The Colon & Rectal Clinic of Ft. Lauderdale
One reason people do not talk about hemorrhoid problems with their doctor is because they anticipate a painful, traditional hemorrhoid surgery.
A minimally invasive surgical approach now available in the United States, called Procedure for Prolapse and Hemorrhoids (PPH), may help patients recover from hemorrhoid surgery faster with less pain when compared to conventional hemorrhoidectomy procedures.
Our Frequently Asked Questions section refers to United States-based generally standard and accepted practices. As always, please check with your healthcare provider to determine their practices, guidelines, and what they recommend for you.
Each of us has veins, or hemorrhoids, within the anus that tend to stretch under pressure, somewhat like varicose veins in the legs. It is believed these veins exist to protect and cushion the anal canal. When these veins swell and descend into the anal canal, they are considered “prolapsed.” One set of veins is inside the rectum (internal hemorrhoids) and another is under the skin around the anus (external hemorrhoids).
A number of factors contribute to hemorrhoidal issues — constipation with prolonged straining and pregnancy are two of the most common causes. With aging, the muscles and other anatomic structures that support the tissue weaken and help contribute to the prolapse of the hemorrhoid.
There are two types of hemorrhoids — internal and external.
Internal hemorrhoids usually are not painful, but may bleed. Sometimes, an internal hemorrhoid may stretch until it bulges outside the anus. This is called a prolapsed hemorrhoid. A prolapsed hemorrhoid can go back inside the rectum on its own over time, or it can be gently pushed back inside. If the prolapsed hemorrhoid cannot be pushed back inside, consultation with a physician about surgical treatment options is necessary.
External hemorrhoids involve the veins around the anus. They can be itchy or painful and can sometimes crack and bleed. If a blood clot forms, one may feel a tender lump on the edge of the anus, and see bright red blood on toilet paper or in the toilet after a bowel movement.
Symptoms of hemorrhoids, both external and internal, include:
Aching after a bowel movement
Anal or rectal itching
Bright red blood on toilet tissue or in toilet bowl
Appearance of anal tissue pads or sensitive lumps
Consult your physician if you experience any of these hemorrhoid symptoms.
Hemorrhoids are one of the most common ailments for men and women alike — affecting more than half the population at some point in their lives. Onset commonly occurs after the age of 30, but hemorrhoids are reported in people of all ages. More than 525,000 patients in the United States are treated annually for symptomatic hemorrhoids6. Of these, approximately 10–20 percent will require surgical treatment for the condition.
Hemorrhoids can affect men and women alike; however an individual may be more likely to get hemorrhoids as they age or if their parents had them. Pregnant women often get hemorrhoids because of the strain from carrying the baby and from giving birth. For most women, such hemorrhoids are a temporary problem. Obesity, straining during bowel movements, sitting too long on the toilet, or standing or lifting too much can make hemorrhoids worse. Constipation is oftentimes the main cause of hemorrhoids.
The following are tips for hemorrhoid prevention:
Include more fiber in your diet. Fresh fruits, leafy vegetables, and whole-grain breads and cereals are good sources of fiber.
Drink plenty of fluids (except alcohol). Eight glasses of water each day is ideal.
Do not read on the toilet. Sitting and straining too long encourages swelling.
Exercise regularly.
Avoid laxatives, except bulk-forming laxatives, such as Fiberall®, Metamucil®, etc. Other types of laxatives can lead to diarrhea, which can worsen hemorrhoids.
When you feel the need to have a bowel movement, don’t wait for long periods before using the bathroom.
Take warm soaks three or four times a day.
Clean your anus after each bowel movement by patting gently with moist toilet paper or moistened pads, such as baby wipes.
Use ice packs to relieve swelling.
Use acetaminophen (Tylenol®), ibuprofen (Motrin®), or aspirin to help relieve pain.
Apply a cream that contains witch hazel to the area or use a numbing ointment. Creams that contain hydrocortisone can be used for itching or pain.
If you find you are struggling with hemorrhoid symptoms, it is important to visit your physician to correctly identify the problem. The physical evaluation to confirm a diagnosis of hemorrhoids should include observation, palpation, and anoscopic examination.