorrhoids won't return after treatment, but if you follow the dietary recommendations and make sure to prevent constipation, your chances of having a severe case of them are diminished.