Though rarely if ever life-threatening, hemorrhoids are no laughing matter. At the very least, they can be a source of itching irritation, discomfort, bleeding and – more rarely – overt pain. Studies and estimates suggest that 4% to 5% of people in the US will experience hemorrhoids at some point in their life, with peak prevalence being in the ages of 45 to 65 years.
The hemorrhoids are a set of blood vessels present in everyone in and around the anus. In common usage, however, the term “hemorrhoids” is used when one or more of these vessels become swollen and problematic. The human body has both internal and external hemorrhoid veins and either set, or both, can become swollen and inflamed. Internal hemorrhoids can bleed and itch, but usually don’t hurt, while the external ones can itch or be slightly painful and may or may not bleed. Presence of blood on the toilet paper is a common symptom in addition to the discomfort. Blood in the stool, especially in the absence of swollen hemorrhoids visible to a doctor’s inspection, can also be an indication of colorectal cancer. Therefore the presence of blood on either the stool or toilet paper is something to have checked by your doctor if it is recurring on a regular basis.
Problems with the hemorrhoids are caused by increased pressure to the anal area, such as when pushing out hard stool on a regular basis or during pregnancy and as a result of giving birth. Thus it is not uncommon for women who have given birth to develop hemorrhoids of a temporary nature. The pressure of pushing in the abdomen causes blood to pool in the hemorrhoidal veins, enlarging and irritating them. The physical stress of passing hard stool or wiping too hard can cause them to break open slightly and bleed. It used to be thought that hemorrhoids were like varicose veins, but in the anus, but this is not the case. Modern evidence suggests that weakening of the tissues around and supporting the hemorrhoid veins may contribute to their becoming swollen. This is the basis for a treatment of severe hemorrhoids called sclerotherapy, in which chemicals are injected near and around the veins themselves, causing the supporting tissue to form scar tissue and become more firm. (“Sclero” means hard.) Fortunately, the majority of sufferers will not need such therapy.
There are a number of simple home approaches hemorrhoid sufferers can take to treat their condition. The most basic treatment is to drink more water and get more fiber in one’s diet, as lack of these contributes to hard stool. The fiber need not be a commercial fiber supplement, as one can simply eat more foods high in fiber such as fruits and vegetables. These foods also contain compounds called flavonoids, which have beneficial effects on hemorrhoids – and the rest of the body as well – independent of fiber. There are also non-prescription topical medications that one can apply. Some of these simply contain 1% hydrocortisone, a common steroid anti-inflammatory that may relieve itching and some pain. Others contain phenylephrine, which causes veins to constrict, becoming smaller. Even a plain petroleum jelly such as Vaseline can offer relief by minimizing the rubbing and chafing of hemorrhoids that can occur when a person walks. If over-the-counter hydrocortisone seems to help but not enough, a doctor may prescribe a 2% or 2.5% hydrocortisone ointment. However long term use of this level of steroid, such as beyond two weeks, is not recommended – and fortunately usually not needed.
Surgery and other procedures such as ‘banding’ of the hemorrhoids (a doctor tying them off) are treatments of last resort for the minority of patients who do not respond to dietary changes and topical medications. Recovery from surgical removal of hemorrhoids is typically slow and painful, and therefore done as seldom as possible. Remember, a small amount of blood, such as faint streaks, on the toilet paper once in a while is not a cause for alarm, but larger and more persistent amounts of bleeding are something it is best to tell your doctor about. Chances are good that such a problem can be quickly remedied.
Colonoscopy.com provides people with a listing of available gastroenterologists in their area, giving individuals with colorectal concerns access to an information portal where they can find credible and unbiased medical advice.