Hemorrhoids: A Common Ailment with Frequent Questions

What are hemorrhoids? What causes hemorrhoids?

Hemorrhoids are swollen and inflamed veins in the rectum or anus. Older adults are usually affected, and an increased pressure in the veins of the anus may lead to or worsen the condition.

  • Hemorrhoids can occur inside the rectum (internal hemorrhoids) or near the anal opening (external hemorrhoids).

When a hemorrhoid pushes through the anal opening, it is known as a protruding or prolapsed hemorrhoid. External hemorrhoids can form swollen and painful blood clots.

Why are hemorrhoids so common?

Although hemorrhoids can be painful and irritating, they are not usually a serious condition.

  • Hemorrhoids have been reported to occur in up to 75 percent of people in the U.S.

Straining during bowel movements is the most common cause of hemorrhoids, with rectal bleeding as the most common symptom. Increased anal pressure in pregnancy, diarrhea, constipation, excessive sitting or inactivity (for example - long hours at the computer), and being overweight can all increase the risk for hemorrhoids.

Hemorrhoids can be a pain! What are typical hemorrhoid symptoms?

Painful bowel movements, itching, hard lumps, rectal bleeding, and swelling are common symptoms of hemorrhoids. Internal hemorrhoids can lead to bleeding from straining and constipation, and may push through the anal opening.

  • If you see blood after a bowel movement or develop severe pain, contact your doctor to rule out a more serious condition.

  • Blood clots may also form in hemorrhoids. Bleeding hemorrhoids usually leave a bright red color on the toilet paper, in the stool or in the toilet bowl.

Are there different types of hemorrhoids?

Hemorrhoids may occur on the inside or outside of the body.

  • Internal hemorrhoids occur just inside the anus at the beginning of the rectum and cannot usually be seen or felt by a doctor. These internal hemorrhoids may push through the anus and result in external hemorrhoids.
  • External hemorrhoids occur at the anal opening and may protrude outside of the anus. Both hemorrhoid types can occur at the same time. Be sure to visit your healthcare provider for a diagnosis, especially if bleeding occurs.

What are the options to help prevent hemorrhoids in the first place?

Lifestyle changes can help to prevent hemorrhoids. Avoid sitting for prolonged periods of time; take a break at least every two hours.

  • Eat foods high in fiber, such as fresh fruits, vegetables and whole grains, or use a fiber supplement.

Drink plenty of water and get regular exercise. If needed, stool softeners or laxatives can be used short-term for constipation and may help to prevent the development of hemorrhoids. If constipation is a chronic problem, see your doctor.

What are the best drugs or home remedies to treat hemorrhoids?

Treatments for hemorrhoids such as hemorrhoid creams, ointments, sprays and suppositories can be purchased at the pharmacy. These products may contain a local anesthetic for pain, a corticosteroid for itching, or a topical vasoconstrictor to decrease swelling.

  • Talk to your healthcare provider if you need creams or suppositories for longer than one week.

Common brands include Preparation H, Americaine, and Tronolane - although generic brands are available and will cost less.

What else can be done to help relieve hemorrhoids?

OTC remedies won't cure hemorrhoids, but can offer relief. Other options include soaking in a warm sitz bath of water only. Moist toilettes specifically made for hemorrhoids can be used after a bowel movement. Avoid straining during a bowel movement; adding fiber to the diet can help alleviate straining.

  • Avoid taking medications that can lead to constipation.

If these actions do not seem to relieve your symptoms, it may be time to visit with your healthcare provider to discuss other options.

What if the home remedies don't work for hemorrhoids?

If an over-the-counter hemorrhoid treatment is not effective, and the hemorrhoid causes significant pain or bleeding, you may need a minimally invasive procedure to shrink or remove the hemorrhoid.

  • Clot removal, rubber band ligation, and sclerotherapy are all options.

These procedures are usually performed as day surgery, and may only require a local anesthetic.

Which surgical procedures are used for the remedy of hemorrhoids?

  • Your physician will be able to examine you and tell you about your best options.

Rubber band ligation is the most common procedure for internal hemorrhoids and is effective in about 75 percent of patients. A rubber band is placed on the hemorrhoid to cut off the blood supply, and in a few days the hemorrhoid dies and falls off. A hemorrhoidectomy can be effective in up to 95 percent of patients for treatment of hemorrhoids, but is usually reserved for larger internal hemorrhoids.

What's the bottom line on hemorrhoids?

Remember, hemorrhoids are a common topic in healthcare worth discussing.

Prevention is key here. Staying at a normal weight, avoiding long periods of sitting, not straining during a bowel movement, and extra fiber in your diet can help to prevent hemorrhoids. If you see blood during a bowel movement (http://www.drugs.com/cg/rectal-bleeding.html), contact your doctor to rule out any complications. Consider using over-the-counter remedies and warm sitz baths for minor symptoms, but don't hesitate to seek out advice from your doctor, too.

Sources:

  1. U.S. Food and Drug Administration. Consumer Updates. Searching Online for ‘Hemorrhoids’? February 2013. Accessed 4/15/2013. http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm338906.htm
  2. National Digestive Diseases Information Clearinghouse (NDDIC). Hemorrhoids. April 2012. Accessed 4/15/2013. http://digestive.niddk.nih.gov/ddiseases/pubs/hemorrhoids/

Last updated: 2013-04-21 by Leigh Anderson, PharmD.

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