hHemorrhoids aren’t exactly a conversation starter, but you or someone you know has likely dealt with them. In fact, there’s a good chance they’re sitting next to you at the dinner table: It’s estimated that nearly 50% of all people will have hemorrhoids by age 50.
Despite their ubiquitous presence, there are many misconceptions about hemorrhoid treatment. And since many people feel self-conscious about seeing a doctor for hemorrhoids, they don’t always get the help they need.
Many treatment options and lifestyle changes can relieve troublesome hemorrhoids. Here’s what colorectal surgeons want you to know.
Technically, everyone has hemorrhoids. “Hemorrhoids in themselves are actually part of normal anatomy, so [they’re] There is nothing to be ashamed of. We are born with hemorrhoidal tissue,” says Dr. Titi Adegbwega, chief of colorectal surgery at South Shore University Hospital in Long Island. “When people say they ‘have hemorrhoids,’ what they’re really saying is this. . It’s normal now that he’s acting weird or bothering me.”
Sometimes called “piles,” these are cushions of tissue in the anal canal that help support the uterus. Hemorrhoids are usually caused by constipation or anything that increases pressure inside the abdomen, such as pregnancy and childbirth, says Dr. David Greenwald, director of clinical gastroenterology and endoscopy at Sinai Hospital.
Hemorrhoids may cause symptoms when they become swollen or inflamed. They are either internal (inside the anal canal) or external. “External hemorrhoids often feel like a lump, while internal hemorrhoids are invisible except that they protrude beyond the rectal opening,” he says. Common symptoms of hemorrhoids include itching, bleeding, and back pain.
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Internal hemorrhoids can be uncomfortable but usually not very painful. “External hemorrhoids, on the other hand—they’re a pain in the butt,” Adegbwega says. “You feel them, they itch, they itch.” For small external hemorrhoids, these symptoms last for a few days. However, when people have external hemorrhoid thrombosis — which is a blood clot that forms — the severe pain can last three to five days, and the symptoms gradually subside over three weeks, Adegbwega says.
If you have severe pain around the clock (especially after bowel movements), the most likely culprit is a rectal fissure, which refers to a tear in the lining of your anus. “It’s a cut, and like when you have a wound, there’s always pain associated with that wound,” Adegbwega says.
Inflammation of the rectum, usually caused by local infections, is another possible diagnosis for rectal discomfort and may be accompanied by fever or flu-like symptoms.
This is why seeing a colorectal surgeon is essential if you have such issues. Reviewing your history can help guide doctors toward a possible diagnosis.
Hemorrhoids often grow on their own. Additionally, “there are a variety of management options that don’t involve surgery or any procedures that can alleviate your hemorrhoid symptoms,” Adegbwega says.
Here is what doctors recommend if you have hemorrhoids.
Loosen your stool
Constipation is one of the main causes. “Hemorrhoids are blood vessels, and they’re very delicate,” says Dr. Albert Chung, a colorectal surgeon in private practice in Orange County, California, and founder of the YouTube channel “Your Friendly Proctologist.”
When these blood vessels become inflamed, symptoms can occur. That’s why Chang’s first line of attack is implementing a lifestyle to ensure loose stools 90-95% of the time. “It’s impossible to have 100%, because life is like that,” he says. But Chang says you can develop more loose stools that are easy to pass by focusing on getting enough fiber, water and exercise.
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Greenwald also endorses lifestyle remedies to prevent constipation: get at least 25 grams of fiber per day, ensure adequate fluid intake (typically defined as 64 ounces or more of fluid per day), and Engage in 30 minutes or more of regular exercise. Unfortunately, Greenwald says, doctors routinely see patients rely on medications for symptomatic relief of hemorrhoids without addressing the root cause of the problem, which is often stress and constipation. Only making these lifestyle changes can be “effective in preventing hemorrhoids” in the first place.
Some people may also benefit from adding a stool softener, fiber supplement, or both to their routine. Here are a few popular options:
- Document the sodium Adegboyega says, (Kulas) is a useful laxative if constipation is triggering your hemorrhoids.
- Psyllium husk fiber (which you can buy in unflavored powder form or under brand names like Metamucil), acts as a sponge, helping to drain water in your GI tract and keep things moving, Adegbwega explains. . When you take psyllium husk you need to increase your water intake, he says; If not, it can make the stool more bulky.
- Polyethylene glycol (MiraLAX), an osmotic laxative, and chestA stimulant is toxins, other medications that doctors prescribe.
Talk to your doctor about which of these—if any—is the best option for you.
Loosening your stool can happen in a variety of ways, but don’t overlook the simple: “Some people just need to drink more water,” he says.
Use a pooping stool
Although we take bowel movements for granted, having one is a complex process that requires the coordination of many body parts and processes, Chang explains. “The pelvic floor muscles require complete relaxation, which involves lowering the pelvic floor on the toilet bowl and opening the internal rectal sphincter,” so stool can flow freely, she says.
