How to ease the pain of hemorrhoids

Hemorrhoids can be particularly uncomfortable, even if they are not dangerous or life-threatening. However, the discomfort is easy to treat.

Hemorrhoids are caused by a movement of tissues, veins and arteries located in the anus and rectum. Although they can be painful and uncomfortable, hemorrhoids are usually not dangerous. 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 very 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 passing stool. Constipation leads to a compression of the internal tissues that can cause hemorrhoids;
  • your diet lacks fibre, which can increase the risk of constipation;
  • you are pregnant or have given birth. The pressure of the fetus can lead to internal hemorrhoid problems. What’s more, the labour involved in childbirth adds more pressure—this is what 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 stay seated for long periods of time.

What are the symptoms of hemorrhoids?

Symptoms of hemorrhoids include:

  • inflammation;
  • pain or burning sensation, especially with external hemorrhoids;
  • light bleeding;
  • discomfort;
  • itching, especially with external hemorrhoids.

How to relieve your symptoms

  • 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 these foods aren’t enough to relieve your symptoms, 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 section on this topic.
  • Avoid straining during defecation, or staying seated 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 came out of the anus, cold compresses can reduce inflammation.
  • Take a sitz bath in lukewarm water (around 40ºC) for about 15 to 20 minutes, three or four times a day, to relieve the pain.
  • Do not stay seated for long periods of time. Take short walks, get up and stretch at regular intervals.
  • Sit on an eggshell-type cushion. Avoid donut-shaped cushions, as they put pressure on the rectal and anal regions and aggravate hemorrhoids.
  • Avoid activities that require lifting heavy loads.
  • Avoid foods known to cause hemorrhoids such as spicy foods, nuts, coffee and alcohol.
  • Exercise and lose weight if necessary.

What medications relieve and treat the problem?

There are a number of effective, over-the-counter products that you can use to relieve  your symptoms and treat your hemorrhoids:

  • Witch hazel pads (Tucks®) help to relieve the discomfort, burning sensation and itching caused by hemorrhoids;
  • Local anesthetics (Anusol Plus®, Nupercainal® etc.) relieve the pain temporarily but rapidly;
  • Astringent agents (Preparation H® cooling gel, etc.) protect the affected area from irritation, decrease inflammation, and relieve burning and itching sensations;
  • Protective agents (Preparation H® cream, ointment or suppositories, etc.) form a barrier on the skin and decrease inflammation;
  • Anti-inflammatory agents (Cortate®, etc.) relieve itchiness and reduce inflammation of external hemorrhoids;
  • Wet wipes (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 be used as a complement to topical medications.

When dealing with external hemorrhoids, it’s better to use creams and ointments rather than suppositories, which tend to float too far up 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.

Don’t hesitate to ask your pharmacist if you have any questions on the  prevention and treatment of hemorrhoids.