The term “hemorrhoids” in medical jargon actually refers to the blood vessels that can be found inside the anal canal where our stools go for their immediate exodus from our body and not the bleeding hemorrhoids that we sometimes suffer from. These anal blood vessels can be classified into two types depending on their position: 1) the internal one that is exactly inside the anal canal; and 2) the external one that is nearer the anal opening.
The hemorrhoids swell when blood clots occur in them since these are blood vessels, and yet can also sometimes rupture. Symptoms of thrombosis of the external anal blood vessel are very noticeable. If blood is present in the stool, then you’re now suffering from prolapsed internal anal blood vessel – which will be further confirmed by performing diagnostic examinations like anoscopy or proctoscopy. Such abnormality isn’t really painful at all, though it needs greater medical attention.
One of the preliminary measures that doctors recommend in the treatment of such swollen to bleeding hemorrhoids (once the external vessel ruptures at uncommon cases, or most especially in the case of the internal vessel) along with high-fiber diets and sitz baths is the intake of non-steroidal anti-inflammatory drugs or NSAIDs. NSAIDs are actually used as pain relievers for acute and chronic medical conditions. Popular over-the-counter NSAIDs include ibuprofen, aspirin, and naproxen.
NSAIDs are prescribed by doctors to patients who are suffering from thrombosis of the external anal blood vessel at a limited period of time only due to its adverse effects – mainly on the gastrointestinal tract and the renal system. Such drugs that relieve the pain and inflammation that is present in such abnormality, as well as those that are used to relieve abdominal discomforts such as diarrhea and constipation that actually cause bleeding hemorrhoids, can cause gastric hemorrhage and ulceration; that’s why some doctors prescribe safer pain-relieving alternatives like paracetamol and those that contain codeine (at safe doses) for such conditions instead. Common gastrointestinal reactions from NSAIDs include nausea, vomiting, and dyspepsia (abdominal bloating).
Adverse renal reactions from NSAIDs include salt and fluid retention, high blood pressure, and in severe cases, renal impairment and failure. Prolonged use of NSAIDs can also cause cardiovascular problems including stroke, erectile dysfunction, and allergies that can lead to Steven-Johnson syndrome. NSAIDs are not prescribed to pregnant women who also have such abnormality, particularly those who are on their third trimester; such drugs can induce premature birth and miscarriage and paracetamol is given instead.
Steroids can also be given to patients to relieve pains that were caused by bleeding hemorrhoids, but should not be taken longer than 14 days or their skin will thin. But if all else failed and such abnormality is still present, surgical procedures will then be performed. Cauterization will be done for the swollen external vessel (cryogenic agents like liquid nitrogen, infrared rays, and laser can be used today for this procedure), while deeper and much-more technical procedures will be done for the prolapsed internal vessel.
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