If you’ve heard about hemorrhoids but don’t know much about them, this guide is just for you.
Although people shy away from talking about hemorrhoids, they are very common. Nearly 50% of adults may develop hemorrhoids by the age of 50. Approximately 75% of the entire population experience hemorrhoids at some point in their lives.
The good news is that not all cases need medical intervention. If you have a mild case of hemorrhoid, you can easily manage it with careful hygiene practices and topical creams. However, if none of these treatments seem to relieve your condition, getting a surgical procedure is also an option.
Hemorrhoids refer to swollen veins in the lowest part of the rectum and anus. The swollen veins outside the anus and inside the rectum can cause pain, rectal bleeding, and anal itching. Generally, symptoms subside with at-home treatments and a fiber-rich diet, but some individuals need medical treatments and procedures.
What are Different Types of Hemorrhoids?
There are two types of hemorrhoids: internal and external. Most patients realize they have internal hemorrhoids when these veins grow out and bulge outside the anus. These patients often see blood around the stool, which indicates the presence of internal hemorrhoids. Since internal hemorrhoids are present in the rectum, many people may not know about their presence.
External hemorrhoids are obvious because they are present as hard lumps or swollen blood vessels. Many times, these lumps or vessels are itchy and painful. These hemorrhoids develop under the skin that is around the anus. The overlying skin erodes and becomes itchy or painful, so external hemorrhoids are quite uncomfortable.
In case there is a blood clot inside an external hemorrhoid, an individual may feel severe or sudden pain. Typically, there may be a lump around the anus. The clot dissolves, and the excess skin forms a skin tag, which becomes itchy.
However, internal hemorrhoids are painless and do not cause any significant discomfort even if they are bleeding. For instance, people who may see blood dripping while sitting on the toilet may not feel any pain or discomfort. When internal hemorrhoids prolapse (bulge) beyond the anus, they cause numerous problems. As the hemorrhoid protrudes, it sometimes collects tiny amounts of stool particles and mucus, which leads to irritation. This irritation is called pruritus ani. Unfortunately, individuals who constantly wipe to relieve the itch can worsen this problem.
What are the Symptoms of Hemorrhoids?
Both internal and external hemorrhoids exhibit different kinds of signs and symptoms. Let’s take a look at some of these.
Internal hemorrhoids
Since internal hemorrhoids are far inside the rectum, you can’t feel or see them. They don’t cause any pain or itchiness because this area does not have too many pain-sensing nerves. Here are the signs and symptoms you may observe if you have internal hemorrhoids.
- Blood on toilet paper after you use the bathroom
- Tissues that prolapse or bulge outside the anal opening. These tissues may hurt after you poop.
- You may observe prolapsed hemorrhoids as moist bumps. These bumps are pinker than the surrounding area and sometimes go back inside without any intervention. In most cases, they go back inside if you gently push them back.
External hemorrhoids
External hemorrhoids are present under the skin and around the anus. There are numerous pain-sensing nerves in this area, so you can feel many symptoms, including.
- Itching
- Swelling
- Pain
- Bleeding
Thrombosed Hemorrhoids
If there is a blood clot inside an external hemorrhoid, it can make the hemorrhoid turn blue or purple. Such a hemorrhoid is called a thrombosed hemorrhoid. Here are the symptoms you may observe:
- Bleeding
- Pain
- Itchiness
What are the Causes of Hemorrhoids?
If you have a family history of hemorrhoids, you can be at a greater risk of acquiring them. Other causes include a build-up of pressure on the lower rectum. As this pressure grows, the veins in the area swell up and cause pain.
Here are some reasons that can lead to hemorrhoids.
- Straining while lifting a heavy object
- Pushing during bowel movements
- Obesity
- Consuming a low-fiber diet
- Pregnancy (due to increasing pressure on the uterus)
- Anal sex
- Standing or sitting for long periods
In addition to that, people who suffer from diarrhea or constipation frequently may also end up developing hemorrhoids. Vomiting, sneezing, and coughing could make them worse.
How to Diagnose Hemorrhoids
Once you experience any of the symptoms listed above, visit your doctor to get a diagnosis. The doctor will begin the assessment by asking about your symptoms or family history. Here are other ways a qualified doctor will diagnose hemorrhoids.
