Hemorrhoids affect over 1 million people in the Western world each year. They are much less common in underdeveloped countries, which is likely due to the high-fat, low-fiber diet that is more popular in Westernized countries. This diet is more commonly associated with hemorrhoids because it leads to chronic constipation and straining on the anorectal area. Other activities and conditions that cause strain in this region, such as heavy lifting, can also be associated with hemorrhoids.
Hemorrhoids result from dilatation and protrusion of blood vessels and tissues into the anal canal. This occurs due to strain on the vascular system and weakness of anatomic support in that area. Hemorrhoids are classified as internal and external based on their anatomy.
The primary symptoms associated with hemorrhoids are bleeding, protrusion of tissue from the anus and mucus discharge from the anus. Hemorrhoidal bleeding is often bright red and appears in the toilet or on the toilet paper after wiping. Internal hemorrhoids are classically not painful, but external hemorrhoids can hurt.
Heavy Squats and Other Risks
Risk factors for developing hemorrhoids are chronic straining at stool, constipation, low-fiber diet, prolonged sitting, pregnancy, obesity and increased age. Since hemorrhoids are exacerbated by factors that cause excessive pressure in the anorectal area, exercises such as heavy squats can increase the risk of developing them as well. You should take caution when performing heavy squats, especially if you have or had hemorrhoids or if you have one of the other risk factors for developing them.
Diagnosis and Treatment
Hemorrhoids are diagnosed by anoscopy, which is direct visualization of the anus. Internal hemorrhoids are graded as follows: first-degree internal hemorrhoids bleed but do not prolapse and are visualized during anoscopy; second-degree internal hemorrhoids protrude with the straining but return when straining ceases; third-degree internal hemorrhoids are constantly prolapsed but easily reduced manually; and fourth-degree internal hemorrhoids cannot be reduced.
Treatment options include surgical excision and various other surgical therapies. Other therapeutic options include warm sitz bath, increased fluid intake to prevent constipation, corticosteroid suppositories to reduce inflammation, and pain-relieving medications or ointments.
- "Harrison's Principles of Internal Medicine, Ch. 291"; Susan L. Gearhart, M.D.; 2008
- Family Doctor: Hemorrhoids - Reducing the Pain
- "Current Medical Diagnosis and Treatment, Ch. 15"; Kenneth R. McQuaid, M.D.; 2011.