Infective hemorrhoids: Causes and treatments

Post by Master, Doctor Mai Vien Phuong - Gastrointestinal Endoscopy - Department of Medical Examination & Internal Medicine - Vinmec Central Park International General Hospital.

Hemorrhoids are varicose veins in the lower rectum. Hemorrhoids often ease on their own or are treated with over-the-counter products. But in rare cases, infected hemorrhoids can cause dangerous complications, so the condition requires immediate medical treatment.

In some cases, certain types of hemorrhoids and hemorrhoid treatments can lead to infection.
Infective hemorrhoids when healthy blood flow to the rectal area is limited. Healthy blood flow to the rectal area means a steady supply of white blood cells and certain proteins that are part of the immune system. This helps reduce the risk of infection.
Internal hemorrhoids rarely get infected. An internal hemorrhoid is a hemorrhoid that forms in the rectum, above the dentate line. This is the part of the large intestine that ends at the anus. Sometimes, an internal hemorrhoid can push down from the rectum, called an internal hemorrhoid.
A prolapsed internal hemorrhoid can usually be gently pushed back into the rectal wall. But it's still more likely to get infected than other types.
This is because blood flow to the vein may be cut off. This is called an embolized internal hemorrhoid. Without nutrients, oxygen, and immune system cells to be transported in the blood, an infection can quickly form.
You may be more at risk of blocked hemorrhoids, embolism, and subsequent infection if you have a condition that reduces blood flow to the rectum. Some conditions that can cause reduced blood flow to the rectum are:
Diabetes Crohn's disease Obesity Atherosclerosis (narrowing of the arteries) Blood clots can be a risk factor for infections In addition, HIV infection or another condition that weakens the immune system can increase the risk of infected hemorrhoids.
Infection can also develop after hemorrhoid treatment procedures. In particular, rubber band ligation can sometimes lead to infection.
2. What are the symptoms of infected hemorrhoids? Symptoms of infected hemorrhoids include:
Bloody bowel movements Swelling around the anus Itching in and around the anus Pain, especially when sitting or straining to have a bowel movement A lump under the skin around the anus. But the infection can also bring on other symptoms. Signs of infection include:
Fever Pain that gets worse, even after standard hemorrhoid treatment Redness around the anus, especially near the site of infection If you suspect hemorrhoids have become infected Please see a doctor for timely treatment. Infection can lead to serious complications, such as peritonitis, pelvic inflammatory disease. This is a life-threatening infection of the abdominal wall and internal organs.

3. How to Diagnose Infected Hemorrhoids To diagnose a hemorrhoid infection, your doctor will review your medical history and current symptoms. Symptoms such as fever can help your doctor make a diagnosis.
A physical exam will also be performed to check for visible signs of infection, such as redness around the hemorrhoid. If you have internal hemorrhoids, your doctor may decide to remove it before it becomes infected.
Some other tests are also done such as:
Blood tests Urinalysis tests X-rays 4. How to treat infected hemorrhoids Antibiotics are used to treat infected or tissue hemorrhoids infection due to hemorrhoidectomy.
Antibiotics prescribed for peritonitis include cefepime (Maxipime), imipenem (Primaxin).... The specific antibiotic you are prescribed will depend on the severity of your infection, the spectrum of the bacteria, and the type of antibiotic you are prescribed. common bacteria in the country and any problems or allergies you may have with certain medicines.
Surgery to remove infected tissue around the hemorrhoid or tissue in the abdomen (if the infection has spread) may be needed in severe cases. This is called decontamination and can help the body heal from the infection.
In addition to medications and possible surgical procedures, home remedies can help relieve symptoms:
Apply ice or cold around the anal area Take an oral pain reliever, such as acetaminophen ( Tylenol) or ibuprofen (Advil) Spacers that contain an anesthetic. Also, tweaking your diet can make you less likely to strain during bowel movements. A diet that includes foods rich in fiber, such as fruits, vegetables, and whole grains, can help soften stools. However, always check with your doctor before trying any type of home treatment.
5. How to prevent infected hemorrhoids To prevent infected hemorrhoids you need to:
Avoid getting hemorrhoids of any kind. Eat a high-fiber diet (20 to 35 grams per day) and drink plenty of water. Maintain a healthy weight Avoid sitting for hours Get regular exercise, including aerobic activity, such as brisk walking, tennis or dancing Go to the bathroom as soon as you need to, because it delays going. Diarrhea can make stools harder to pass. See your doctor as soon as you have symptoms related to hemorrhoids. In short, the severity of the hemorrhoid infection will determine how long it will take to clear up and if treatment will require more than antibiotics. Due to ddos, if you have a personal or family history of hemorrhoids, you are more likely to develop hemorrhoids in the future. However, one hemorrhoid infection does not mean that the next hemorrhoid is more likely to become infected. It is important to pay attention to the symptoms and treat them early.

References:
Jindal A, et al. (2015). A randomized open label study of “imipenem vs. cafepime” in spontaneous bacterial peritonitis. ncbi.nlm.nih.gov/pubmed/26474358 Mayo Clinic Staff. (2018). Hemorrhoids. mayoclinic.org/diseases-conditions/hemorrhoids/diagnosis-treatment/drc-20360280 Mayo Clinic Staff. (2018). Peritonitis. mayoclinic.org/diseases-conditions/peritonitis/diagnosis-treatment/drc-20376250 Muldoon R. (2018). Hemorrhoids: Expanded version. fascrs.org/patients/disease-condition/hemorrhoids-expanded-version Zutshi M. (2018). 5 simple ways you can prevent hemorrhoids. health.clevelandclinic.org/5-simple-ways-you-can-prevent-hemorrhoids/