Whom Do Hemorrhoids Affect
Although most people think hemorrhoids are abnormal, almost everyone has them. Hemorrhoids help control bowel movements. Hemorrhoids cause problems and can be considered abnormal or a disease only when the hemorrhoidal clumps of vessels enlarge.
Hemorrhoids occur in almost everyone, and an estimated 75% of people will experience enlarged hemorrhoids at some point. However only about 4% will go to a doctor because of hemorrhoid problems. Hemorrhoids that cause problems are found equally in men and women, and their prevalence peaks between 45 and 65 years of age.
Treatment Of External Hemorrhoids At Home
Home remedies for external hemorrhoids that you can apply include:
- Take a warm bath
- Clean the anus very gently after defecation, it is recommended to use a damp cloth or cotton cloth
- Apply an ice pack to the anus to reduce swelling
- Use over-the-counter pain relievers such as paracetamol, ibuprofen to relieve discomfort
- Apply some ointment, hemorrhoid cream with hydrocortisone or witch hazel extract
You can refer to the article “12 home remedies for hemorrhoids for women”.
How Do You Stop Hemorrhoids From Flaring
Here are six self-help tips to ease hemorrhoid pain and promote healing:
- Eat high-fiber foods. Eat more fruits, vegetables and whole grains.
- Use topical treatments. Apply an over-the-counter hemorrhoid cream or suppository containing hydrocortisone, or use pads containing witch hazel or a numbing agent.
- Soak regularly in a warm bath or sitz bath.
- Take oral pain relievers.
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Can Hemorrhoids Be Prevented Or Avoided
Just about everyone has hemorrhoids at some time. But some things may make you more likely to get them. People whose parents had hemorrhoids may be more likely to get them. Pregnant women often get hemorrhoids because of the strain from carrying the baby and from giving birth. Being very overweight or standing or lifting too much can make hemorrhoids worse.
What To Do With External Hemorrhoid Bleeding
Bleeding with external hemorrhoids is a normal symptom. As external hemorrhoids swell, the anal tissue is stretched. This causes the tissue to become thin as it stretched. Further irritation to the external hemorrhoid, such as having a bowel movement, can lead to bleeding.
While bleeding from external hemorrhoids is not a cause for concern, it is important to make sure that you have been checked by your medical provider. Because other sources of anal bleeding can be very concerning, make sure that your hemorrhoids have been determined to be the source of bleeding.
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External Hemorrhoid Itch Relief
External hemorrhoids can become extremely itchy. The itching may even affect your quality of life.
There are ways to relieve and soothe the symptoms of itching. One way is to have a sitz bath.
A sitz bath involves sitting in a few inches of warm water for 15 minutes several times a day.
This reduces swelling that causes itching.
Additionally, applying a cold pack or ice pack like hemorrwedge can numb the area and bring down swelling that causes itching.
Key Points To Remember
- Home treatments for hemorrhoids work for most people: Eat more fibre, drink more fluids, use a stool softener, and use ointments to help your symptoms.
- When home treatments don’t work on internal hemorrhoids, fixative procedures may help. These are treatments that involve cutting off the blood flow to the hemorrhoids using rubber bands, lasers, heat, or electrical currents. These procedures are usually less painful than surgery.
- You might consider surgery to remove hemorrhoids for internal hemorrhoids that bulge from the anus or external hemorrhoids that are causing symptoms and have not improved with home treatment.
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What Causes The Symptoms Of External Hemorrhoids
External hemorrhoids cause symptoms in two ways. First, acute thrombosis of the underlying external hemorrhoidal vein can occur. Acute thrombosis is usually related to a specific event, such as physical exertion, straining with constipation, a bout of diarrhea, or a change in diet. These are acute, painful events.
Pain results from rapid distention of innervated skin by the clot and surrounding edema. The pain lasts 7-14 days and resolves with resolution of the thrombosis. With this resolution, the stretched anoderm persists as excess skin or skin tags. External thromboses occasionally erode the overlying skin and cause bleeding. Recurrence occurs approximately 40-50% of the time, at the same site . Simply removing the blood clot and leaving the weakened vein in place, rather than excising the offending vein with the clot, will predispose the patient to recurrence.
External hemorrhoids can also cause hygiene difficulties, with the excess, redundant skin left after an acute thrombosis being accountable for these problems. External hemorrhoidal veins found under the perianal skin obviously cannot cause hygiene problems however, excess skin in the perianal area can mechanically interfere with cleansing.
Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 6th ed. Philadelphia, Pa: Elsevier 2006. 1509-12.
BARRON J. Office ligation treatment of hemorrhoids. Dis Colon Rectum. 1963 Mar-Apr. 6:109-13. .
External And Internal Hemorrhoids
Internal hemorrhoids are far enough inside the rectum that you can not normally see or feel them. Generally they do not hurt because you have few nerves sensitive to pain. Bleeding may be the only sign of them.
External hemorrhoids are under the skin around the anus, where there is much more sensitivity to nerve pain, so they tend to hurt as well as bleed.
