Questions To Ask Your Doctor
- Why do I have hemorrhoids?
- Are there any lifestyle changes I can do that can relieve or prevent hemorrhoids?
- I saw blood on toilet paper. Is this serious?
- Are having hemorrhoids a sign of another health condition?
- Will I always have hemorrhoids?
- Is there medicine I can take for hemorrhoids? Are there side effects?
How To Ease Pain When Using The Restroom With Hemorrhoids
by Doctor Cutler | Mar 12, 2021 | Hemorrhoids |
Being afraid of a painful trip to the toilet is no fun. A squeaky wheel, however, gets the grease, and because about half of all people will deal with itchy or burning hemorrhoids at some point in their life, theres actually a lot of research that has been done to treat problematic hemorrhoids. Now, you get to benefit from that!
So, if you have questions about how to poop with a hemorrhoid, know that they have been asked many times before. As a proctologist, Ive spent more than 30 years answering these and other burning questions from my patients.
The tips in this post should guide you to immediate relief and ideally towards painless trips to the toilet in the future.
What Can My Doctor Do For Hemorrhoids
There are many ways that hemorrhoids can be handled and treated. These options vary depending on the condition, severity and location of the hemorrhoids. Below are methods that may be employed to treat your hemorrhoids.
1. Injections
Internal hemorrhoids may be injected with a solution that causes a scar to be formed and close off the hemorrhoids. This procedure will only hurt a little but is usually very effective.
2. Cauterization or Coagulation
This method is a painless method of burning off, removing and sealing the end of the hemorrhoids with an electric probe, infrared light or laser beam.
The Coagulation method allows the hemorrhoid to close and shrink and is most effective for treating prolapsed hemorrhoids.
3. Rubber band ligation
Rubber band ligations are also mostly employed in cases of prolapsed hemorrhoids as well as protruding internal hemorrhoids that have been pushed outside .
In this treatment, the doctor will put a small rubber band around the hemorrhoid to cut off blood supply to the tissues therein.
Rubber band ligations will usually cause the hemorrhoid to dry up, shrink in size and fall due to the unavailability of blood.
4. Surgery or Hemorrhoidectomy
For large internal or external hemorrhoids that keep on worsening and bring excruciating discomfort to the patient, a surgical procedure may be required to remove the hemorrhoids or a newer technique using staples may be applied.
Most of these medical treatments are effective in treating hemorrhoids.
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When To See A Doctor About Your Hemorrhoids
A Centre of Excellence for Piles Treatment
It is understandable that people usually dont talk about hemorrhoids openly due to embarrassment. The same problem exists when a person thinks about seeing a doctor. Talking to a doctor about hemorrhoids may seem awkward, but it is important to open up about your problem to find the best solution. Seeing a doctor is usually recommended when piles symptoms appear and dont go away for more than a week. In most people, hemorrhoids resolve on their own. But if your condition doesnt improve within a week, you should immediately see a doctor for piles.
Even though hemorrhoids dont always require surgical treatment, consulting a doctor is essential to prevent the condition from advancing. The doctor will diagnose the disease and determine how serious it is. The treatment method is chosen according to the severity of the hemorrhoids. Read ahead to find out when and who you should see for hemorrhoids.
Causes And Risk Factors Of Hemorrhoids
Several conditions and habits are thought to cause hemorrhoids:
- Chronic constipation or diarrhea
- Straining too hard during bowel movements
- Sitting on the toilet for a long time
Straining, constipation, and prolonged sitting can all affect the blood flow in the area, causing blood to not move at its expected rate within the vessels, leading to hemorrhoids.
Factors that raise your risk of developing hemorrhoids:
- Lack of fiber in the diet.
- Obesity: Being overweight can put pressure on the hemorrhoidal tissue.
- Aging: As we get older, the connective tissue in the rectum and anus becomes weaker, potentially resulting in bulging hemorrhoids.
- Pregnancy: As the fetus grows and puts pressure on the abdomen, the veins in the rectum and anus may become enlarged. The problem typically goes away after birth.
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How Do You Know If You Have Hemorrhoids
The most common symptoms of hemorrhoids are:
- Anal pain/painful bowel movements
- Rectal bleeding
- Itchiness
- Swelling around the anus
However, these symptoms could also be a sign of something more serious, like anal cancer or polyps. Hemorrhoids also have many symptoms in common with anal fissures, which occur when the skin around the anus is torn. Anal fissures tend to be much more painful than hemorrhoids, however.
