To heal following surgery or to prevent hemorrhoids from recurring, any underlying constipation should be treated by using stool softeners and laxatives, drinking plenty of liquids, eating foods that are high in fiber, and/or taking a fiber supplement.
Dryness may aggravate hemorrhoids and may cause excessive bleeding. Never use a dry tissue to wipe the affected area as it may cause unwanted scratches that can worsen the swollen vessels. Instead use a non-perfumed, non-medicated wet tissue to wipe off without drying out your skin. You may also place vitamin E capsules in the opening of the anus to sooth the area and re-hydrate it.
Much less invasive than hemorrhoidectomy surgery, hemorrhoid ligation, also called hemorrhoid banding, is a simple process that can be performed in a doctor’s office in just minutes with little discomfort and most patients returning to work the same day. Effective for the treatment of both internal hemorrhoids and external hemorrhoids, hemorrhoid banding offers patients a permanent and painless solution to the discomfort and recovery time associated with other hemorrhoid removal options.
If you are older than age 50 or have a family history of colon cancer, it is a good idea to tell your doctor any time you have new rectal bleeding, notice blood on your stools, have changes in bowel habits, or have anal pain. These symptoms may be signs of colon cancer or other conditions. Your doctor may recommend screening tests to see if you have a more serious problem. See the Examinations and Tests section of this topic.
Hemorrhoids can often be effectively dealt with by dietary and lifestyle changes. Softening the feces and avoiding constipation by adding fiber to one’s diet is important, because hard feces lead to straining during defecation. Fruit, leafy vegetables, and wholegrain breads and cereals are good sources of fiber, as are bulk laxatives and fiber supplements such as Metamucil or Citrucel. Exercising, losing excess weight, and drinking six to eight glasses a day of water or another liquid (not alcohol) also helps. Soap or toilet paper that is perfumed may irritate the anal area and should be avoided, as should excessive cleaning, rubbing, or wiping of that area. Reading in the bathroom is also considered a bad idea, because it adds to the time one spends on the toilet and may increase the strain placed on the anal and rectal veins. After each bowel movement, wiping with a moistened tissue or pad sold for that purpose helps lessen irritation. Hemorrhoid pain is often eased by sitting in a tub of warm water for about 10 or 15 minutes two to four times a day (sitz bath). A cool compress or ice pack to reduce swelling is also recommended (the ice pack should be wrapped in a cloth or towel to prevent direct contact with the skin). Many people find that over-the-counter hemorrhoid creams and foams bring relief, but these medications do not make hemorrhoids disappear.
You are more likely to get hemorrhoids if you have infrequent bowel movements. Fiber contributes to a healthy digestive system and regular unstrained bowel movements. Dr. Murrell recommends 20-25g of fiber a day. There are natural fiber supplements such as psyllium husks but traditionally green vegetables, legumes and fruits are a healthy source of fiber.
When you visit your doctor, you will probably be asked to describe your symptoms. The doctor will perform an examination to see whether your anus is inflamed, and whether enlarged hemorrhoids are present.
Many patients have been referred for surgery because they have severely swollen prolapsed hemorrhoids or very large external skin tags. When questioned, the patients are asymptomatic. Treat hemorrhoids only if they cause problems for the patient. Similarly, patients often ask when they should have surgery. Remind them that their hemorrhoids do not bother anyone else, and they should opt for aggressive treatment only when symptoms become bothersome.
It can also be done with a spinal anesthetic block while you are awake (similar to an epidural injection given during childbirth), or with a combination of relaxing and sedating drugs given intravenously (IV) and a local anesthetic injected around the anus.
Considering fiber’s impact on stool size, you must first eliminate dietary fiber and fiber laxatives from your diet! There are three key properties of fiber — bulk, acidity, and gases (the last two from fermentation) — that make it such a disastrous choice for those living with hemorrhoidal disease:
Perrotti P, Antropoli C, Molino D, De Stefano G, Antropoli M. Conservative treatment of acute thrombosed external hemorrhoids with topical nifedipine. Dis Colon Rectum. 2001 Mar. 44(3):405-9. [Medline].
Hemorrhoid or haemorrhoid (also commonly called piles) are vascular structures (similar to veins) in the anal canal which help with stool evacuation. We only speak of hemorrhoids (or piles) when they become swollen or inflamed. But Hemorrhoids are a normal part of the anatomy and everyone has these structures. They act as a cushion that is made of complex tissue. Their job is to aid the passage of stool. Hemorrhoids are very common. Nearly three out of four adults will have hemorrhoids from time to time.
It is important to see your doctor if you notice bleeding from your rectum. You need to make sure the cause is hemorrhoids and not some other problem. Bleeding from your rectum or anus or bloody stools may be a sign of something more serious such as cancer.
Exercise is helpful in relieving constipation and in decreasing pressure on the hemorrhoidal veins. Individuals should be encouraged to have a bowel movement as soon as possible after the urge arises and not sit on the toilet for long periods of time. Once that urge passes, stools can become constipated and straining with a bowel movement may occur.
Remember that while this might be a little embarrassing and uncomfortable, hemorrhoid exams are usually painless. Also, your doctor is accustomed to caring for this sort of problem, which is very common.
Take over-the-counter pain medication. Many people with hemorrhoids experience pain, especially during bowel movements. If you’re experiencing pain because of hemorrhoids, try taking an over-the-counter pain reliever, like acetaminophen, in conjunction with topical treatments.
Medication for hemorrhoids is a major industry, but there is little proof that medications actually improve this condition. In some cases, they can relieve pain and swelling using a combination of anti-inflammatory agents and pain-killers. Sadly, reducing the recurrence of this condition is not that easy.