Sometimes prolapsed hemorrhoids can be bigger and protruding from the anal sphincter, which makes you sick. You may be able to see them as wet protuberances that are more pink than the surrounding area.
And they are more likely to hurt, at the time of excretion. Prolonged hemorrhoids usually come back on their own. Even if they do not, you can often push them gently back into place.
A blood clot can form in an external hemorrhoid, turning it purple or blue. This is called a thrombosis.
It can hurt, itch a lot and it could bleed. When the clot dissolves, you may still have some excess skin, which could be irritated.
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Cure For External Hemorrhoid Thrombosis
There are a number of treatments for external hemorrhoid thrombosis. The most common of these are non-surgical treatments such as using stool softeners, increasing your intake of fiber, taking more fluid everyday and adopting warm baths.
Also, there are some newer and more conservative treatment options that are available today and among them are topical nifedipine. This treatment offers better and quick results than lidocaine ointment which has been the preferred choice of treatment for many years now.
Surgery is also an effective choice of treatment for external hemorrhoid thrombosis. This is especially the case if its in an acute condition. This kind of surgery can be done in an outpatient department of a hospital or in the doctors clinic. The result for those who opt for surgery is quick and has scored a high level of satisfaction and acceptance among patients.
Your doctor will recommend a method of treatment after evaluating you. Depending on whether the condition is mild, serious or moderate, the right treatment will be recommended.
Medicines For Treating Piles
Theres a range of medicines that can help to relieve the symptoms of piles. Always read the patient information leaflet that comes with your medicine and ask your pharmacist for advice if you have any questions.
- If youre passing hard poo, a fibre supplement such as ispaghula husk or mild laxative such as lactulose will soften it.
- Over-the-counter painkillers, such as paracetamol, may help to ease any pain from piles. Dont take painkillers that have an opioid in them , as these could make you constipated and add to your problems.
- Soothing creams, ointments and suppositories may ease any pain and itchiness from piles. There are lots of different products available over the counter. Some contain a local anaesthetic such as lidocaine. Only use these for a few days as they may affect the sensitivity of your skin ask your pharmacist for more information.
- Products that contain corticosteroids, such as Anusol HC and Proctosedyl, may reduce swelling and pain. Dont use these for more than a week as they can damage the skin around your anus. Most are available over the counter and others on prescription.
It can sometimes take up to a month for self-help measures and medicines to work. If your symptoms dont improve after this time, contact your GP. They may refer you to a specialist.
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Origin Of External Hemorrhoids
The most common cause of external hemorrhoids occurs when the effort is repeated in a bowel movement. In this sense, hemorrhoids develop when the veins of the rectum or anus dilate or enlarge.
These dilatations can be internal or external. External hemorrhoids are usually found under the skin surrounding the anus.
What Causes Recurring Hemorrhoids
In many cases, hemorrhoids can be recurring. You may wonder why your hemorrhoids have come back, but unless you have treated your hemorrhoids with surgery, it is likely you will experience flare-ups.
The common causes of flare-ups are the same causes of hemorrhoids in general:
- Straining during bowel movements
- Sitting or standing for prolonged periods of time
- Chronic constipation
- Frequently lifting heavy objects
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How To Treat External Hemorrhoids
The best ways to treat external hemorrhoids are through conservative measures like adopting the lifestyle changes mentioned above. You may also find over-the-counter or prescribed stool softeners and laxatives helpful.
Other treatment options are all about reducing the discomfort of the symptoms. Applying ice packs or cold compresses to the area can help with swelling and relieve irritation. A sitz bath provides relief by soaking the rectal area in warm water for 15 minutes three or four times per day. You can use your bathtub filled with two-to-three inches of warm water, or a shallow plastic basin available at drug stores, specifically designed for this. The basin fits over the toilet and allows you to soak only the rectal area.Remember, dont add anything to the warm water unless directed by a doctor. A sitz bath is an excellent first treatment option because it is non-invasive and can bring immediate, frequent relief.
Over-the-counter pain relievers such as Ibuprofen and Tylenol can also be used to reduce pain. Ointments, pads, or suppositories that contain medications can also temporarily relieve itching and pain. While you can self-administer many of these treatments, please note that creams with hydrocortisone shouldnt be used for more than a week. If your symptoms havent improved, you should stop using the cream and talk with your doctor about other treatment options.
When To Seek Medical Advice
See your GP if you have persistent or severe symptoms of haemorrhoids. You should always get any rectal bleeding checked out, so your doctor can rule out more potentially serious causes.
The symptoms of haemorrhoids often clear up on their own or with simple treatments that can be bought from a pharmacy without a prescription . However, speak to your GP if your symptoms don’t get better or if you experience pain or bleeding.
Your GP can often diagnose haemorrhoids using a simple internal examination of your back passage, although they may need to refer you to a colorectal specialist for diagnosis and treatment.
Some people with haemorrhoids are reluctant to see their GP. However, theres no need to be embarrassed, because GPs are very used to diagnosing and treating haemorrhoids.
Read more about diagnosing haemorrhoids.
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How To Remove External Hemorrhoids Without Surgery
Although some external hemorrhoids will require surgery, there are many ways to treat hemorrhoids without surgery.
