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Hemorrhoids

What are hemorrhoids?

Highlights

  1. Hemorrhoids cause pain, severe itching, and difficulty sitting.
  2. Consistent heavy lifting, being obese, or having other constant strain on your body can increase your risk of hemorrhoids.
  3. Do not use soap to clean around your anus when treating a hemorrhoid.

Hemorrhoids are swollen veins located around the anus or in the lower rectum. About 50 percent of adults experienced the symptoms of hemorrhoids by the age of 50.

Hemorrhoids can either be internal or external. Internal hemorrhoids develop within the anus or rectum. External hemorrhoids develop outside of the anus. Hemorrhoids are also known as piles.

External hemorrhoids are the most common and most troublesome. Hemorrhoids cause pain, severe itching, and difficulty sitting. Fortunately, they are treatable.

What are the symptoms of hemorrhoids?

Symptoms

Symptoms of hemorrhoids include: 

  • extreme itching around the anus
  • irritation and pain around the anus
  • itchy or painful lump or swelling near your anus
  • fecal leakage
  • painful bowel movements
  • blood on your tissue after having a bowel movement

Although hemorrhoids are painful, they aren’t life-threatening and often go away on their own without treatment. If you have them often, you may develop symptoms of anemia, such as weakness and pale skin due to blood loss, though this is rare.

What causes hemorrhoids?

Causes

Experts aren’t sure what causes hemorrhoids to develop. Possible factors include: 

  • straining during a bowel movement
  • complications from chronic constipation
  • sitting for a long period of time, especially on the toilet
  • a family history of hemorrhoids

Risk factors

Risk Factors

Hemorrhoids can be passed on genetically from parent to child, so if your parents had hemorrhoids, you’re more likely to get them. Consistent heavy lifting, being obese, or having other constant strain on your body can increase your risk of hemorrhoids.

Also standing too much without taking a break to sit can cause hemorrhoids to develop. And consistent anal sexual intercourse and diarrhea can also increase your risk of hemorrhoids.

You’re also more likely to develop hemorrhoids if you’re pregnant. When the uterus enlarges, it presses on the vein in the colon, causing it to bulge.

How are hemorrhoids diagnosed?

Diagnosis

A visual examination of your anus may be enough to diagnose hemorrhoids. To confirm the diagnosis, your doctor may do a different examination to check for any abnormalities within the anus. This check is known as a digital rectal exam. During this exam, your doctor inserts a gloved and lubricated finger into your rectum. If they feel anything abnormal, they may order an additional test called a sigmoidoscopy.

A sigmoidoscopy involves your doctor using a small camera to diagnose an internal hemorrhoid. This small fiber-optic camera, called a sigmoidoscope, fits into a small tube and then inserts into your rectum. From this test, your doctor gets a clear view of the inside of your rectum so that they can examine the hemorrhoid up close.

What are the treatment options for hemorrhoids?

Treatment

Treatment for hemorrhoids can occur at home or at a doctor’s office.

Pain relief

To minimize pain, soak in a warm tub of water for at least 10 minutes every day. You can also sit on a warm water bottle to relieve the pain of external hemorrhoids. If the pain is unbearable, use an over-the-counter medicated suppository, ointment, or cream to relieve the burning and itching.

Fiber supplements

If you’re constipated, you can also use an over-the-counter fiber supplement to help soften your stool. Two common supplements of this type are psyllium and methylcellulose.

Home remedies

Over-the-counter topical treatments, such as hydrocortisone or hemorrhoid cream, can ease your discomfort from hemorrhoids. Soaking your anus in a sitz bath for 10 to 15 minutes per day can also help.

Practice good hygiene by cleaning your anus with warm water during a shower or bath every day. But don’t use soap, as soap can aggravate hemorrhoids. Also avoid using dry or rough toilet paper when you wipe after a bowel movement.

Using a cold compress on your anus can help reduce hemorrhoid swelling. Pain relievers, such as acetaminophen, ibuprofen, or aspirin can also alleviate the pain or discomfort.

Medical procedures

If home treatments aren’t helping with your hemorrhoids, your doctor might recommend getting a rubber band ligation. This procedure involves the doctor cutting off the circulation of the hemorrhoid by placing a rubber band around it. This causes loss of circulation to the hemorrhoid, forcing it to shrink. This procedure should only be performed by a medical professional. Do not try this at home.

If rubber band ligation isn’t an option in your case, your doctor may perform injection therapy, or sclerotherapy. In this procedure, your doctor injects a chemical into the blood vessel directly. This causes the hemorrhoid to reduce in size.

Prevention

Prevention

To prevent or avoid worsening hemorrhoids, avoid straining during a bowel movement. Also, try to increase your water intake. Drinking enough water can keep your stool from hardening.

Use the restroom as soon as you feel a bowel movement coming on to prevent hemorrhoids from developing. Exercise regularly to prevent becoming constipated, and don’t sit for long periods, especially on hard surfaces like concrete or tile.

Consuming foods that are high in dietary fiber can minimize the risk of developing hemorrhoids in the future. 

Good dietary fiber sources include:

  • whole wheat
  • brown rice
  • oatmeal
  • pears
  • carrots
  • buckwheat
  • bran 

Dietary fiber helps create bulk in the intestines, which softens the stool, making it easier to pass.

What are the complications associated with hemorrhoids?

Complications

Complications from hemorrhoids are rare, but can include:

  • blood clots in the swollen vein
  • bleeding
  • iron deficiency anemia caused by blood loss

Outlook

Outlook

With proper treatment, you’ll likely experience an improvement. Following your doctor’s directions and maintaining a regimen, including exercise and avoiding sitting for long periods of time, that reduces hemorrhoid symptoms can also improve your outlook. 

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