Preventing Hemorrhoids: An Ounce of Prevention is Worth a Pound of Cure

The topic of hemorrhoids is not the easiest discussion to have whether you’re talking to a family member or your doctor. Hemorrhoids are medically defined as swollen veins in the rectum or anus, inside or outside of the anal canal. For many, hemorrhoids can go unnoticed until they start bleeding.

Taking preventive measures not only reduces the risk of developing hemorrhoids, but also the risk of possible complications.

Hemorrhoid Symptoms

Hemorrhoids typically affect adults, but can develop in younger individuals. They’re caused by repeated pressure on the rectal and/or anal veins, which causes those veins to stretch and occasionally lose their attachment to the rectal wall.  When this happens, they may prolapse, or protrude from the anus.

Hemorrhoid signs and symptoms to watch for include:

  • Discharge, itching, and pain following bowel movements
  • Swelling or a lump felt around the anus
  • A sensation that you still “have to go” after a bowel movement
  • Rectal bleeding – a smear or streak of blood can often be seen on toilet paper, or in the toilet water.  It’s typically bright red and can be seen in or on the stool.

The majority of hemorrhoids, as well as those that produce the most symptoms, are located inside the anus. Those that occur outside the anus are known as prolapsed hemorrhoids and are typically located near the anal opening.

Often, because the majority of internal hemorrhoids are painless, the first indication that you have an internal hemorrhoid is the sign of blood in the stool or toilet water. An external hemorrhoid may not be noticed until the hemorrhoid forms a blood clot that can range from pea-sized to walnut-sized. The bulge of the hemorrhoid itself may have a bluish tinge to it.

In the majority of cases, hemorrhoids and the pain they cause are prevalent for a day or two up to 10 days , but typically dissipate within 2 weeks as the blood clot dissolves.

An external or prolapsed hemorrhoid is more obvious and those patients who experience them often state that they can feel the mass protruding from the anus.

Hemorrhoid Diagnosis

Hemorrhoids are typically diagnosed through visual signs of rectal bleeding, or a rectal exam performed by a proctologist, also known as a colorectal surgeon.  An anoscope (a lighted tube) may also be inserted into the rectum to visually examine the anal canal. In most cases, the physician will suggest a colonoscopy or sigmoidoscopy to rule out colon cancer.

Preventing Hemorrhoids

A number of steps can help prevent hemorrhoids:

  • Resist the urge to rush a bowel movement.  Avoid straining as well as prolonged sitting on the toilet.
  • Increase fiber in your diet (recommending 25 to 30 g daily).
  • Drink eight to 10 glasses of fluids daily.
  • If overweight or obese, talk to your doctor about a safe weight loss program.
  • Exercise regularly.

For most, rectal bleeding caused by a hemorrhoid is intermittent, and many hemorrhoids clear upon their own.  However, risks of developing hemorrhoids increase with:

  • Lack of dietary fiber
  • Obesity
  • Pregnancy
  • Chronic diarrhea or constipation
  • Prolonged sitting or standing
  • Diagnosis of colon cancer
  • Liver disease
  • Anal sex

If left untreated, some hemorrhoids, depending on severity and number, can result in inflammation or infection.  At times, a blood clot in the hemorrhoid can contribute to severe pain. Chronic bleeding caused by hemorrhoids can contribute to an increased risk of anemia.

Hemorrhoid Treatment Options

For intermittent hemorrhoids or small hemorrhoids, home treatment options often involve measures to relieve discomfort. This can be achieved by sitting in warm water for 10 to 20 minutes several times daily.  Your physician may recommend bed rest and application of ice packs to the anal area to reduce the swelling and accompanying pain of a blood clot or swollen hemorrhoid.

Over-the-counter or prescription hemorrhoid medications and creams applied externally can reduce itching, reduce swelling, and relieve minor pain. Cotton pads soaked in witch hazel may ease itching, and hemorrhoid creams that contain lidocaine can temporarily relieve pain, while preparations containing hydrocortisone can relieve inflammation.

A physician may recommend a stool softener, coupled with a well-balanced and nutritious diet that contains a variety of high-fiber foods. Increased water intake is often recommended; up to half a gallon (approximately 2L) of water a day may reduce hard stools and ease bowel movements without straining.

When such approaches to treatment do not relieve symptoms or decrease the size, discomfort, or possible bleeding of hemorrhoids, surgery may be recommended.

If you believe you have hemorrhoids, or find bowel movements painful or difficult, schedule a visit with your physician.  An ounce of prevention is worth a pound of cure.