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Report anorectal problems to doctor

DUBAI — Anorectal problems cause untold misery for at least half of the population at one time or the other.

Because of embarrassment, many patients choose simply to suffer in silence. Others delay consulting physician until the symptoms become unbearable, explains Dr Shaimaa Hamza Ibrahim, Specialist Surgeon, Zulekha Hospital, Sharjah.

Hemorrhoids are positively correlated with the presence of hernia or genitourinary prolapse. The common cause of all three conditions may be a connective tissue disorder. Hemorrhoids are also caused by prolonged sitting or standing, and lifting of heavy objects. The patient may complain of bleeding, which is usually bright red and seen on the outer part of stools after defecation. The internal tissues may enlarge and protrude from the anal opening, especially after defecation. The patient may describe this protrusion as a soft bit of tissue that shrinks back to normal shortly after defecation or that requires the patient to manually push the tissue back to its normal position after each bowel movement.

Eventually, the patient with long-standing prolapse may discover that the tissue can no longer be replaced. This condition is known as permanent prolapse. Because the protruding tissue interferes with proper closure of the anal sphincter, the patient with permanent prolapse may notice fecal staining of underwear.

Low-fiber diets are responsible for hemorrhoids as it yields harder stools that patients will often strain to pass which can cause bowel smooth muscle hypertrophy and injure the tissues of the anal canal.

Toilet habits

Straining to pass stool throughout one’s life is the primary reason for hemorrhoids. However, more recent research has demonstrated that the cause may be prolonged sitting on the toilet.

Hemorrhoids do not discriminate markedly between men and women although it is known that men seek treatment in greater numbers than women. Pregnancy is a prominent risk factor. Hemorrhoids gradually increase with age.

Patients should be referred if they mention prolapse (especially prolapse that must be manually replaced or cannot be reduced) or bleeding and are under the age of 12 years, or if the problem persists for more than seven days.

Physician treatment of internal hemorrhoids depends on the degree of severity.

When self-treating hemorrhoids, it is wise to follow directions on the labels of the products that advise use for no more than seven days.

It is also important to note that if you have rectal bleeding, you must see a physician to determine the cause.

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