- Physical exam: Your doctor will examine your rectum and anus to check for swelling or any lumps.
- Rectal exam: Your doctor will put on gloves and insert a finger into your rectum (after applying a lubricant). That will help the doctor feel for lumps, tenderness, and other problems. This exam also helps the doctor to feel the muscle tone and tenderness of the rectum.
If the doctor wants to rule out other conditions or diagnose internal hemorrhoids, they may order additional tests. Here are some of these tests that may give a better picture.
- Colonoscopy: Your doctor examines the entire large intestine using a flexible and long tube. This tube is called a colonoscopy. If there is a need, the doctor will collect tissue samples to detect any other issues.
- Anoscopy: With a short plastic tube or an anoscope, the doctor examines the anal canal to detect any complications.
- Sigmoidoscopy: A doctor will look into the patient’s lower colon using a flexible, lighted tube or a sigmoidoscope. The doctor can use the test tube for taking tissues for any further tests.
How to Treat Hemorrhoids
Many times, symptoms of hemorrhoids disappear on their own. But if they don’t, it’s best to consult a doctor. A professional and qualified doctor will recommend the best course of action to take. Most people turn to home remedies for treating hemorrhoids. Adding more fiber-rich foods to your diet and making simple lifestyle changes can relieve mild symptoms within two to seven days.
Remember to add many vegetables, fruits, and grains to your daily diet. Avoid straining during bowel movements and consume adequate amounts of water. Take warm sitz baths for at least twenty minutes at least once a day for relieving hemorrhoids. You can also use ice packs for easing swelling and pain.
Apart from home remedies, surgical and non-surgical treatments are the most effective treatment methods for getting rid of hemorrhoids.
Non-surgical treatments: These are medications for relieving itching, swelling, and pain. Non-surgical treatments also include over-the-counter topical creams.
Surgical treatments: In case someone has large hemorrhoids or no treatments seem to offer any relief, surgery is the only option. Your doctor can use infrared light, lasers, chemicals, or tiny rubber bands to get rid of hemorrhoids. If they are exceptionally large or keep coming back, the doctor may remove them using a scalpel.
Medical Procedures for Treating Hemorrhoids
Rubber band Litigation
This process is the most common treatment in the U.S. for treating hemorrhoids. A doctor will place a small elastic band around the hemorrhoid’s base, which causes it to shrink. The procedure takes two to four sessions, performed six to eight weeks apart.
Complications such as infection and bleeding are rare. However, affected individuals may feel some tightness or mild pain. Other procedures include infrared or laser coagulation, cryosurgery, and sclerotherapy. Each of these procedures works on the same principle as rubber band ligation. But they are not effective enough to prevent a recurrence. Recurrence and side effects vary according to each procedure. Consulting your doctor is the only way to determine the best course of treatment.
Hemorrhoidectomy
A person may require surgery if they have large protruding hemorrhoids. You may also need this surgery if internal hemorrhoids keep returning despite rubber band litigation. In traditional surgery, a doctor makes a narrow incision around both internal and external hemorrhoid tissue. That way, the doctor is able to remove the affected blood vessels. This surgery successfully cures more than 90% of cases.
Although patients require general anesthesia, they can go home the same day. After a week or ten days after the surgery, the patient can return to work.
Staples
Patients who are looking for an alternative method to traditional hemorrhoidectomy can go for this procedure. Doctors use a stapling device for treating prolapsed or bleeding hemorrhoids. The surgeon will use a stapler for anchoring the hemorrhoids in their normal position. This process also requires general anesthesia.
How to Relieve Hemorrhoids through Lifestyle Changes and Home Remedies
Certain lifestyle and dietary modifications can prevent us from internal and external hemorrhoids. Ask your doctor for a fiber supplement or add more fiber sources to your diet. Foods rich in fiber include wheat, beans, broccoli, and oat bran, etc.
Increase your intake of fluids to soften stools and make them easier to pass. Take up some form of exercise. For example, you can jog or brisk walk every morning/evening for at least half an hour a day. Physical activity stimulates bowel movement, so any form of exercise is helpful for preventing hemorrhoids.
Go to the bathroom immediately whenever you feel the urge to defecate. If you wait for a more convenient time, you can add more pressure to the rectum. As a result, there will be an increase in pressure and strain. It’s best to schedule a set time every day to relieve yourself so you can establish a regular bowel habit.
