Volume 9, Number 7 SAINT MARY’S COLLEGE HEALTH AND WELLNESS SERVICES April 2005
Hemorrhoids are swollen veins in the lower rectum and anus. The anus is at the end of the rectum and is the opening through which bowel movements pass from your body. Hemorrhoids are a common problem. Another name for them is piles. Hemorrhoids may be internal (inside the rectum) or external (around the anus). Internal hemorrhoids are often painless but they sometimes cause a lot of bleeding. The internal veins may stretch and even fall down (prolapse) through the anus to outside the body. The veins may then become irritated and painful. External hemorrhoids can be seen or felt easily around the anal opening. When the swollen veins are scratched or broken by straining, rubbing, or wiping, they sometimes bleed.
HOW DO THEY OCCUR? Veins in the rectum and around the anus tend to swell under pressure. Hemorrhoids can result from too much pressure on these veins. You may put pressure on these veins by: straining to have a bowel movement when you are constipated; waiting too long to have a bowel movement; sitting for a long time on the toilet, which causes strain on the anal area; coughing and sneezing often; or by sitting for a long while. Hemorrhoids may also develop from: diarrhea, obesity, injury to the anus and some liver diseases. Flare-ups of hemorrhoids may occur during periods of stress or as a result of overuse of alcohol. Some people inherit a tendency to have hemorrhoids. Pregnant women should try to avoid becoming constipated because they are more likely to have hemorrhoids during pregnancy. In the last trimester of pregnancy, the enlarged uterus may press on blood vessels and cause hemorrhoids. Also, the strain of childbirth sometimes causes hemorrhoids after birth.
WHAT ARE THE SYMPTOMS? Symptoms of hemorrhoids include:
•
itching, mild burning, and bleeding around the anus (for example, you might
see bright red blood on toilet paper after wiping)
•
swelling and tenderness around the anus
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pain with bowel movements
•
painful lumps around the anus ranging in size from a pea to a walnut (in severe
cases).
HOW ARE THEY DIAGNOSED? Your health care provider will examine your rectum and anus. Your provider may use a special light tool called a proctoscope or anoscope to look inside the rectum.
HOW IS IT TREATED? The following treatments usually help to relieve most cases
of hemorrhoids:
•
High-fiber diet – Eat more high-fiber foods, which will help prevent
constipation. Good sources of fiber include fresh fruit; raw or cooked vegetables,
especially asparagus, cabbage, carrots, corn, and broccoli; and whole-grain
cereals with bran, such as shredded wheat or bran flakes.
•
Fluids – Drink plenty of fluids, especially water. Every day drink six
to eight 8-ounce glasses of fluid (not alcohol). Fluid helps to soften bowel
movements so they are easier to pass.
•
Sitz baths and cold packs – Sitting in lukewarm water 2 or 3 times a
day for 15 minutes cleans the anal area and may relieve discomfort. (If the
bath is too hot, swelling around the anus will get worse.) Also, you might
try putting a cloth-covered ice pack on the anus for 10 minutes, 4 times a
day.
•
Medications – For mild discomfort, your health care provider may prescribe
cream or ointment for the painful area. The cream may contain witch hazel,
zinc oxide, or petroleum jelly. Your provider may also prescribe medication
suppositories to put inside the rectum.
•
Procedures and surgeries – A number of procedures can be used to remove
or shrink hemorrhoids. If you have protruding internal hemorrhoids, you health
care provider can do a procedure called hemorrhoid banding. Your provider will
put a tight band around the enlarged vein and either cut the hemorrhoid open,
remove the blood clot, and let the vein heal, or let the hemorrhoid dry up
and fall off. This method is effective in most cases. Other methods include
destroying the hemorrhoid by freezing, electrical or laser heat or infrared
light. Or your provider may shrink the hemorrhoid by injecting a chemical around
the vein. For severe cases of hemorrhoids, a surgical procedure called a hemorrhoidectomy
may be done. For this procedure you are first given an anesthetic to prevent
you from feeling pain. Then your provider cuts the inflamed part of the hemorrhoid
and removes it.
HOW LONG WILL THE EFFECTS LAST? Usually hemorrhoids do not pose a danger to your health. In most cases the symptoms go away in a few days. The painful lumps of more severe cases should get better in a couple of weeks.
HOW CAN I TAKE CARE OF MYSELF? Always tell your health care provider when
you have rectal bleeding. Although bleeding may result from hemorrhoids, more
serious illnesses, such as colon cancer, can also cause bleeding. Follow these
guidelines to help prevent hemorrhoids and relieve discomfort:
•
Do not strain during bowel movements. The straining makes hemorrhoids swell.
•
Follow your high-fiber diet and drink plenty of water.
•
Don’t over use laxatives. Diarrhea can be as irritating to the anus as
constipation.
•
Ask your health care provider what nonprescription product you should buy to
relieve pain and itching. Also, ask about any side effects of any medications
prescribed to you.
•
Exercise regularly to prevent constipation.
•
Avoid a lot of wiping after a bowel movement if you have hemorrhoids. Wiping
with soft, moist toweled paper may relieve discomfort.
•
Avoid lifting heavy objects when you have hemorrhoids. It may increase the
pressure on the veins and make the hemorrhoid worse.