Hemorrhoidal Disease – Risk Factors, Symptoms and Treatment Methods

Hemorrhoids refer to abnormally engorged and enlarged vascular structures within the rectum, which play a crucial role in maintaining rectal tightness. These vascular cushions enable the body to regulate bowel movements and gas expulsion. When blood flow is impaired, the veins dilate, potentially leading to hemorrhoidal disease. Hemorrhoids are categorized into two types: internal, which are less severe and remain within the rectum, and external, which are significantly enlarged and may protrude during defecation.

While physical activity is often regarded as beneficial for health, excessive exertion can be one of the most common causes of hemorrhoidal disease. Sports disciplines that require intense abdominal muscle engagement (e.g., powerlifting, CrossFit, bodybuilding) lead to increased intra-abdominal pressure, which directly affects the venous system in the rectum. Forceful straining during weightlifting negatively impacts the hemorrhoidal veins, causing congestion and enlargement, which promotes the development of hemorrhoids. Similar effects can be observed in intense physical labor. However, it is equally important to note that a sedentary lifestyle and lack of movement can also contribute to the formation of hemorrhoids. Insufficient activity disrupts normal blood flow in the vessels, and prolonged sitting in one position creates pressure that impairs blood drainage from the hemorrhoidal veins. A comparable mechanism of hemorrhoid development can be seen in certain sports such as rowing, cycling, or horseback riding. Hemorrhoids, however, are not solely the result of excessive physical activity or its absence. Diet plays a crucial role as well. Poor dietary habits are a frequent cause of hemorrhoidal disease. Key factors include inadequate fiber intake, dehydration, frequent consumption of processed foods, and excessive fat consumption. These factors lead to hardened and compacted stool, which in turn contributes to constipation. Difficult bowel movements can irritate or damage the hemorrhoidal veins, facilitating the onset of hemorrhoids. This explains why individuals with obesity are more prone to anal varices. Digestive disorders, however, are not exclusively linked to poor nutrition. Hemorrhoids often accompany conditions that involve constipation or diarrhea, such as irritable bowel syndrome (IBS) or foodborne infections. Chronic constipation may result from the use of opioid painkillers, which is common among post-surgical patients. Enlargement of the hemorrhoidal veins can also stem from damage or dysfunction of the anal sphincter muscles, as seen in neurological patients with spinal cord diseases or injuries. Another critical aspect is personal hygiene. Hemorrhoids can develop due to vigorous wiping or the use of rough toilet paper. The quality of underwear is also significant—if it is too tight or made from synthetic materials, it can cause skin irritation, chafing, or injury. It is also important to note that lingering moisture, whether from improper drying after bathing or accumulated sweat, can promote the growth of pathogens. This, in turn, can lead to skin changes and inflammatory conditions, which may result in hemorrhoidal disease.

The accumulation of blood in hemorrhoidal clusters and their enlarged size result in significant discomfort. Hemorrhoids cause a distressing itching sensation that leads to intense scratching, potentially irritating the rectal skin and causing permanent damage. A characteristic symptom is the persistent feeling of excessive moisture in the anal and genital regions, often accompanied by damp underwear. The condition is marked by pain, particularly during bowel movements – especially with hard stools, which can damage the hemorrhoidal structures and trigger bleeding. However, blood in the stool may indicate more serious conditions such as colorectal cancer or gastrointestinal infections, so its presence should prompt a visit to a proctologist. Untreated hemorrhoids can lead to severe complications, including anal abscesses, fecal incontinence, inflammatory changes, or thrombosed hemorrhoids.

Preventing hemorrhoids is crucial since prevention is better than treatment. It is advisable to implement appropriate measures to reduce the risk of developing hemorrhoids. Effective strategies include: a light, high-fiber diet, adequate hydration, avoiding prolonged sitting, wearing breathable underwear made of hypoallergenic fabrics, regular physical activity such as walking, running, Nordic walking, or swimming, and maintaining proper hygiene in intimate areas.

Among the most effective methods for managing hemorrhoids, herbal remedies hold a prominent position. Phytotherapy in the treatment of hemorrhoids focuses on reducing swelling, controlling bleeding from enlarged nodes, and strengthening the walls of venous vessels to minimize their fragility. The herbs used in this therapy not only exhibit astringent properties but also anti-inflammatory, tightening, and antiseptic effects. The most commonly utilized plants include oak bark, arnica, witch hazel, horse chestnut, and burdock root. These can be consumed as infusions or applied topically in the form of compresses, rinses, or sitz baths, which directly target the affected areas. Additionally, these herbs are often ingredients in ointments and creams available in pharmacies. In addressing constipation, which exacerbates hemorrhoid symptoms, herbs with carminative, digestive-stimulating, or stomach-soothing properties such as chamomile, juniper, or dill may be beneficial. However, caution is advised when using laxative herbs like aloe vera juice, senna leaves, or buckthorn bark, as improper use can lead to diarrhea, further irritating the hemorrhoids.

Should the aforementioned approaches fail to yield desired outcomes, surgical removal of hemorrhoids may become necessary. These procedures are entirely painless and minimally invasive (e.g., sclerotherapy, cryotherapy, or the Barron technique) and are primarily recommended for cases of external hemorrhoidal disease. Meanwhile, conventional surgery, involving the excision of the affected vascular node, is performed when hemorrhoids are exceptionally large and cause severe pain.