Hemorrhoids

Causes

Hemorrhoids develop for many different reasons. Some of the most common include:

• Chronic constipation or diarrhea
• Excess straining while having a bowel movement
• Low-fiber diet
• Pregnancy
• Obesity
• Heavy-lifting
• Sitting on the toilet for long periods
• Jobs that require sitting for a long time

Hemorrhoids in women

It’s common for both men and women to get hemorrhoids. However, women who have experienced pregnancy and childbirth may be especially prone to developing them. Carrying and delivering a baby involves forceful pressure which can cause the veins to swell. For many women, the veins will never shrink to where they were before childbirth.

Symptoms of hemorrhoids

If your hemorrhoids are not bothering you, we don’t need to bother them. But if they become inflamed, painful, or uncomfortable, they can impact your quality of life and should be addressed medically. Symptoms of inflamed hemorrhoids may include:

• Itching or irritation in the anal or rectum region
• Shooting pain or a burning sensation during bowel movements
• Swelling in and around the anus
• Bleeding or bright red blood noted on toilet paper after bowel movements

External hemorrhoids often bring on abrupt pain. Bleeding and a formed clot that stretches the skin of the anal area are the cause of the pain.

Internal hemorrhoids are graded on a scale of one to four, with symptoms that increase in severity as the grade does. They’re rarely painful, although you can experience some bleeding and burning.

Grade 1: Painless rectal bleeding

Grade 2: Pain and discomfort from prolapsing or protruding from the anal opening

Grade 3: Pain and discomfort from prolapsing or protruding from the anal opening that requires you to manually push them back inside

Grade 4: Pain and discomfort from hemorrhoids that are stuck in the prolapsed position and generally require surgery

Consult your primary care or family doctor if you are experiencing these signs and symptoms. Most of the time, they’re indications of hemorrhoids, which a primary care doctor can treat successfully. In some cases, however, your doctor may choose to refer you to a gastroenterologist, or a colorectal specialist or surgeon.

Diagnosis

Hemorrhoids are usually visible to a physician who is conducting a physical exam. In some cases, it may be necessary to undergo a colonoscopy to gather more information and confirm what type of medical treatment is ideal. Some of the most common procedures performed to gather this information are colonoscopies, sigmoidoscopies, and anoscopy.

Treatment

The goal of hemorrhoid treatment is to make you more comfortable by reducing your symptoms. Getting help early for hemorrhoids can improve your quality of life and also help identify and address potentially serious problems quickly and safely. Working with a healthcare provider ensures you undergo a thorough evaluation and receive a plan of care to treat and permanently resolve the problem.

At-home remedies for hemorrhoid symptoms

Your doctor will likely recommend increasing the amount of fiber in your diet. Food recommendations to increase your fiber intake include:

• Vegetables and fruits (especially fruits with peels)
• Foods with bran and oats (for example bran cereal or oatmeal)
• Nuts (chia seeds, flax seeds, pumpkin seeds, and almonds)
• Berries (raspberries, blackberries, strawberries, and blueberries)

Increasing your daily fluid intake can also help control or reduce constipation. Higher fluid consumption makes the stool softer and less painful to pass. Adults should drink 48 to 64 ounces of fluid per day. A stool softener or laxative can also be helpful to minimize straining during bowel movements.

Your healthcare provider may also recommend witch hazel pads, such as Tucks pads, which draw water from the hemorrhoids and can be soothing. Warm baths can also help to temporarily reduce discomfort.

Additionally, exercise aids the body in moving waste out appropriately. Our experts recommend going for a walk, bike ride, swim, or participating in other aerobic exercises as a way of achieving good colon health.

Hemorrhoid creams and ointments

If you continue to suffer from hemorrhoids despite at-home remedies and adding more fiber and fluid into your diet, your healthcare provider can suggest other treatment options. For example, an over-the-counter cream, ointment, or other medication may bring temporary relief. Preparation H is probably the most well-known topical therapy for external hemorrhoids available at your local drugstore, although there are many others. Internal hemorrhoids may be better treated with suppositories (creams or medicines inserted into the rectum). However, hemorrhoid creams typically don't cure the hemorrhoid or prevent future flair-ups.

If you try these measures for a few weeks with no improvement, or if your symptoms change suddenly, seek additional guidance from your primary care physician, gastroenterologist, or a colorectal specialist.

Minimally invasive procedures and surgery

If you have severe or recurrent internal hemorrhoids, your provider may recommend an outpatient procedure, such as rubber band ligation. This involves placing a tiny rubber band around the internal hemorrhoid. The band cuts off blood flow to the hemorrhoid, causing it to fall off several days later. It’s a bit uncomfortable, but it’s not painful.

Uncommonly, surgery may be an option if all other treatments have failed. Surgery can be more painful than the hemorrhoid itself, so surgical options are reserved for the most severe cases. Your doctor will explain the risks and benefits of your options so you can make an informed treatment decision.