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We may think we have hemorrhoids but it may be something else

If not hemorrhoids, then what?

Probably hemorrhoids – we think when there is blood in the feces and we feel pruritus and burning near the anus. However, these unpleasant ailments can be symptoms of other diseases as well. These are diseases that imitate hemorrhoidal disease.

Hemorrhoids, or differently hemorrhoids (remember that it is not hemorrhoids), has every human being. They are creations in the anal canal that are a bundle of arterial and venous vessels. Together with sphincter, hemorrhoids ensure that in every situation – apart from defecation – our anus remains sealed. Problems, on the other hand, begin when the so-called hemorrhoidal disease, i.e. slipping of these corpora cavernosa down the sphincter or their inflammation or thrombosis.

Hemorrhoids are surrounded by two circular muscles – internal and external, or sphincter muscles. These muscles are tense most of the time. This tension causes blood to accumulate in the hemorrhoids, and they themselves swell and adhere to each other tightly, creating a “defensive ring” that prevents intestinal contents from being removed from the body in an uncontrolled way. The stool is made possible by the fact that the muscles of the sphincter relax and the blood from the hemorrhoids flows away. When the vessels are excessively filled with blood, and when passing stool they do not empty completely, as a result, they become irritated and lose their elasticity.




It is not known exactly how many people suffer from a hemorrhoidal disease. The disease is so shameful that it does not admit much to it, and even less benefit from the help of specialists and undertakes treatment. The highest incidence – among cases known and treated – is recorded in people over 50 years of age. However, it is also estimated that occasional or frequent complaints associated with bad effects of hemorrhoids are now felt by every third person over 30 years of age.

The causes of hemorrhoidal disease are still not fully explained, but it is known that age is not the only factor in its development. The risk of its occurrence must also include people whose loved ones suffered from this disease, obese people leading a sedentary lifestyle, performing work requiring high muscular effort, standing or sitting in one position, as well as those using a diet low in fiber (easier to remove from the body of food leftovers), into fluids (improving intestinal peristalsis) , sitting for long periods on the toilet and complaining of frequent constipation or diarrhea (increased effort during stool pressure or too frequent defecation lead to weakening sphincters).

Haemorrhoidal disease is also common in pregnant and postpartum women, as well as in patients with such conditions as hypertension, heart failure, tumors in the abdominal cavity and pelvis, congenital weakness of the anal sphincter muscles. Athletes also suffer from it, for example riders, riders and barbells, and those who have a very unhealthy habit of sitting in the toilet for a long time.




An additional difficulty in assessing the scale of occurrence of a haemorrhoidal disease is that in the initial phase it may not show any symptoms. What the patient senses is only minor swellings around the anus. In contrast, the first noticeable sign of this disease is usually painless, bright red, slight bleeding when passing stool.

Other symptoms of malfunctioning of haemorrhoids cause more discomfort and even lead to a complete change in lifestyle. It is about pruritus, the impression of swelling and pressure, irritation and a feeling of persistent humidity of the anus, feeling of incomplete stool and incomplete bowel movements and leaving traces of feces on the underwear. The symptom of a hemorrhoidal disease may also be pain – sometimes very strong, lasting for several days. It appears when blood in the hemorrhoids coagulates.

However, not all signs of a haemorrhoidal disease appear immediately and at the same time, because the disease itself develops gradually. It starts with the so-called internal haemorrhoids, i.e. minor bleeding, which does not originate from the hemorrhoid itself, but from the membrane located higher and ends with the so-called external hemorrhoids – sphincter weakness, and hemorrhoids become damaged, turn into “tumors” that fall outside and cannot be brought back into the anus.


Other disease with similar symptoms


When there is pruritus and burning around the anus, the first thought is suspicion of a haemorrhoidal disease. It turns out, however, that these ailments may also be symptoms of completely different diseases.

The most common of these is anal pruritus. It is estimated that approximately 5% of the total population complains about it. Unfortunately, this disease is still little known, therefore its treatment usually involves leveling symptoms. From the observation of doctors, it appears that the majority of patients come to the so-called spontaneous pruritus, whose causes cannot be determined. It is known that it occurs more often in people who consume too much chocolate, coca-cola, yellow cheese, citrus fruit, alcohol, spicy spices and … milk.

Another, equally embarrassing “imitation” of a hemorrhoidal disease is incontinence, i.e. reduced ability to control gas and stool discharge. Colloquially, it is called stool incontinence. The most common causes include damage to the nerves of the anal muscles during labor, surgical procedures and injuries of the tissue surrounding the anus, which can also destroy the muscles located there and inhibit the control of the sphincter muscles. Faecal incontinence may also occasionally occur during diarrhea, accompanied by a feeling of pressure on the stool, as well as in people with multiple sclerosis (when the nerves that control sphincter work are compromised). We must also remember (and unfortunately accept) that with age, sphincter muscles naturally weaken. Therefore, incontinence is a problem for many older people.

The skin around the mouth of the anus is one of the most sensitive places on the surface of our body. It is extremely easy to irritate and even cut it – for example with rough toilet paper. In this way, the so-called anal fissures. It is a shallow, narrow crack, loss or ulceration of the mucous lining of the rectum. Over time, the affected mucosa may become inflamed, with symptoms of acute pain, pruritus, burning and often bleeding. The joint is formed as a result of mechanical damage or rupture of the end section of the anal canal due to, for example, physical exertion, constipation, excretion of too hard, heavily stooled stool.

Irritation of the skin, caused inaccurate wiping or washing after defecation, can also lead to the formation of peroral eczema. In this case, the anal area is very red and swollen, and the skin peels off and there are wet bubbles on it.