Even if youre fairly certain youre dealing with hemorrhoids, its still a good idea to go see a doctor to rule out any serious conditions, especially if youre over the age of 50.
A Noticeable Bulge At The Anus That Seems To Retract Following A Bowel Movement
Internal hemorrhoids can prolapse or fall outside of the anal opening during a bowel movement. Initially, the tissue may retract on its own or be easily pushed back inside. But prolapse can worsen over time and can eventually cause significant irritation, itching, bleeding, and pain as this internal tissue becomes trapped outside of the anus. Early treatment helps prevent the prolapse from worsening.
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What Are The Treatment Options For Hemorrhoids
Knowing when to see your doctor for hemorrhoids is essential as it will determine what treatment options you have. If hemorrhoids havent advanced to the chronic stage, they can be treated using either home remedies or non-surgical methods, such as:
- Rubber band ligation, where a rubber band is placed at the base of the hemorrhoid to cut off the blood supply. The hemorrhoid tissue shrinks due to the shortage of blood and falls off within a week leaving scar tissue behind.
- Sclerotherapyis another non-surgical technique where a chemical is injected into the hemorrhoids to shrink them.
- Coagulationis also effective for the treatment of internal hemorrhoids where an infrared light or electric current is used to halt the blood flow and shrink the hemorrhoid tissue.
If your condition is chronic, these non-surgical methods wont be a suitable choice for you as they will require repeated sittings. As a result, it will take weeks to get rid of hemorrhoids completely. So, instead of using these methods, the doctor may suggest that you opt for a surgical procedure to cure hemorrhoids. The surgical methods include:
When Can A Hemorrhoid Pop
If a hemorrhoid has become thrombosed, meaning its bulging and painful, it will burst on its own and secrete blood. While similar to a pimple or boil which will build up in pressure until it pops a thrombosed hemorrhoid will simply begin to bleed if it becomes too full with blood and/or puss. Of course, the hemorrhoid would have caused severe pain in the days leading up to bursting. Most people would have already sought medical attention due to the intense symptoms of thrombosis, thus taking care of the problem before the hemorrhoid bursts. This is perhaps why it is rare to hear about a hemorrhoid popping on its own.
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When To Seek Care For Hemorrhoids
Most cases of hemorrhoids do not require immediate care, but you should visit your provider for any discomfort or worsening symptoms. Your provider will work with you to identify proper treatment and make sure your symptoms are not due to a larger health issue .
Seek care right away if you:
- experience severe pain around your anus, or during bowel movements.
- have rectal bleeding, which may indicate more severe underlying conditions that require treatment.
- have symptoms that worsen or persist after one week.
- notice any unusual changes in the tissue in or around your anus.
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Classification Of Internal Hemorrhoids:
- Grade 1 – A hemorrhoid is present but only visualized by a doctor with ansocopy or colonoscopy. The hemorrhoid does not extend out the anus.
- Grade 2 – The hemorrhoid extends out of the anus with a bowel movement or with straining. After your BM, the hemorrhoid goes back inside on its own.
- Grade 3 – The hemorrhoid extends out of the anus with a bowel movement or with straining. You have to manually push the hemorrhoid back inside the anus. If you have this, you should seek medical attention, but it is not urgent.
- Grade 4 – A hemorrhoid extends outside the anus and are not able to be manually pushed back inside. If you have this seek medical attention immediately. There are significant potential complications.
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When Should I See A Doctor
Any type of anal pain, especially if it involves bleeding or swelling tissue should be properly evaluated by an MD. The pain may not always be hemorrhoids and its extremely important to see a doctor to make sure theres nothing more serious going on. Other conditions that sometimes exhibit similar symptoms as hemorrhoids include colorectal cancer, IBS, constipation and anal fissures.
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.
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When To See A Doctor About Hemorrhoids
Talking about rectal problems like hemorrhoids can feel embarrassing. But this common problem affects an estimated 3 in 4 Americans sometime during their lifetimes half of them by the time they turn 50.
With hemorrhoids being such a widespread problem, its no surprise that local drugstores have plenty of treatments promising to help. But what if over-the-counter treatments dont help? Can medical care solve your problem and relieve your discomfort?
At Paonessa Colon & Rectal Surgery, we say, Yes. And the good news? Getting medical hemorrhoid treatment doesnt always mean you need surgery. In fact, you can rest easy knowing that most of the time, it doesnt.
