Hemorrhoids

Painful and potentially embarrassing if you can’t sit down, hemorrhoids are swollen veins in the anus or lower rectum, that will affect about 75 percent of people at some point in their lives. If you have an internal hemorrhoid inside the rectum, you may not even be aware of it. External hemorrhoids, which involve the veins outside of the anus, can be sore and itchy. Blood clots may form in external hemorrhoids causing bleeding, painful swelling, or a hard lump around the anus. Nonetheless, hemorrhoids are not dangerous and often disappear within days or weeks.

Hemorrhoid causes People are more prone to getting hemorrhoids during pregnancy, due to the weight of the fetus, if they are overweight, or have a parent who gets them. They are also most common in adults ages 45 to 65. Straining when you have a bowel movement is one of the common causes of hemorrhoids. Sitting on the toilet too long also puts pressure on the veins in the anus.

Hemorrhoid symptoms With an internal hemorrhoid you may notice blood on the toilet paper when you wipe or feel pain when you have a bowel movement. If an internal hemorrhoid bulges outside of the anus, called a prolapsed hemorrhoid, you may feel a lump when you wipe. Both internal and external hemorrhoids may also crack and bleed and be itchy and painful.

Hemorrhoid diagnosis/tests If you notice bleeding, consult your doctor who will conduct a physical examination to make sure you do have hemorrhoids and not some other condition, such as colitis or colorectal cancer. She may perform a digital rectal exam, with a gloved finger and/or anoscopy, which involves looking into the anus using a tube-like instrument with a light on the end. She may also recommend other tests, including a colonoscopy or barium enema X-ray.

Hemorrhoid treatment Most hemorrhoids will heal within a few weeks. In the meantime, here’s what you can do to relieve hemorrhoid pain.

• Keep the area clean Use moistened wipes, such as Tucks, after each bowel movement and take short warm soaks a few times a day.

• Medications Over-the-counter (OTC) pain relievers, such as acetaminophen, ibuprofen or aspirin may help ease the pain. OTC creams and suppositories may help relieve itching and pain but should only be used short-term since they can damage skin. Your doctor may also recommend a stool softener or fibre supplement.

• Go easy If you have painful hemorrhoids, stay off your feet for a day if possible and avoid heavy lifting and straining. Use ice packs to combat swelling.

• Surgery and other options If at-home treatments don’t work, there are other options which include injecting internal hemorrhoids with chemicals (sclerotherapy) or a procedure called rubber band ligation which involves placing a rubber band at the base of the hemorrhoid to stop the blood flow to the area. If hemorrhoids are extremely large or prolapsed, sometimes surgical removal, called a hemorrhoidectomy is recommended.

Hemorrhoid prevention Unless you change your diet or lifestyle, hemorrhoids will probably come back so you need to deal with the root cause. Since constipation is often to blame for hemorrhoids, eat more fibre (25g per day), drink plenty of fluids and get regular exercise to keep your bowel movements regular.

Outside resources
National Digestive Disease Information: Hemorrhoids