Although hemorrhoids aren't necessarily life-threatening, they can be really bothersome and affect over 75% of people over the age of 45. To some people, this topic can be considered embarrassing to discuss with their clinician. However, hemorrhoid signs and symptoms can be similar to other more serious conditions, such as colon cancer or IBD, in which a clinician should be consulted to rule out these conditions. They can also be a sign of other gastrointestinal disorders. With appropriate testing, hemorrhoids can be effectively treated to address any health conditions that may be causing it or to identify other more severe diseases that may present with similar symptoms. Functional medicine labs can be an excellent tool to equip your patients with the personalized health strategies needed to address all the risk factors associated with hemorrhoids.

[signup]

What Are Hemorrhoids?

Hemorrhoids can be referred to as piles. They are swollen veins that can develop inside and outside of the anus and rectum. They might cause discomfort, pain, and rectal bleeding. Hemorrhoids are a normal part of our anatomy, but they only become problematic when they enlarge and cause bothersome symptoms. When veins swell, they lead to hemorrhoids. There are different forms of hemorrhoids; external, internal, and prolapsed. External hemorrhoids develop beneath the skin around the anus, the exit point for stool. Internal hemorrhoids develop inside the rectum, the link between the large intestine and the anus. They usually don't cause pain but can lead to bleeding. Both internal and external hemorrhoids can prolapse, protruding from the anus.

Complications from hemorrhoids are uncommon but can include blood clots in external hemorrhoids, skin tags (extra skin left after a blood clot dissolves in an external hemorrhoid), infection of a sore on external hemorrhoid, and strangulated hemorrhoids, where the blood supply to an internal hemorrhoid is limited due to muscle constriction around the anus, and anemia.

What Causes Hemorrhoids?

Hemorrhoids can affect anyone, including teenagers, although they are less common in children due to their slow development. Individuals might be more prone to getting them if they are overweight or obese, going through pregnancy, suffer from chronic constipation or diarrhea, strain during bowel movements, consume a low-fiber diet, or regularly lift heavy items. Straining while having a bowel movement increases pressure on the veins in the anus and rectum, leading to hemorrhoids. Picture them as similar to varicose veins but in the area around one’s bottom.

Any activity that causes straining and raises pressure on the abdominal area or lower body can cause the veins around the anus and rectum to swell and become inflamed. Hemorrhoids can develop due to pressure on the pelvic region, particularly from weight gain, especially during pregnancy, forcefully pushing during a bowel movement because of constipation, and straining while lifting heavy objects or weightlifting.

Hemorrhoid Symptoms

Symptoms of hemorrhoids vary based on location. Internal hemorrhoids typically don't cause pain and often go unnoticed as they usually can't be felt unless prolapsed. People might not realize they have internal hemorrhoids due to the lack of symptoms. If there are any experienced symptoms of internal hemorrhoids, there might be blood on the toilet paper, in the stool, or the toilet bowl, indicating rectal bleeding. Prolapsed hemorrhoids can be distressing and painful. Your patients might report that they feel them protruding from the anus and that they can be gently pushed back inside them. Some more of the common symptoms involve external hemorrhoids.

Common signs of external hemorrhoids include:

• Itching around the anus
• Firm lumps near the anus that might feel sore or tender
• Discomfort or pain in the anus, especially while sitting
• Rectal bleeding

What Are The Benefits of Regular Lab Testing For Patients Who Suffer From Hemorrhoids?

After beginning treatment, it's crucial to reevaluate either when your patient’s symptoms go away or if they continue for 1-3 months. If symptoms persist, exploring other contributing factors and conducting further testing is a good idea. Once symptoms have resolved, retesting can help ensure that the underlying conditions are managed effectively and minimize other risk factors. If there is a history of hemorrhoids, performing tests every six months can assist in preventive measures to lower the chances of recurring hemorrhoids and to establish that protocols such as fiber intake are optimized.

It's important to note that not every anal issue stems from hemorrhoids. Some hemorrhoid symptoms resemble those of other gastrointestinal problems. For instance, rectal bleeding could indicate conditions like Crohn's disease, ulcerative colitis, or colon or rectal cancer, stressing the importance of testing to rule out these other conditions.

Top Labs To Run Bi-Annually On Patients With Hemorrhoids

The functional labs that should be run regularly for a patient with hemorrhoids typically involve ruling out other diseases or assessing underlying conditions that can cause hemorrhoids. The following are labs frequently used by clinicians:

Gut Zoomer

The Gut Zoomer examines different harmful microorganisms in the digestive system that could contribute to long-term illnesses. When these microbes multiply excessively and disrupt the gut's balance (dysbiosis), it could indicate conditions like Crohn's disease or Ulcerative colitis, which this test can help rule out these conditions in hemorrhoids. Microbiome imbalances can also lead to other digestive disorders, such as constipation or diarrhea, linked to the development of hemorrhoids. Insufficient fiber intake can also contribute to imbalances in the microbiome, making fiber intake essential in part of the personalized protocols to address both disruptions in the microbiome and hemorrhoids. The results of this stool test can help clinicians investigate underlying causes of hemorrhoids for their patients and help rule out other conditions. Retesting after completing treatment protocols can help monitor the effectiveness of treatments.

Weight Management and Wellness Metrics Profile

The Weight Management Profile identifies hormone imbalances that can impact weight gain, obesity, and struggles to maintain a healthy weight, which can contribute to developing hemorrhoids. This test is performed utilizing a saliva and blood spot sample. As a screening tool, it also acts as an early sign of insulin resistance and potential risks for metabolic syndrome and diabetes. This test also helps fix imbalances to aid weight control and manage risks for heart-related metabolic issues and diabetes. It enables healthcare providers to pinpoint hormone imbalances responsible for weight gain, slower metabolism, higher body fat storage, and cravings for food and sugar. Retesting allows practitioners to monitor the effectiveness of treatments.

Anemia Panel

If your patients have recurring hemorrhoids with bleeding, you will want to assess if they are at risk for developing anemia. Anemia, although rare, is considered a complication of hemorrhoids. This anemia panel is completed through a blood sample and analyzes six different markers of anemia. Imbalances in these markers indicate anemia, thus calling for treatments to address these imbalances. Regular testing can help ensure that these levels are sufficient to reduce the risk of anemia due to hemorrhoids.

Additional Labs to Check 

A healthcare provider will diagnose hemorrhoids by examining symptoms and conducting a physical assessment. Additional procedures might involve a digital rectal exam to detect swollen veins, Anoscopy, to inspect the lining of the anus and rectum, or imaging via a Sigmoidoscopy to examine the lower portion of the colon and rectum. In some cases, a colonoscopy might be performed to validate other test results or to screen for colon cancer.

[signup]

Summary

Hemorrhoids can be an uncomfortable topic for your patients to discuss with you. Hemorrhoids can be painful and irritating but don't tend to cause serious health issues. All of us are born with hemorrhoids, and only when they get inflamed may they create symptoms. Complications can occur but are rare, and hemorrhoid symptoms are similar to other, more serious conditions. Therefore, regular testing is recommended to help prevent complications, reduce the risk of developing hemorrhoids, or rule out other conditions. If you're patients are experiencing symptoms of hemorrhoids, functional medicine testing and treatments can help evaluate and alleviate their symptoms. Moreover, you can help your patients take appropriate measures to prevent the recurrence of hemorrhoids.