In this modern age, Adegbwega says, people spend long hours sitting on the toilet on their phones, which is not good for hemorrhoids. While toilet reading is an old habit, limit your time on the toilet to a few minutes. “You can also use a step stool to help place you in a more upright position, which reduces the need for excessive straining,” adds Adegbwega. If you don’t want to buy a stool designed to be used during bowel movements like a squatty potty or a tushi ottoman, you can try a footrest or even a yoga block or two.
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Following bowel movements, doctors also recommend a “sitz bath” for those struggling with hemorrhoids. It’s more of a toilet bowl that you fill with warm water to sit on after a bowel movement to help relax your rectal area. Or you can just take a warm bath for 10-15 minutes. “It generally helps soothe the area and helps with swelling,” says Adegbwega. Some people also find it helpful to put an ice pack on the area, which can have a numbing effect.
Try an anticonvulsant
If it seems too good to be true, it probably is. “Potions” sometimes advertised on the Internet to treat hemorrhoids should be avoided, Greenwald says.
Adegbwega says stick to doctor-trusted creams and suppositories, such as Preparation H, “which can provide a really good amount of relief,” and temporarily reduce hemorrhoid tissue. Lidocaine is another good choice, he says, because its direct purpose is to help with pain and itching. Witch hazel pads also help reduce symptoms.
When you see a doctor for hemorrhoids, they often prescribe hydrocortisone, a steroid medication that helps with inflammation, Adegbwega says. You can buy it over the counter at 1% strength, but “most of the time we give it as a prescription, it’s 2.5%,” either in cream form or suppository version.
See a doctor
i didIf your hemorrhoid symptoms don’t resolve on their own in two to four weeks with home remedies, Chang says it’s time to see a doctor.
Adegbwega similarly points to the need to see a health care provider if your hemorrhoids are persistent: either your primary care physician, gastroenterologist, or colorectal surgeon. (Many women also believe in their gender.) That’s because telling a doctor you have rectal pain doesn’t confirm a diagnosis without a thorough examination, including a review of your patient history and symptoms. Digital test.
“It’s important for this area to be evaluated to make sure that what we call hemorrhoids are actually hemorrhoids that are causing these symptoms,” says Adegbwega. Follow-up tests such as a flexible sigmoidoscopy or colonoscopy may also be recommended to rule out serious stomach conditions, polyps or colon cancer.
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Chung estimates that 90% of his patients come to him with hemorrhoids, and of the 14 million views on his YouTube channel, his most popular videos are related to hemorrhoids, such as “External Hemorrhoids Treatment” and ” How to create a routine and avoid surgery.”
Before your appointment, do your homework. Research, go on Reddit, visit online forums to learn more, Chang advises. “People think that Dr. Google is scary. I think, Dr. Google is useful, because it gives you more questions to ask the doctor when you finally see them.
Surgical interventions and other treatment methods
The treatments discussed above—from nutritional supplements to salts—often take effect quickly, typically within five to seven days, Greenwald says. However, some hemorrhoids will not respond to anti-inflammatory suppositories and creams and may require additional treatment including applying heat therapy, a rubber band ligation technique that cuts off blood flow to internal hemorrhoids, and even surgery (hemorrhoidectomy ), he says. .
Some doctors prefer to perform surgical intervention only as a last resort. “Hemorrhoids are rarely life-threatening and never turn into cancer,” says Chang. Unless you’re losing so much blood that you’re severely anemic, or you have painful chronic hemorrhoids, Chang prefers to avoid surgery on his patients. “The biggest thing is training. I train them with gentle pooping so they can be successful.
As Chang eloquently puts it, “Bleeding from your hand doesn’t bother anyone, but if it’s coming from your butt, people are already going to the phone, going to the Internet to find a solution.”
For many people, it’s because they’re worried about colorectal cancer, a disease that’s on the rise among young people. But doctors stress that depending on circumstances — such as your age, family history of colon cancer,, And when you have your last colonoscopy – is key. “Rectal bleeding is one of the most common symptoms of colorectal cancer, but it’s also the most common symptom of hemorrhoids,” says Adegbwega. This is why medical care issues are sought, because it is difficult to determine what is causing the bleeding without assessing the bigger picture.
Of course, it’s natural to feel concerned when you see blood in your stool. “Most of the time, this bleeding isn’t something serious like cancer; it’s usually from hemorrhoids,” Adegbwega says. When you have bleeding hemorrhoids, the blood will be bright red, because the hemorrhoids are at the end of the rectal canal. “The bleeding itself is a very small part of the puzzle.”
When in doubt, err on the side of caution and book that appointment. “It’s important for people not to be embarrassed about seeking help for anal and rectal problems,” says Greenwald. “Like I always say, don’t die of shame.”
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