How to Relieve Hemorrhoids: Causes, Symptoms, Treatments

Hemorrhoids are dilated veins that form in the anus or rectum. It’s normal for the veins in the anal area to swell slightly when you have a bowel movement. However, hemorrhoids differ in that they remain permanently dilated. About 1 in 2 adults over the age of 50 have hemorrhoids. The primary causes include constipation, pregnancy, and the loss of tissue tone with age. In pregnant women, symptoms often resolve after childbirth. Symptoms are occasional and easily recognizable: itching near the anus, discomfort when sitting, and bleeding during bowel movements. Typically, a hemorrhoid episode lasts a few days before symptoms subside. Most individuals can manage symptoms with home treatments and over-the-counter medications. For persistent pain or discomfort, medical treatment may be necessary.

Understanding Hemorrhoids

External vs. Internal Hemorrhoids

External Hemorrhoids appear under the skin at the opening of the anus, causing swelling and sensitivity due to the presence of numerous nerve fibers. The risk of a blood clot forming in these veins is higher than with internal hemorrhoids.

Practical Tip: To ease discomfort, soak in a warm sitz bath for about 15 minutes several times a day. This can reduce swelling and provide relief from itching.

Internal Hemorrhoids develop inside the anus or the lower rectum. They are classified by their stage of development and can progress if untreated:

• First degree: The hemorrhoid remains inside the anus.

• Second degree: The hemorrhoid protrudes during defecation but retracts afterward.

• Third degree: The hemorrhoid must be gently pushed back after defecation.

• Fourth degree: The hemorrhoid cannot be pushed back inside.

Case Study: A patient experiencing third-degree hemorrhoids found relief through dietary changes and regular sitz baths, which managed symptoms and prevented progression to a fourth degree.

Recognizing Hemorrhoid Symptoms

Symptoms to watch for include:

• Burning, itching, or discomfort in the anal area.

• Bleeding and slight pain during defecation.

• A sensation of swelling inside the rectum.

• Mucus discharge from the anus.

• Protruding tender lumps (with internal hemorrhoids of the 2nd, 3rd, or 4th degree).

People at Risk

Certain groups are more susceptible to developing hemorrhoids:

• Those with a family history of hemorrhoids.

• Pregnant women.

• Women who have had vaginal deliveries.

• Individuals with liver cirrhosis.

Risk Factors

Several factors increase the likelihood of developing hemorrhoids:

• Chronic constipation or diarrhea.

• Obesity.

• Prolonged toilet sitting.

• Regular heavy lifting.

• Engaging in anal intercourse.

Preventative Measure: Maintain a healthy weight through diet and exercise, and avoid prolonged sitting periods, especially on the toilet.

Possible Complications

Severe pain often indicates a blood clot within a hemorrhoid, known as hemorrhoidal thrombosis. This condition, while painful, usually resolves within 1 to 2 weeks with pain relievers and emollient laxatives. After the clot clears, a small, painless swelling called a mariscus may form. Rarely, ulceration or significant blood loss can occur, leading to anemia.

Important Note: Seek medical attention for any anal bleeding, even if mild, as it could indicate another condition or a more serious problem.

Prevention Strategies

Dietary Adjustments

Increasing dietary fiber is the best prevention strategy. Fruits, vegetables, cereals, and whole grains are excellent fiber sources. Gradually incorporate these into your diet to soften stools and ease their passage. Drink plenty of water daily.

Example: Begin your day with a high-fiber breakfast, such as oatmeal topped with berries or a smoothie containing kale and flaxseeds.

Regular Physical Exercise

Engage in about 20 minutes of brisk walking daily to stimulate intestinal transit. Avoid sitting for extended periods; stand or walk briefly every hour.

Practical Advice: Set a timer to remind yourself to stand or walk hourly, especially if you work at a desk.

Intestinal Hygiene

Regular bowel movements are crucial. Don’t delay defecation, as waiting hardens stools. Avoid straining or holding your breath during bowel movements, and limit time spent on the toilet.

Tip: If regularity is a challenge, consider natural stool softeners or increase fiber intake.

Prevent Recurrence

Consider fiber supplements like psyllium (Metamucil®, Fibropur®, Prodiem®) if necessary. These can be taken long-term without issue. Ensure adequate fluid intake to prevent digestive tract blockage. Avoid non-fiber laxatives.

Basic Care and Advice

Maintain anal area cleanliness by showering or bathing daily. After bowel movements, use water-soaked toilet paper or damp cloths for gentle cleaning. Avoid scented toilet paper.

Itch Relief: Apply cold compresses to the anus for 10 minutes, 3-4 times a day. If a clot or hemorrhoid has descended, take a sitz bath in warm water for 10-15 minutes, 2-3 times daily for relief. Sit-in baths designed for toilets are available in pharmacies. Dry gently and apply unscented powder to keep skin dry.

Wear cotton underwear as synthetic fabrics retain moisture. Avoid irritants like coffee, alcohol, strong mustard, hot pepper, and other strong spices until hemorrhoids heal. Avoid heavy lifting to reduce vein pressure.

Treatments for Hemorrhoids

Most minor symptoms respond well to symptomatic treatment. Local creams or suppositories, combined with dietary and hygiene practices, can alleviate discomfort and aid stool passage. Combat constipation and ensure adequate hydration.

For moderate to severe cases, consult a doctor. Systemic treatments like analgesics, anti-inflammatory drugs, or venotonics may be prescribed. In herbal medicine, Horse chestnut is indicated for hemorrhoidal crises.

Specialized Interventions: For persistent cases, procedures like rubber band ligation, which cuts off hemorrhoid blood supply, causing it to wither, may be necessary. Sclerotherapy, injecting a chemical solution to shrink the hemorrhoid, is another option.

Patient Experience: A patient who underwent rubber band ligation reported minimal discomfort and quick recovery, highlighting its effectiveness for second-degree hemorrhoids.

Managing Lifestyle and Emotional Wellbeing

Emotional Impact

Hemorrhoids can affect emotional wellbeing, causing anxiety or embarrassment. Open communication with healthcare providers and support networks is crucial. Remember, hemorrhoids are common and manageable.

Stress Management

Stress can exacerbate symptoms. Practice relaxation techniques like deep breathing, meditation, or yoga to reduce stress and promote bowel regularity.

Clothing Choices

Opt for loose-fitting clothes and cotton underwear to keep the anal area dry and reduce irritation.

Long-term Management

Even after symptoms subside, continue preventive measures to avoid recurrence. Adopting a healthy lifestyle with balanced nutrition and regular exercise is essential for long-term management.

By implementing preventative measures and appropriate treatments, many can manage symptoms and significantly improve their quality of life. A healthy lifestyle with a balanced diet and regular physical activity is key to preventing hemorrhoids’ onset and recurrence.