According to the American Gastroenterological Association, by the age of 50, half of all Americans have experienced hemorrhoids, but as a physician, I find that many of my patients are uncomfortable talking about them. This is unfortunate because hemorrhoids, although rarely serious, can be a recurring annoyance that can usually be easily treated. But first you have to recognize the condition and discuss treatment options with your doctor.
Internal and External Hemorrhoids
Hemorrhoids are the result of veins around the rectum and anus becoming swollen and distended, almost like when you see varicose veins in the leg.
There are two types of hemorrhoids: internal and external. Internal hemorrhoids occur in the lower rectum and typically do not cause any discomfort, though they can produce bleeding. If an internal hemorrhoid prolapses (extends beyond the anus), it can potentially cause an infection or itching. External hemorrhoids can be painful and irritating. These happen when the veins around the anus become swollen and the skin over the vein becomes irritated. Blood clots can form inside this type of hemorrhoid, which can cause sudden pain. Though there is some discussion over what causes hemorrhoids, most physicians believe they’re caused by a restriction of blood flow to the area. This means that straining during bowel movements, chronic constipation, sitting for a prolonged period of time on the toilet and even pregnancy may cause hemorrhoids.
Treatment Options: From Self-Care to Surgery
For the most part, hemorrhoids can be treated at home. But first things first – take measures to prevent them from happening. This means eating high-fiber foods, drinking plenty of water and eating healthy. Exercise will also help make your body a healthier environment, which means it’s not as conducive to the formation of hemorrhoids.
If you have hemorrhoids, try taking a sitz bath (a warm water bath where the water goes up to your hips) twice a day for twenty minutes and after each bowel movement. After the bath, pat your body dry and do not rub the area surrounding the hemorrhoids.
You can also use creams or ointments that contain witch hazel to relieve the pain temporarily. Small ice packs on the affected area can also help, as will sitting on a cushion instead of a hard surface. Take oral pain relievers as needed to help relieve any discomfort. Your doctor may suggest over-the-counter creams, ointments, suppositories or pads containing witch hazel, hydrocortisone and lidocaine, which provide temporary relief from pain and itching.
For persistent bleeding or painful hemorrhoids, minimally invasive procedures are available and can be done in your doctor’s office or Kelsey-Seybold’s Ambulatory Surgery Center. One such procedure is what’s known as rubber band ligation. In this case, the doctor places one of two tiny rubber bands around the base of an internal hemorrhoid to cut off its circulation. The hemorrhoid falls off within a week.
When all else fails, or as with the case of most large hemorrhoids, surgery is an option. In this procedure, called hemorrhoidectomy, your surgeon removes excessive tissue that causes bleeding.
Be on the Lookout for These Serious Signs
While most hemorrhoids can be treated at home (if your only symptoms are mild pain and itching), there might be an occasion when you’ll need medical intervention to make them go away completely. See your doctor if you’re experiencing any type of rectal bleeding, if you have severe pain or discomfort, if you’ve tried home treatment and it isn’t helping, or if you’re passing stools that contain blood.
Sometimes, symptoms that patients mistake for hemorrhoids turn out to be polyps or worse. It’s better to be safe than sorry. If you have any questions, schedule an appointment.