Treatment and Prevention of Hemorrhoids

It’s a more common problem than people know, because we usually don’t talk about it: hemorrhoids. An estimated 50% of all people will have this condition, also known as “piles,” at some point in their lives. Five percent of the population has them at any given time, so in a room of twenty or so adults, somebody there probably has them. (It’s best to not test this, however!) They are very uncommon in children and somewhat more common among Caucasians than other races.

Hemorrhoids are normal veins that sit just above and right around the anal opening, the internal and external hemorrhoid veins, respectively. Either of these sets of veins can become swollen and enlarged and cause problems. Piles usually announce their presence by way of itching or pain in the anal area or with blood on toilet paper or on the stool in the toilet. Seeing this can be a bit shocking but it’s usually not especially serious. In cases of this when the person has no symptoms of hemorrhoids it’s worth checking in with the doctor, to rule out the possibility of colorectal cancer.

The first step in treatment is to clean the area gently but well – moist towelettes (“wipes”) are a good choice, some even medicated for the condition. The application of hydrocortisone, found in most over-the-counter remedies helps to shrink the veins and also prevents further irritation by lubricating and minimizing friction in the area. Other lubricants can help if based on petrolatum (‘Vaseline’), while clear lubricants for use in sex will not work as well. Increasing the amount of fiber and liquid in one’s diet can help if the hemorrhoids are accompanied by constipation. Taking a laxative is not recommended as it can cause diarrhea, which can irritate the area further. For both cleaning and comfort, sitting in a warm bath can help. Sitting on a cold pack and taking over-the-counter pain relievers can help in cases of pain.

When hemorrhoids persist longer than a week despite taking all the measures above, a trip to the doctor can be helpful. The doctor will in some cases prescribe a topical anti-inflammatory stronger than hydrocortisone, in addition to ruling out a more serious condition. Hydrocortisone itself should not be used on a single area for more than a week, because it can weaken tissues. An option for persistent hemorrhoids is rubber band ligature – the doctor basically tying off the veins at their most swollen points and allowing that portion of tissue to die. The dead piece(s) will fall off naturally in about a week. After-effects of this quick office procedure can include mild to medium pain and a false feeling of needing to make a bowel movement. As above, pain is treated with cold packs and standard pain killers. Only in the most serious cases are the hemorrhoids surgically removed. This is done under full anesthesia and has a longer recovery period than banding.

To avoid getting hemorrhoids in the first place – or to keep them from coming back – it’s important to avoid things that can stimulate their swelling. This means trying to avoid constipation, straining while defecating, or sitting idly for long periods on the toilet. Pregnancy and giving birth can cause or exacerbate hemorrhoids because of the straining and pushing. While this cannot be avoided, hemorrhoids associated with pregnancy usually disappear after giving birth, though the remedies given above can help speed this up.

Diet is also very important for prevention of hemorrhoids. Make sure you get plenty of fiber in your foods, meaning more fruits and vegetables. You can also find the amounts of fiber listed with the nutritional information given on food packaging. Taking a fiber supplement such as psyllium or methylcellulose can help keep stool soft and prevent constipation. It’s also important to drink plenty of liquids, especially water, because even mild dehydration can lead to constipation. Dehydration is sometimes perceived as hunger, so when hungry between meals try a glass of water or some other healthy drink first instead of snacking. This can also help a person lose weight, something that is also reported to help with hemorrhoids – a real two-for-one benefit.

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