What Can You Do About Hemorrhoids?

Hemorrhoids: What Are They?

Hemorrhoids are an uncomfortable condition that effects almost half the population at some point by the age of 50. Hemorrhoids are characterized by bulging swollen blood vessels in and/or around your anus and can be very uncomfortable. Symptoms of hemorrhoids include:

• Bleeding during bowel movements
• Itching in the anal region
• Pain or discomfort, particularly when sitting

Two Types of Hemorrhoids

• External Hemorrhoids
  These are under the skin around the anus and can be particularly painful or itchy due to the irritation of the surrounding skin.
• Internal Hemorrhoids
  Located inside the rectum, they are typically less painful but can cause bleeding. Noticeable as spots of blood on toilet paper, internal hemorrhoids may lead to more serious concerns if they prolapse or extend outside the anus, which warrants immediate medical consultation.

What Causes Hemorrhoids?

The development of hemorrhoids is linked to changes in blood flow and pressure within the veins of the lower rectum and anus. Common factors that can lead to this condition include:

• Pregnancy: The additional weight and pressure on the pelvic area can contribute to the formation of hemorrhoids.
• Obesity: Excess body weight can increase pressure in the pelvic veins.
• Chronic Constipation: Straining during bowel movements and prolonged sitting on the toilet can impede blood flow and increase pressure.

Treatment Options for Hemorrhoids

A diagnosis of hemorrhoids is typically made after an exam by a healthcare provider. After diagnosis, most treatment is directed at symptom management, as most small hemorrhoids typically go away on their own after a few days.

Medications

• Local Anesthetics: Products like Nupercainal OTC can numb the area, reducing pain and itching.
• Topical Corticosteroids: Preparation H with hydrocortisone can ease inflammation and itching. It's important to limit use to under a week unless advised by a healthcare professional.
• Medications that shrink hemorrhoids: Preparation H rectacaine relieve itching and even shrink hemorrhoids temporarily.
• Astringents and Protectants: Such as witch hazel and zinc oxide, these can soothe the skin and protect it from further irritation.

Some people also find sitting in a warm and shallow bath (a “sitz” bath) can soothe the anal area, particularly following bowel movements. It may also help to wear cotton underwear and loose clothing, as this prevents moisture buildup, which can make discomfort worse.

If hemorrhoids are large and/or persistent, it’s sometimes necessary to undergo procedures to get them removed by a medical professional.

Procedures

• Rubber Band Ligation: A minimally invasive procedure that cuts off circulation to the hemorrhoid, causing it to shrink and fall off.
• Coagulation Therapy: Involves using heat, electricity, or a laser to burn away the hemorrhoidal tissue.
• Hemorrhoidectomy: Surgery is sometimes necessary when hemorrhoids are large or persistent and other therapies haven’t helped. Surgeries are the most permanent treatment option but are more invasive than others.

Prevention Strategies

While not all hemorrhoids can be prevented due to factors like pregnancy, many strategies can reduce the risk:

• Diet and Hydration: Increase fiber intake and drink plenty of water to soften stools and reduce straining.
• Toilet Habits: Don't sit for extended periods or strain during bowel movements. Respond to the natural urge rather than forcing the process.
• Physical Activity: Regular exercise can help prevent constipation and reduce pressure on the veins.
• Weight Management: Maintaining a healthy weight can decrease the risk of developing hemorrhoids.
• Careful Lifting: Avoid heavy lifting or ensure proper technique to prevent increased abdominal pressure.

When to Seek Medical Attention

Whether you are self-treating or have been prescribed treatment for your hemorrhoids, there are certain situations when you should seek medical attention. This includes:

• Persistent and/or heavy bleeding: If rectal bleeding persists or becomes extreme, it is important to seek medical attention in order to both determine the cause as well as prevent blood loss.
• Prolapsed hemorrhoid If your internal hemorrhoid has prolapsed and is protruding out of your anus, it is essential to seek medical attention. This protrusion can cut off blood flow and may need surgery to reverse.