Focusing on your hygiene is one way to relieve hemorrhoids.
Thoroughly cleaning your anus after a bowel movement, avoiding straining during bowel movements, and regular use of a stool softener can help with the healing process.
Keeping a close eye on your eating and drinking habits can help as well. You should have a healthy, balanced diet that is rich in fiber. Additionally, you should drink the right amount of water daily to keep yourself hydrated. Avoid prolonger periods of sitting as well.
Who Is At Risk For External Hemorrhoids
If your parents have had hemorrhoids, you may be more likely to have them as well. Hemorrhoids may also be caused by pregnancy.
As we age, hemorrhoids can occur due to increased pressure caused by sitting a lot. And anything that causes you to strain during bowel movements can lead to external hemorrhoids.
If youre not sure what the cause of your hemorrhoids may be, your doctor might be able to determine why.
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Can Natural Home Remedies Treat And Prevent Hemorrhoids
Regardless of the size or swelling of a hemorrhoid, no treatment is required if symptoms do not exist. Prevention is perhaps the most effective treatment. Diet and adequate hydration are very important to maintain normal bowel movements. Hemorrhoid symptoms can occur with the passage of hard stool and constipation, as well as diarrhea and frequent bowel movements. People with constipation may require a high-fiber diet, adequate hydration, and stool softeners. Those with too frequent bowel movements may require antidiarrheal medications and diet adjustments. These preventive measures decrease the amount of straining that is required to have a bowel movement, thus decreasing the pressure within the blood vessels to prevent swelling. The internal hemorrhoid always stays protruded or prolapsed and is at risk for thrombosis or strangulation should the anal muscles go into spasm.
Grade 1 hemorrhoids are treated symptomatically. There can be some spasm of the anal muscles. Warm sitz baths, sitting in a warm tub for 20 minutes, two or three times a day may be helpful. Avoiding spicy food may also prevent anal itching. Over-the-counter medications may be helpful.
What Are The Risks Of Treatments For Hemorrhoids
Most non-surgical treatments have few risks. Possible problems may include:
- Pain or discomfort. For some people, the pain may be so bad that they will not be able to do their normal activities for a day or so.
- Bleeding, which may require another doctor visit to treat.
- Temporary trouble urinating because of pain. If you are completely unable to urinate, you’ll need treatment.
- Infection or abscess.
Rubber band ligation appears to cause more pain than other types of non-surgical procedures. Infrared photocoagulation usually causes fewer side effects.footnote 2
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Symptoms Of External Hemorrhoids
One of the first symptoms people may notice with external hemorrhoids is bright red blood in their stool. The bright red blood is typically seen in the toilet or on toilet paper after a bowel movement. Any amount of bleeding can feel scary, but this rectal bleeding is often painless and doesnt typically involve a large amount of blood. Dark blood or blood that appears to be formed in the stool should be reported to your doctor.
A bulge or small lumps of tissue can often be felt around the anus with external hemorrhoids. You may also experience painful bowel movements, itching, and irritation. In some cases hemorrhoids can also cause leakage of feces making it difficult to wipe or clean the area. While all of these symptoms are uncomfortable, hemorrhoids are very treatable and are not usually medically concerning.
Is Vaseline Good For Hemorrhoids
Vaseline can be used as a temporary treatment for hemorrhoids.
As long as Vaseline is not applied to open, irritated skin, its safe for most people. Excessive use of petroleum jelly in the sensitive and delicate anal area may lead to further irritation.
So if you have hemorrhoids or are prone to them, Vaseline should be used with care.
The fact that Vaseline has soothing effects on any kind of soreness makes it an attractive treatment option for the discomfort from hemorrhoids.
However, it is important to remember that abdominal stress can aggravate piles so gentle and soothing application should be sought instead of full-on applications which may worsen rather than alleviate pain in this case.
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Hemorrhoids Treatment: Rubber Band Ligation
The principle of rubber band ligation is to encircle the base of the hemorrhoidal clump with a tight rubber band. The tissue cut off by the rubber band dies, and is replaced by an ulcer that heals with scarring.
A similar procedure was described in 460 BC by the Greek physician Hippocrates:
And hemorrhoids you may treat by transfixing them with a needle and tying them with very thick and woolen thread, for application, and do not foment until they drop off, and always leave one behind and when the patient recovers, let him be put on a course of Hellebore.
Rubber band ligation can be used with first-, second-, and third-degree hemorrhoids, and may be more effective than sclerotherapy. Symptoms frequently recur several years later, but usually can be treated with further ligation.
The most common complication of ligation is pain. However, bleeding one or two weeks after ligation or bacterial infection in the tissues surrounding the hemorrhoids may occur.
What Are The Causes Of External Hemorrhoids
The most common cause of hemorrhoids is repeated straining while having a bowel movement. This is often caused by severe cases of constipation or diarrhea. Straining gets in the way of blood flow into and out of the area. This results in the pooling of blood and enlargement of the vessels in that area.
Pregnant women may also be at an increased risk of hemorrhoids because of the pressure that the uterus places on these veins.
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