Healing oils appears to be working. I’m about one third the way through the bottle. The discomfort has decrased quite a lot. I’m being patient with the healing process, as stated in the instructions. Thanks for what apprears to be a good therapeutic product. * – “Tony”
Sometimes the symptoms of enlarged hemorrhoids are so bad that treating the symptoms alone is no longer enough. Then there are various procedures that can be done to remove the tissue that is causing problems.Hemorrhoids are normal “cushions” of tissue filled with blood vessels, found at the end of the rectum, just inside the anus. If they become enlarged, they can cause unpleasant symptoms. The most suitable type of treatment will mainly depend on the size of the hemorrhoids and the severity of symptoms. Each approach has its own advantages and disadvantages. Depending on the procedure, side effects can occur – some more severe than others.Sclerotherapy and “rubber band ligation” (“banding”) are generally carried out as day procedures, without an anesthetic. If someone has grade 3 or grade 4 hemorrhoids, doctors often recommend surgery. A general or local anesthetic is usually needed for this. You then have to stay in the hospital for a few days, and stay off work for some time too.
Preliminary findings appear to indicate that the novel technique of retroflexed endoscopic monopolar coagulation of grade II-III internal hemorrhoids is safe and effective, and it may be seamlessly incorporated into the end of a colonoscopy for the evaluation of hematochezia.  In a study involving 100 patients, investigators reported a 5% postprocedure complication rate (3% bleeding, 2% pain; all managed conservatively) and a 6% recurrence rate at a median follow-up of 3 years.
Some people, especially children, intentionally withdraw stools to avoid pain. This habit may lead to fecal impaction — a formation of a large lump of solidified feces (fecaloma) inside the rectum or the colon. Fecal impaction in the rectum requires manual —with a finger — disimpaction, a procedure that has the potential to cause even more emotional and physical trauma, particularly for a child. Fecal impaction inside the colon may require emergency surgery to resolve it [link].
Horse chestnut is commonly used as an herbal remedy for poor blood flow and swelling. According to research published in Alternative Medicine Review, horse chestnut has been shown to improve microcirculation, capillary flow and vascular tone, all of which are helpful for how to get rid of hemorrhoids. (9)
Like mainstream practitioners, alternative practitioners stress the importance of a high-fiber diet. To prevent hemorrhoids by strengthening the veins of the anus, rectum, and colon, they recommend blackberries, blueberries, cherries, vitamin C, butcher’s broom (Ruscus aculeatus), and flavonoids (plant pigments found in fruit and fruit products, tea, and soy). Herbal teas, ointments, and suppositories, and other kinds of herbal preparations, are suggested for reducing discomfort and eliminating hemorrhoids. In particular, pilewort (Ranunculusficaria), applied in an ointment or taken as a tea, can reduce the pain of external hemorrhoids. Acupuncture, acupressure, aromatherapy, and homeopathy are also used to treat hemorrhoids.
There are several natural home remedies, for example warm Sitz baths, dietary changes, stool softeners, and exercise, to treat hemorrhoids. OTC or prescription medicine or surgery may be required to repair the hemorrhoids, for example, rubber band ligation, sclerotherapy, laser therapy, hemorrhoidectomy, and stapled hemorrhoidectomy.
Stapled hemorrhoidopexy involves a special device, called stapler, which lifts and fixates the prolapsed hemorrhoids. The stapler will also excise mucosal tissue to block the blood flow to the remaining hemorrhoids. However, stapling procedure is associated with a greater risk of recurrence.
Simillis C, Thoukididou SN, Slesser AA, Rasheed S, Tan E, Tekkis PP. Systematic review and network meta-analysis comparing clinical outcomes and effectiveness of surgical treatments for haemorrhoids. Br J Surg. 2015 Dec. 102 (13):1603-18. [Medline].
TIMOTHY MOTT, MD, FAAFP, is Family Medicine Specialty Leader to the Surgeon General of the U.S. Navy at Naval Hospital Pensacola (Fla.). Dr. Mott is also an associate professor of family medicine at the Uniformed Services University of the Health Sciences in Bethesda, Md….
Coagulation — this technique uses either laser, infrared light, or heat (bipolar) treatments to shrivel and harden the inflamed hemorrhoids. Coagulation has few side effects, but often has a high rate of recurrence compared to rubber band ligation.
Although people assume that any anal pain while using the toilet is hemorrhoids, there are a number of other anorectal disorders that can cause symptoms, including dermatologic diseases, diverticulitis, abscess and fistula, fissure, sexually transmitted diseases, warts, HIV, infections and inflammatory ulcers. These conditions will be ruled out by your doctor when you go for a rectal exam if they aren’t the cause.
Hemorrhoids are a common problem and most often may be treated by a primary care provider, internist, emergency or urgent care provider. Surgeons may need to operate to remove enlarged or inflamed hemorrhoids.
Apply products that contain medicine to numb an area (local anesthetic). These products often have the suffix “-caine” in the name or the ingredients. Although these products help some people, especially those who have painful external hemorrhoids, some people become allergic to them. Ask your doctor before using products.
In most cases constipation can be handled by taking fiber and drinking water but sometimes a laxative is necessary. Steer away from taking laxatives that stimulate the intestine as these can actually increase the pressure in the area and cause symptomatic hemorrhoids. Try osmotic laxatives instead.
The conjugated billiary salts form in the gallbladder from bile, and are the precursors of gallbladder stones. Fat-free or low-fat diets and obstruction of the duct that connects the gallbladder to the duodenum contribute to formation of gallstones. The obstruction itself may be caused by salts, stones, inflammation, or a combination of all three.