Small clots, or – in later stages – extensive growths, as well as burning, pruritus, feeling of humidity, bleeding and low pain around the anus are also symptoms of an infectious disease referred to as condylomata acuminata. They are otherwise called dermal warts or venereal warts, and are caused by human papillomavirus (HPV) infection. Most often, they can be infected by sexual intercourse (heterosexual and homosexual). There is also the possibility of a child being infected by the mother during delivery. The virus can also be moved on the hands, for example when using a shared towel, but these cases occur rather sporadically.




Strong, acute pain pulsating around the anus (just under the skin, or deeper, felt along the rectum), which intensifies during sitting, coughing or passing stool, are symptoms characteristic of perianal abscess. This is the “reservoir” of viscous, dense mash resulting mainly from bacterial infection of the anal area with staphylococcus bacteria, streptococcus, intestinal bacilli, and sometimes pathogenic fungi. The abscess develops more often in men, especially those suffering from Crohn’s disease, ulcerative colitis or anal fissure.

If the perianal abscess is not treated or not fully healed, the oil from the anus is leaking or from the hole in the skin in its vicinity, and consequently the formation of the so-called. anal fistula. For clarification, it is a narrow, straight (sometimes branched) channel, one outlet (primary, internal) in the rectum and the other (secondary, external) on the skin of the rectum. The fistula is usually accompanied by pain intensifying during the bowel movement or immediately after giving up, but also the presence of a perceptible under the fingers of the nodule and skin changes – irritation, inflammation, skin color change.

The occurrence of haemorrhoids in the last stage of the haemorrhoidal disease may be confused with the loss of the rectum itself. The latter is a result of muscle weakness, on which the rectum and perineal muscles are suspended. This state of affairs can be caused by many births, rectal surgery, chronic constipation and recurrent diarrhea, and can also occur with neurological conditions, ie multiple sclerosis or strokes.

In the first phase the anus falls only after passing the stool, but as the disease progresses it also happens after a slight contraction of the abdominal muscles, for example during a sneeze. Finally (in the last stage) the anal mucosa is constantly outside. The classic symptom of rectal laxity is pain, which occurs during or immediately after the bowel movement, but also the inability to maintain the gases and stools, which still dirty the patient’s underwear.




At the end of the infamous list of “imitators” of the hemorrhoidal disease are tumors of the large intestine. They are most often manifested by bleeding (overt and latent), abdominal pain, flatulence, constipation, and a change in the rhythm of defecation. Remember that the described anal fissure, condyloma acuminata, anal fistulae have similar symptomatology (ie a set of symptoms). With such symptoms you always have to go to the doctor, do not treat them yourself and only the doctor can rule out other diseases in the area. The most tragic mistake is the treatment of “hemorrhoids” when you really are dealing with cancer! Unfortunately, many patients invariably consider the anal area to be embarrassing and prefer to treat themselves. However, the price of this false shame can be high.

The therapy of hemorrhoidal disease is as follows: Grade 3 and 4, as well as thrombotic complications, are treated surgically and / or related methods (banding, freezing and others). Steps 1 and 2 can be treated conservatively. Above all, regulation of stools, a diet aimed at loosening stools, changing the lifestyle (increased physical activity!), Locally ointments and / or suppositories. There are also oral preparations that improve venous circulation. Finally, we repeat again: there are no embarrassing diseases, only tragedies of late diagnosed cancers.

It is not known exactly how many people suffer from a hemorrhoidal disease. The disease is so embarrassing that only a few admit it and even less treat it.

Good to know




It is embarrassing to talk about ailments of the anus, but overcoming embarrassment allows for quick diagnosis of the disease and its treatment. Doctors warn – if symptoms such as pruritus, burning, pain, blood in the stool are repeated, you should definitely go for proctological research.

Per rectum examination (through the rectum) – performed with your finger; during the test the finger enters the rectum to a depth of 7-8 cm.

Rectoscopy and anoscopy – tests consist of inserting the speculum through the rectum to view the anal canal. They last from several to several minutes and are performed under local anesthesia.

Colonoscopy – the patient is placed on the left side, the endoscope is inserted through the rectum (extremely flexible optical-electronic device), which allows examination of the large intestine along its entire length, taking tissue samples for analysis and even performing minor procedures. The test lasts about 20 minutes and is performed under local or general anesthesia.

Sigmoidoscopy – a test also performed with an endoscope, but its purpose is to examine the last 60-80 cm of the large intestine, ie the rectum, sigmoid and part of the stool. It fulfills a diagnostic and therapeutic function, it also allows the removal of specimens for histopathological examination.

Rectal infusion (colon infusion) – radiological examination, which involves the administration of a contrast agent (barite or – less frequently – iodine solutions) to the large intestine and X-ray images of this organ.





1. Eat high fiber foods – cereal products, wholemeal bread, fruits, vegetables.

2. Drink plenty of water and juices, minimum 2 liters a day.

3. Avoid dishes and drinks that irritate or stimulate the intestines, ie coffee, tea, spicy spices, alcohol.

4. Do not sit, just move! Gymnastic at home, go for walks.

5. Play sports – swimming is best. Ride the bike sensibly.

6. Avoid carrying heavy loads.

7. Follow the rules of personal hygiene.

8. Do not wear tight clothing or made of materials that irritate the skin.

9. Use the toilet at certain times and do not sit long on the toilet seat.

Anal fissure, genital warts, anal fistula have similar symptomatology. With such symptoms you should always go to the doctor, instead of treating yourself

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