Help for when hemorrhoids become a problem

Here’s a fun fact you can impress everyone with: Hemorrhoids are actually a part of the normal anatomy of the anus and lower rectum.  Their job is to act as cushions to protect the anal skin from the passage of stool. Generally, hemorrhoids are not a problem.  But if they begin to swell, bleed or protrude to the point of coming out of the rectum to the outside of the anus, then there is a problem.

There’s no doubt a discussion of hemorrhoids is usually not a common topic.  Most people consider them to be one of the most embarrassing medical conditions to have. Also known as piles, hemorrhoids are swollen veins and are referred to as varicose veins of the anus.  If you happen to be someone suffering from this ailment, you are not alone as nearly three out of four adults will have hemorrhoids from time to time. Over the age of 45, up to 75% of people have them experiencing the annoying discomfort of rectal itching, pain, and even bleeding after a bowel movement.

Two types of hemorrhoids

Hemorrhoids come in two types – internal and external.  Internal hemorrhoids form inside the anus cavity and usually are painless.  This type, however, can cause some bleeding after a bowel movement.  They can also protrude outside the anus appearing like small, grape-like masses.

External hemorrhoids form right outside the opening to the anus and can cause swelling, protrusions, and pain.

Home remedies for hemorrhoids

Hemorrhoids are rarely dangerous but are one of the most common causes of rectal bleeding.  By following some simple self-help home methods along with over-the-counter remedies, most hemorrhoids will shrink and clear up in a couple of weeks. 

If at any time you experience rectal bleeding, feel a lump in the anus, or have ongoing rectal pain, it is important to see your doctor as these could be signs of an unrelated and more serious condition such as colorectal or rectal cancer.  

·      Sitz baths

Sitting in a bathtub filled with three to four inches of warm water (not hot) can help relieve itching and irritation.  Sit in the tub with your knees bent for about 10 to 15 minutes about two to three times a day and if possible, after every bowel movement.  Do not scrub the area and be sure to gently dry afterwards.  There are special “sitz baths” to place directly on your toilet seat to make soaking easier.

·      Fiber supplements

Try a psyllium husk fiber supplement such as Metamucil. Fiber supplements can reduce bleeding, inflammation, and enlargement by drawing water into the stool, making it more bulky and easier to pass.  If a psyllium husk supplement causes gas or bloating, try instead a supplement containing wheat dextrin (Benefier) or methycellulose (Citrucel).

·      Topical over-the-counter products

There are various wipes and creams for hemorrhoids that can be applied topically to soothe pain and relieve itching.  Many of the wipes are infused with witch hazel (Tucks) as well as soothing creams that contain lidocaine, hydrocortisone, or other ingredients like phenylephrine (Preparation H). 

·      Ice it

Placing ice in a small cold pack and directly applying to the trouble area several times a day can help dull pain along with reducing swelling for relief for at least a little while.

·      Practice good bathroom habits

Be careful not to strain and force things to happen. If you find yourself unable to go after a few minutes, try again later.  Have a routine of when you go to the bathroom which typically after meals is a good time to visit the restroom.

Other remedies to try at home include the following:

·      For pain or soreness, try using an over-the-counter medication such as acetaminophen, aspirin, or ibuprofen.

·      Avoid scratching as this can lead to skin damage and increased irritation.

·      Wear soft, cotton underwear.  Cotton helps keep the area aired out preventing moisture which will only lead to more irritation.

Procedures for treatment of hemorrhoids

When hemorrhoid symptoms persist or an internal hemorrhoid has prolapsed, then a person may require a minimally invasive treatment.  These procedures are generally performed in a surgeon’s office or as outpatient surgery in a hospital and include the following:

·      Rubber band ligation – This common procedure for hemorrhoids is where a small elastic band is placed around the base of a hemorrhoid to cut off its circulation.  The hemorrhoid withers and falls off within a week and is effective for most people.  ‘

·      Injection (sclerotherapy) – The doctor injects a chemical solution into the hemorrhoid tissue to shrink it.  While the injection causes little or no pain, it may be less effective than rubber band ligation.

·      Coagulation (infrared, laser or bipolar) – Coagulation techniques use laser or infrared light or heat.  They cause small, bleeding, internal hemorrhoids to harden and shrivel. 

·      Hemorrhoid removal (hemorrhoidectomy) – This procedure is the most effective and complete way to treat severe or recurring hemorrhoids.  A surgeon removes excessive tissue that causes bleeding.  The surgery may be done with a local anesthetic combined with sedation, a spinal anesthetic or a general anesthetic. 

·      Hemorrhoid stapling – This procedure blocks blood flow to hemorrhoidal tissue and is typically used only for internal hemorrhoids.