Hemorrhoids are enlarged or swollen veins in the lower rectum. The rectum is the part of intestines just before anal opening.

The most common symptoms of hemorrhoids are rectal bleeding, itching, and pain. You may be able to see or feel hemorrhoids around the outside of the anus, or they may be hidden from view, inside the rectum.

Hemorrhoids are common, occurring in both men and women. Although hemorrhoids do not usually cause serious health problems, they can be annoying and uncomfortable. Fortunately, treatments for hemorrhoids are available and can usually minimize the bothersome symptoms.

Hemorrhoids are more common in people who are older and in those who have chronic diarrhea or constipation, pelvic tumors, during or after pregnancy, and in people who sit for prolonged periods of time and/or strain (push hard) to have a bowel movement.

Symptoms of hemorrhoids can include the following; Painless rectal bleeding, anal itching or pain, discomfort or soreness in anal area, tissue bulging around the anus, leakage of feces or difficulty cleaning after a bowel movement

To diagnose hemorrhoids, the doctor will examine ones rectum and anal area thoroughly. If there is bleeding, testing may include a procedure that allows your healthcare provider to look inside the anus (called anoscopy) or colon (sigmoidoscopy or colonoscopy)

One of the most important steps in treating hemorrhoids is avoiding constipation (hard or infrequent stools). Hard stools can lead to rectal bleeding and/or a tear in the anus, called an anal fissure. In addition, pushing and straining to move your bowels can worsen existing hemorrhoids and increase the risk of developing new hemorrhoids. Increasing fiber in one’s diet is one of the best ways to soften your stools. Fiber is found in fruits and vegetables. Drinking plenty of water and oral fluids helps in minimizing constipation

If increasing fiber does not relieve the constipation, or if side effects of fiber are intolerable, one can try a laxative (stool softener).

Warm sitz baths is a remedy commonly used to relieve the symptoms and even aid in recession of hemorrhoids. During a sitz bath, one soaks the rectal area in warm water for 10 to 15 minutes two to three times daily. Sitz baths are available in most drugstores a. It is also possible to use a bathtub and sit in 2 to 3 inches of warm water. Adding little table salt, vinegar or baking soda to the water can add a soothing effect to the sitz bath. Sitz baths work by improving blood flow and relaxing the muscle around the anus, called the internal anal sphincter.

Various creams and suppositories are available to treat hemorrhoids, and many are available without a prescription. Pain-relieving creams and hydrocortisone rectal suppositories may help relieve pain, inflammation, and itching, at least temporarily.

These hemorrhoid creams and suppositories, particularly hydrocortisone, shouldn’t be used for longer than one week, unless prescribed by ones doctor.

If ones hemorrhoids don’t respond to natural and medical therapy, one may need surgery treatment to destroy or remove the hemorrhoids.

One popular treatment is called "rubber band ligation.” For this treatment, the doctor ties tiny rubber bands around the hemorrhoids. A few days later the hemorrhoids shrink and fall off. The doctor can also use lasers, heat, or chemicals to destroy hemorrhoids, but if none of these options works, then surgery to remove the hemorrhoids is done.

Dr. Ian Shyaka, Resident in Surgery, Rwanda Military Hospital