Hemorroids
Hemorrhoids are caused by a displacement of tissues, veins and ar teries located in the anus and rectum area. Although they can be painful and uncomfortable, hemorrhoids are usually not a serious problem.You can suffer from hemorrhoids at any age, but they appear more frequently with aging. In younger people, they occur in pregnant women or women who have just given birth. More than 50% of North Americans suffer or have suffered from hemorrhoids.
External or internal?
Hemorrhoids vary depending on their location and the severity of the pain or discomfort they cause.
Internal hemorrhoids are located inside the rectum. They generally do not cause pain since this area does not have sensory nerves.
External hemorrhoids are located under the skin, very close to the anal aperture.They can swell, itch and be ver y painful, especially during a bowel movement. When the hemorrhoids are external and cannot be pushed back inside, a medical consultation is necessary.
Mixed hemorrhoids are a combination of internal and external hemorrhoids.
What causes hemorrhoids?
The exact cause is unknown, but many factors contribute to their development.
You are more at risk of suffering from hemorrhoids if:
- You are constipated or strain when evacuating stool. Constipation leads to compression of the internal tissues that can cause hemorrhoids.
- Your diet lacks fibre, which can cause constipation.
- You are pregnant or have given birth. The pressure of the fetus can lead to internal hemorrhoid problems. As well, labour exerts additional pressure that frequently prolongs the symptoms after delivery.
- You frequently lift heavy loads. Lifting weights and the strain required to do so exert pressure on hemorrhoids.
- You sit for long periods of time.
What are the symptoms of hemorrhoids?
The symptoms of hemorrhoids are:
- Inflammation.
- Pain or burning sensation, especially with external hemorrhoids.
- Light bleeding.
- Discomfort.
- Itching, especially with external hemorrhoids.
There are more serious problems that require medical consultation, namely, heavy bleeding and/or thrombosis, pain lasting more than seven days, an indication that the hemorrhoids are infected.
How do I get relief?
- Prevent or relieve constipation. Increase your liquid and fibre intake (prunes, apples, pears, corn, carrots, whole grain cereal). If your hemorrhoids are not serious, these dietary changes may be enough. If you do not get relief, try a fibre supplement such as Metamucil® (mixed with a sufficient amount of water) or stool softener such as sodium docusate (Colace®, etc.). For more information on constipation, consult the PJC Friendly Advice on this topic.
- Avoid straining during defecation or staying on the toilet for a long time.
- After each bowel movement, wash the affected area with water and mild soap or apply compresses. Rinse thoroughly and dry.
- If your hemorrhoids have come out of the anus, cold compresses can reduce inflammation.
- Take a sitting bath in lukewarm water (around 40ºC) for about 15 to 20 minutes, three or four times a day, to relieve the pain.
- Do not sit for long periods of time. Take short walks, get up and stretch at regular intervals.
- Use an eggshell-type cushion to sit on. Donut-shape cushions could be unstable if the size is not right for your body.
- Avoid activities that require lifting heavy loads.
- Avoid foods known to cause hemorrhoids such as spicy food, nuts, coffee and alcohol.
- Exercise and lose weight if necessary.
What medications provide relief and treat the problem?
A number of over the counter products are available to relieve symptoms and treat hemorrhoids:
- Hamamelis water (Tucks®) compresses help relieve the discomfort, burning sensation and itching caused by hemorrhoids.
- Local anaesthetics (Anusol Plus®, etc.) relieve the pain temporarily but rapidly.
- Astringent agents (Preparation H® gel, etc.) protect the affected area from irritation, decrease inflammation and relieve burning or itching sensations.
- Protective agents (Preparation H® cream, etc.) form a barrier on the skin and decrease inflammation.
- Anti-inflammator y agents (Cor tate®, etc.) relieve itchiness and reduce inflammation of external hemorrhoids.
- Moist pads (Cottonelle Fresh™ Folded Wipes, etc.) can be used after each bowel movement to clean the affected area and avoid infections.
- If the pain is too uncomfortable, analgesics such as acetaminophen (Tylenol®, Atasol®, etc.) or ibuprofen (Motrin®, Advil®, etc.) can provide relief and complement the action of topical medications.
When dealing with external hemorrhoids, ointments are more effective than suppositories, which lodge too deeply in the rectum.
Hemorrhoids can potentially lead to more serious complications like excessive bleeding, infection or thrombosis. If such problems arise, or if the hemorrhoids last more than 7 days, see your doctor.
If you have any questions about hermorrhoids, prevention and treatment, do not hesitate to consult your pharmacist.
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