Paul E. Broderick, DO, FAOCPr, a Franciscan Health board-certified proctologist at Franciscan Physician Network Proctology in Martinsville, Carmel and Mooresville and a Fellow of the American Osteopathic College of Proctology, answers your questions and shares expert insight about hemorrhoids.
What Are Hemorrhoids?
Hemorrhoids are swollen and inflamed veins around your anus or in your lower rectum. These groups of vessels are at the end of your GI tract, and if they become inflamed, enlarged, and irritated they can cause a whole variety of symptoms.
There are two types of hemorrhoids and the symptoms will vary depending on the type.
External hemorrhoids are under the skin around the anus and are therefore visible. Because there are more sensitive nerves in this part of the body, they are normally more painful. Straining when passing a stool may cause them to bleed. If you have external hemorrhoids, you may have:
- Anal itching
- One or more hard, tender lumps near your anus
- Anal ache or pain, especially when sitting
Too much straining, rubbing, or cleaning around your anus may make your symptoms worse. For many people, the symptoms of external hemorrhoids go away within a few days.
Internal hemorrhoids are deep inside the rectum and not visible from outside. They are normally painless. Often, the first sign that internal hemorrhoids are present is rectal bleeding. If you have internal hemorrhoids, you may have:
- Bleeding from your rectum - bright red blood on stool, on toilet paper, or in the toilet bowl after a bowel movement
- A hemorrhoid that has fallen through your anal opening, called prolapse
Can I Prevent Hemorrhoids?
There are factors that can help avoid hemorrhoids from forming:
- Eating foods that are high in fiber can make stools softer and easier to pass and can help treat and prevent hemorrhoids.
- Drinking water and other liquids, such as fruit juices and clear soups, can help the fiber in your diet work better.
- Staying active, which is good for the GI tract.
- Avoiding spending a lot of time on the toilet, if possible
How Can I Treat Hemorrhoids?
You can most often treat your hemorrhoids at home by
- Eating foods that are high in fiber
- Taking a stool softener or a fiber supplement
- Drinking water or other nonalcoholic liquids each day
- Not straining during bowel movements
- Not sitting on the toilet for long periods of time
- Taking over-the-counter pain relievers such as acetaminophen or ibuprofen
- Sitting in a tub of warm water, called a sitz bath, several times a day to help relieve pain
- Over-the-counter hemorrhoid creams or ointments or using suppositories—a medicine you insert into your rectum
When Should I See A Doctor About Hemorrhoids?
If your symptoms do not relieve after one week after using over-the-counter products, you should see your physician. There are nonsurgical and surgical options for treating hemorrhoids.
In general, most doctors try not to exercise surgical options until they've extinguished the nonsurgical options, or if somebody presents at a level that is just so advanced or they've suffered with it so long that surgery is the only option.
Hemorrhoid banding or ligation
A procedure that doctors use to treat bleeding or prolapsing internal hemorrhoids. A doctor places a special rubber band around the base of the hemorrhoid. The band cuts off the blood supply. The banded part of the hemorrhoid shrivels and falls off, most often within a week. Scar tissue forms in the remaining part of the hemorrhoid, often shrinking the hemorrhoid
A doctor uses a tool that directs infrared light at an internal hemorrhoid. Heat created by the infrared light causes scar tissue to form, which cuts off the blood supply, often shrinking the hemorrhoid.
By Ariel Anderson
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