Sitz
This warm water bath brings comfort and relief to the buttocks and hips. The name comes from the German word ‘sitzen,’ which means ‘to sit.’ The bath relieves irritation, itching, and spasm of the sphincter muscle. You can easily find a small plastic tub for fitting it over a toilet seat from a local pharmacy. Sitting in a bathtub of warm water regularly also helps. Experts suggest using a sitz bath after every bowel movement for at least twenty minutes. Don’t forget to gently pat your anal area dry once you take a bath. Avoid wiping or rubbing the area.
Colon Cleanse
If constipation is the cause of the hemorrhoids then a colon cleanse could be a solution to prevent flare-ups. Some colon cleanse formulas can be harsh on the stomach which is why we recommend a gentle and natural formula like Natural Colon.
Treat the clot
If an external hemorrhoid forms a blood clot, you feel excruciating pain. When the clot stays for longer than a few days or the pain becomes unbearable, you need to visit a doctor. Typically, clots go on their own, but a surgeon has to remove them from the vein in most cases.
Topical Creams
If you are looking for quick relief from itchy and painful external hemorrhoids, topical creams offer instant relief. You can find effective topical creams from your local pharmacy. An over-the-counter cream or a suppository containing witch hazel and lidocaine can offer relief. Since topical creams have numbing agents and steroids, they relieve swelling and pain. Remember to check labels carefully. Avoid using topical creams for more than a week because steroids can make your skin thin over time.
Use Over-the-counter Painkillers
Pain-relieving medication such as nonsteroidal anti-inflammatory drugs and acetaminophen can relieve swelling and pain. You can use these over-the-round medications according to their instructions or your doctor’s advice. While these painkillers guarantee instant results, they are not helpful for providing any long-term relief.
Increase your Fiber Intake
Most of us don’t get enough fiber from our diet. Ideally, we should aim for 20 to 30 grams of fiber a day. Ask your doctor for a good-quality fiber supplement that contains psyllium or methylcellulose for achieving your daily goal. If you don’t increase your fiber intake, you are sure to experience bloating and constipation.
Make Hydration a Priority
One of the simplest ways to prevent hemorrhoids from flaring up is to drink enough water. When you increase the intake of fluids, the body produces soft stools, and you don’t have to strain. Remember to drink at least eight glasses of water to stay hydrated. Don’t consume caffeinated or sugary beverages because they will dehydrate your body, worsening your condition.
Use an Ice Pack
Applying a cold compress or an ice pack offers short-term relief from swollen and painful hemorrhoids. Don’t forget to apply an ice pack for at least ten minutes, thrice a day. Don’t forget to wrap the pack inside a cloth or paper towel first to protect your skin.
Can Hemorrhoids Lead to Complications?
In rare cases, hemorrhoids could cause further problems such as:
Infection: If external hemorrhoids have sores, an infection can develop.
Anemia: If hemorrhoids last for a long time, you may lose too much blood.
Skin tags: As soon as the clot in a thrombosed hemorrhoid dissolves, the excess skin or skin tags can become itchy.
Strangulated hemorrhoids: If muscles block the blood flow to a prolapsed hemorrhoid, surgery is the most common method to remove these hemorrhoids.
When to See the Doctor
Schedule an appointment with your doctor when you start observing pain or discomfort around the anus. If you feel pain or discomfort when you have a bowel movement or while sitting on the toilet, it’s time for a checkup. If you observe any drastic worsening of symptoms, seek immediate medical help.
Here are some signs that will help you know whether you need medical assistance.
- Itchiness around the anus
- A burning sensation around the affected area
- Swelling or lumps near the anus
- Bluish discoloration of the skin near swollen areas
Bottom Line
We are too embarrassed to talk about hemorrhoids because we assume that they arise due to poor hygiene. However, that’s not always the case. Constipation, lack of physical activity, and a low-fiber diet are just a few of the reasons behind this condition. In women, childbirth and pregnancy can also lead to hemorrhoids. Follow our guide to relieve symptoms and prevent hemorrhoids for living a pain-free life.
Sources
https://www.niddk.nih.gov/health-information/digestive-diseases/hemorrhoids/definition-facts
https://fascrs.org/patients/diseases-and-conditions/a-z/hemorrhoids
