Hemorrhoids: The Real StoryAlthough we all hear occasional jokes about hemorrhoids, when it getspersonal, there is usually silence. This silence comes from a shame of anessential part of our bodies; it is a shame that goes back centuries.If nothing else, I hope this article will end that shame and allow all ofus relief from one of the oldest conditions reportedin medicine. Hemorrhoid problems have been welldocumentedin medicine for over 800 years, whenthe famous doctor and philosopher, Maimonides,first recommended treatments to diminish thesymptoms of hemorrhoids.What Maimonides did not know was thathemorrhoids are natural. Actually, until just a fewdecades ago, no one knew this fact. Yes, we are allborn with hemorrhoids. These hemorrhoids arenothing more than cushions of blood vessels andother tissues, including muscle, found just insideand outside the rectum. At birth, they are barelyvisible, but are, in fact, present. As we age,inevitably, hemorrhoids, especially the inner ones,increase in their size.What are the symptoms of hemorrhoids?Regarding internal hemorrhoids (those just inside therectum), the most common symptom is rectal bleeding. In fact, the mostcommon cause of rectal bleeding in adults is bleeding from internalhemorrhoids. It is usually bright red blood without blood clots, seenduring or immediately after a bowel movement. Other common problemsrelated to internal hemorrhoids involve a feeling of rectal pressure aswell as seepage of mucous or stool. This leakage leads to one of themost unbearable ano-rectal problems—anal burning and itching.External (outer) hemorrhoids may cause painful swelling, especiallyafter straining during a bowel movement or when lifting something heavy.Quite commonly, a blood vessel in a hemorrhoid just under the skin mayYes, we are all born withhemorrhoids. Thesehemorrhoids are nothingmore than cushions ofblood vessels and othertissues, includingmuscle...Brad Levinson, M.D., is a Board-Certified Colon and Rectal Surgeon in practice for 26 years with officesthroughout the Pittsburgh area. For an appointment, call (412) 777-4352.BY DR. BRAD LEVINSONrupture, causing a painful “lump” near the anus.There are many misconceptions regarding hemorrhoids. One has alreadybeen mentioned and corrected. They are present in all of us from birth.Secondly, hemorrhoids are not a disease, but a condition that will causeannoying or painful problems for the majority of us, if nottreated. Another point of confusion is that internalhemorrhoids, not only can rarely be seen from theoutside, but internal hemorrhoids are usually too softto feel when a doctor performs a digital rectal exam(feels with a finger inside the rectum). A physician,usually a specialist, must actually use a certain kindof small instrument to look just inside the rectum tosee the internal hemorrhoids.As for rectal bleeding, there are manymisconceptions. No one bleeds to death fromhemorrhoids. However, one or two drops of bloodhitting the toilet water will make the entire bowl turnred. For anyone this is really a frightening site. Thefirst thing a person thinks is: “I’ll bleed to death”—you won’t! The second thing, a few hours later, theybegin to think is: “I have cancer.” Although hemorrhoidsdo not become cancer, cancer is still a possibility, butfortunately unlikely. The vast majority of bright red rectalbleeding is from internal hemorrhoids, not rectal cancer.Nonetheless, above all, if anyone over the age of 40 has several episodes ofbright red rectal bleeding, they should have their entire colon looked at—acolonoscopy. Although a rectal or colon cancer may be unlikely, it can causebleeding, and it is too serious to overlook.By describing these foolish misconceptions regarding hemorrhoids, hopefullywe can all rid ourselves of the shame of the natural existence of hemorrhoidsand seek treatment as soon as they become a problem.Learning Curves is provided as a service to advertisers of <strong>Allegheny</strong> <strong>West</strong> <strong>Magazine</strong> to share educational and/or informational knowledge with the readership. To inquire about LearningCurves, call (724) 695-3968.26 <strong>Allegheny</strong> <strong>West</strong> <strong>Magazine</strong> June 2010
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