Helping Hemorrhoids

You just had a painful bowel movement and you feel something swollen in your anus. It might hurt just a little. You could have a hemorrhoid.

Hemorrhoids, also known as piles, are swollen veins in your anus and lower rectum, similar to varicose veins. Hemorrhoids can develop inside the rectum (internal hemorrhoids) or under the skin around the anus (external hemorrhoids).

About three out of four adults will have hemorrhoids from time to time. Hemorrhoids have a number of causes, but most of the time the cause is unknown.

The good news is that there are effective treatments for the condition. Many people get relief from at home treatments and lifestyle changes.

Some common signs of external hemorrhoids are itching and irritation, pain or discomfort, swelling around your anus, and bleeding.

Internal hemorrhoids lie inside the rectum. You usually can’t see or feel them and they rarely cause discomfort. But straining or irritation when passing stool can cause: painless bleeding during bowel movements; and a hemorrhoid to push through the anal opening (prolapsed or protruding hemorrhoid) resulting in pain and irritation.

Thrombosed hemorrhoids result in blood pooling in an external hemorrhoid and forming a clot (thrombus). This can lead to severe pain, swelling, inflammation, and a hard lump near the anus.

Those susceptible to hemorrhoids are people that are overweight or obese, that are pregnant, that eat a low-fiber diet, that have chronic constipation or diarrhea, that lift heavy objects, that sit on the toilet for long periods of time, that strain during bowel movements.

There are several causes of hemorrhoids. Straining can put pressure on the veins in the anus or rectum. In fact, any sort of straining puts pressure on your belly and lower extremities which can cause anal and rectal veins to become swollen and inflamed. Hemorrhoids can form due to pelvic pressure from weight gain, especially pregnancy. They can also form pushing too hard because of constipation and straining to lift heavy objects.

Be aware that there are other conditions which may cause rectal bleeding including colon cancer, Crohn’s disease, and ulcerative colitis.

To diagnose hemorrhoids, your doctor will conduct a digital examination (where he inserts a gloved, lubricated finger into your rectum to check for growths) and visual inspection (using either an anoscope, proctoscope, or sigmoidoscope to examine the lower part of your colon and rectum).

You might warrant an examination using a colonoscopy if there is evidence suggesting another digestive system disease, you have risk factors for colorectal cancer, or if you are middle aged and haven’t had a recent colonoscopy.

Some complications of hemorrhoids are anemia, blood clots in external hemorrhoids, infection, skin tags (flap of tissue that hangs off skin) and strangulated hemorrhoids (muscles in the anus cut off blood flow to a prolapsed internal hemorrhoid).

It’s important to note that hemorrhoids often go away on their own without treatment. Symptoms like pain and bleeding usually take about a week to clear up. You can take these steps to heal your hemorrhoids:

·       Apply over-the-counter medications containing lidocaine, witch hazel, or hydrocortisone to the affected area.

·       Hydrate yourself and drink more water.

·       Increase your fiber intake. Try to obtain 20-35 grams of daily fiber intake.

·       Soak in a warm bath (sitz) for at least 20 minutes.

·       Soften stools by taking laxatives

·       Take nonsteroidal anti-inflammatory drugs for pain and inflammation

·       Use flushable wet wipes or toilet paper with tissue after you poop or wet tissue with water before wiping.

If it is necessary to have your doctor treat hemorrhoids, then your doctor can perform a rubber band ligation (places one or two rubber bands around the base of an internal hemorrhoid to cut off circulation), an injection (sclerotherapy) where the doctor injects a chemical solution into the hemorrhoid to shrink it, and coagulation where laser, infrared light or heat to harden and shrivel the hemorrhoid.

A handful of people might need surgery. A hemorrhoidectomy involves removing excessive tissue that can cause bleeding. This procedure is the most effective way to treat severe or recurring hemorrhoids. It can be done under local anesthesia with sedation, spinal anesthesia, or general anesthesia. Complications with this type of surgery include difficulty in emptying your bladder, which can result in urinary tract infections. This situation usually occurs after spinal anesthesia.

Another type of surgical procedure is hemorrhoid stapling or stapled hemorrhoidopexy, which stops blood flow to hemorrhoidal tissue. This procedure is done on internal hemorrhoids. This type of surgery involves less pain than a hemorrhoidectomy and a return to normal activity sooner. Stapling is associated with a greater risk for recurrence and a rectal prolapse, in which part of the rectum protrudes from the anus. Complications include bleeding, urinary retention and pain, and, rarely, a blood infection (sepsis).

Hemorrhoids are very common and you shouldn’t feel embarrassed by seeking an examination with your doctor. You don’t have to suffer in pain needlessly and your healthcare provider may know of ways to prevent hemorrhoids from returning.