Types of Hemorrhoids: An Overview

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Hemorrhoids occur when veins in your rectum dilate and become swollen. Blood pools in the swelling veins, making your veins stretch into your rectal and anal tissue membranes. Often times hemorrhoids can feel quite uncomfortable. While you can’t always see or feel a hemorrhoid, when they fill with blood and enlarge, they can look and feel like a small knob or lump.

Hemorrhoids are extremely common, affecting millions of people across the United States. In fact, the vast majority of people who have hemorrhoids do not even know they have them. While a small number of people have symptoms, an even smaller amount seeks out treatment. 

What Causes Hemorrhoids?

While doctors often do not know why certain people end up having hemorrhoids, many people end up with them following an increase in pressure on the veins in the rectum area. Things that may cause this type of pressure include:

  • Constipation followed by straining during bowel movements
  • Sitting on the toilet for extended periods of time
  • Diarrhea and overuse of laxatives
  • Pregnancy (when the baby puts pressure on your veins, or while pushing during childbirth), and 
  • Sitting for extended periods of time during long air flights, road trips, or in office work environments that are highly sedentary. 

Hemorrhoids tend to be more likely if you do not get enough fiber in your diet, and if you are overweight. They are also more common with age.

The majority of adults will experience a hemorrhoid at some point in life. While all hemorrhoids are similar, there are some variations. Follow along to learn more about the different kinds of hemorrhoids.

Common Types of Hemorrhoids

1. Internal Hemorrhoids are a type of hemorrhoid that is located inside your rectum. Oftentimes they are not visible, and frequently they disappear without any treatment. Some of the time, an internal hemorrhoid may swell up and when this happens, it may rise out of your anus. When this occurs it is referred to as a prolapsed hemorrhoid.

Many times you do not even know if you have an internal hemorrhoid because there aren’t nerves that identify pain in this part of your body. It may be something that comes to your attention when your physician makes note of it following a colonoscopy or childbirth. If hemorrhoids expand in size, you may experience more symptoms that are typical of larger hemorrhoids. This can include a protrusion that you can actually feel as a soft lump, along with burning, cutting or itching sensations and sometimes severe pain.

When you go to the bathroom, feces passing through your rectal area may agitate internal hemorrhoids which can cause some bleeding that you may see on toilet paper. Please note: Any kind of rectal bleeding can be a sign of other more serious health problems, so it is always advisable to discuss this symptom with your doctor.

2. Prolapsed Hemorrhoid is a term used to describe internal hemorrhoids that have swollen and may appear outside of your anus. This type of hemorrhoid, which appears like a swollen lump, may be visible with a mirror. Some people do not experience any symptoms with prolapsed hemorrhoids, while others 

Often physicians are able to assign a grade to a prolapsed hemorrhoid, depending on severity. 

  • Grade one hemorrhoids are not prolapsed in any way.
  • Grade two hemorrhoids are prolapsed but also retract on their own. They may protrude from your anus at certain times like if you are straining during a bowel movement.
  • Grade three prolapsed hemorrhoids stick out of your anus and require you to push them back in yourself. It is possible if you are experiencing this, you may want to consider some type of treatment to avoid possible infections and/or to limit discomfort.
  • Grade four hemorrhoids are large enough that you cannot easily manually push them back into your anus without a significant amount of pain and discomfort. In these cases, it is highly advisable that you consult with your physician to explore treatment options.

3. External Hemorrhoids appear on your anus. You can’t always see them, but if you are able, they tend to appear like lumps. External hemorrhoids are typically not a serious issue, unless they cause you discomfort that negatively affects your daily life. The symptoms of external hemorrhoids tend to be similar to other types, including pain while going to the bathroom – especially if straining, doing certain activities, and sitting (especially on hard surfaces) for prolonged periods.

4. Thrombosed Hemorrhoids can cause people a lot of discomfort. This type of hemorrhoid contains a thrombosis or a blood clot within the tissue of the hemorrhoid. They often look and feel like small lumps around your anus. Thrombosed hemorrhoids are complications associated with hemorrhoids where blood clots appear. They can happen with both external and internal hemorrhoids, though more commonly with external. If you are experiencing one, you may have difficulty sitting, walking or going to the bathroom without discomfort. You may also notice redness along with a blue color around the hemorrhoid area.

If you are experiencing discomfort from hemorrhoids, the experienced team of medical professionals at Gastroenterology Health Partners is here for you using the most advanced treatment options available. For more information or to schedule an appointment, contact Gastroenterology Health Partners today at a location near you. 

Surprising New Connections Found Between Food Insecurity And Liver Disease

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Liver disease is routinely associated with alcoholism and excessive alcohol consumption. However, non-alcoholic fatty liver disease (NAFLD) is actually the most common form of liver disease in the United States. One in 3 adults and 1 in 10 children in the United States suffer from the disease. NAFLD is characterized by excessive fat stores in the liver that leads to inflammation, liver scarring (cirrhosis), liver fibrosis, and liver-related morbidity. NAFLD is usually caused by diabetes, insulin resistance, being obese or overweight, having high blood pressure, having polycystic ovarian syndrome, or having elevated levels of cholesterols or triglycerides. 

Food Insecurity and NAFLD

A study released in October found that 32% of adults with NAFLD were also suffering from food insecurity. According to the USDA, food insecurity is “a lack of consistent access to enough food for an active, healthy life.” Food insecurity is directly caused by a lack of financial resources, and can be connected to many social and physical determinants, such as low wages, lack of affordable housing, high medical costs, health problems, lack of social support, lack of access to educational opportunities/work training, lack of transportation, physical barriers (of the built and natural environment), and other socioeconomic conditions. Food insecurity affects communities across the United States; an estimated 1 in 9 Americans are food-insecure.

Until this point, very little research has been conducted in the United States concerning the connections between food insecurity and health outcomes. Dr. Ani Kardashian, an assistant professor of clinical medicine at the University of Southern California Keck School of Medicine, presented thoughts on the research at the International Liver Congress 2021:

“This study really highlights the importance of us focusing on upstream social determinants of health in the long-term outcomes of people with NAFLD and advanced liver fibrosis…Future studies should focus on designing interventions to reduce food insecurity in our at-risk patients with fatty liver disease.”

Addressing Food Insecurity to Reduce Rates of NAFLD 

As Dr. Kardashian discussed, treating food insecurity like a public health risk could result in better outcomes for those suffering from NAFLD and related conditions. But how do we address something as pervasive and widespread as food insecurity?

Change starts at the local level. Supporting reputable organizations such as Feeding America and mutual aid funds can help. Volunteering at local organizations, contacting your government representatives, educating your community, or even organizing a food drive can incite change. Donating to your local food bank or food pantry is beneficial as well. In Louisville, Dare To Care is an option. In Lexington, God’s Pantry is a widely known resource. In Southern Indiana, Hope Southern Indiana and Center for Lay Ministries are two highly-regarded options. Visit foodpantries.org to see more food pantries near you. There are many ways we can inspire change, and it begins with individual action.

For more information about diagnosing digestive conditions, reach out to Gastroenterology Health Partners (GHP) today. Our clinicians have a passion for seeking out and refining new treatments and advanced solutions for those suffering from disorders of the digestive system. Each of our physicians offers expert specialization, evaluating and treating the entire spectrum of digestive conditions. To learn more about the treatment options available to you, schedule an appointment at one of our locations throughout Louisville, Lexington, and Southern Indiana.