Board-certified general surgeon and proctologist Nina J. Paonessa, DO, leads our team. Shes a specialist who is well-known for her medical expertise as well as her passion for making her patients feel comfortable when addressing this sometimes embarrassing condition. Dr. Paonessa is also the only female colorectal surgeon in Ocean and Monmouth counties, New Jersey.
Types Of Hemorrhoids: Internal And External
Hemorrhoids are either internal or external.
Internal Hemorrhoids These hemorrhoids develop inside the rectum and are not usually visible to the naked eye. Internal hemorrhoids generally don’t hurt, but they often bleed painlessly.
In some cases, internal hemorrhoids may protrude through the anus and can be seen, which is known as becoming prolapsed. When this happens, they will usually shrink back inside the rectum on their own or can be pushed back in.
External Hemorrhoids These hemorrhoids develop under the skin around the outside of the anus. These are the most uncomfortable hemorrhoids and can be itchy or painful, and may feel lumpy. When a blood clot forms within an external hemorrhoid, this is known as a thrombosed hemorrhoid, which can result in severe, ongoing pain. Sometimes clots dissolve on their own, but if they dont, your doctor can remove the clot, a procedure thats most effective if done within 72 hours of the clot forming.
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Prevention Of Rectal Bleeding
The best way to prevent rectal bleeding is to prevent its chief causes.
People at high risk for colorectal cancer should undergo regular screenings, primarily colonoscopy. Colorectal cancer screenings can detect precancerous polyps in the colon or rectum so that they can be removed before they turn into cancer. Screenings can also identify colorectal cancer early, when treatment is more likely to be successful.
How A Doctor Can Help
Doctors can recommend medical treatments and procedures that can reduce or get rid of hemorrhoids. Some of these procedures can be done right in a doctors office and involve very little discomfort.
- Medicated creams/ointments. If an OTC hemorrhoid cream isnt enough, doctors can prescribe stronger creams and ointments.
- Minimally-invasive procedures. There are some minimally-invasive procedures that a doctor can do in their office or in an ambulatory surgery center that typically doesnt require anesthesia or long recovery times. Some of these procedures include rubber band ligation, sclerotherapy injections, and laser/infrared coagulation treatments.
- Thrombectomy. For severe cases that develop blood clots and cause a lot of pain, your doctor can perform an external hemorrhoid thrombectomy to remove the hemorrhoid. Thrombectomies are most effective when performed no more than 72 hours after severe symptoms emerge.
- Surgery. There are several surgical options available when other treatments and procedures havent worked or if you have very large hemorrhoids. If youve struggled to find relief, talk to your doctor to learn if surgery is right for you.
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Signs And Symptoms Of Rectal Prolapse
Rectal prolapse may be uncomfortable, but its not usually painful.
Symptoms of rectal prolapse may include:
- Bright red tissue sticking out of the anus
- An uncomfortable sensation like something is falling out, or like youre sitting on a ball
- Trouble beginning a bowel movement
- Feeling like you cant completely empty your bowels
- Fecal incontinence
What Can You Put On Hemorrhoids To Shrink Them
You can use topical medications for hemorrhoids, although these products mainly provide relief from pain and other symptoms rather than shrinking hemorrhoids. A wide range of these products are available, including ointments, pads, and creams. Oral pain relievers might also offer temporary relief. Soaking in a sitz bath or warm water can help ease the pain as well.
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Feeling You Cant Empty Your Stool Completely
If you have prolapsed internal hemorrhoids, they can cause the sensation that you have stool stuck at your anus. You may also have difficulty cleaning yourself or notice a mucous discharge following a bowel movement because of the displaced tissue.
Dr. Paonessa can remedy these symptoms by treating the hemorrhoid.
If I Need Surgery To Remove Hemorrhoids What Are My Options
If your symptoms dont respond to more conservativetreatments, you have options.
Noninvasive options include:
- Electrocoagulation, a minimally invasive procedure that can treat multiple hemorrhoids at the same time. This is also called the HET procedure.
- Doppler-guided hemorrhoid arterial ligation, which uses a special attachment to pinpoint the hemorrhoidal vessels and cut off the blood supply. This procedure is performed under anesthesia.
- A hemorrhoidectomy may be necessary for very large internal and external hemorrhoids or those that are acutely inflamed or thrombosed, Dr. Zutshi says. It involves cutting out the hemorrhoid tissue, which can be painful, especially during recovery. But there are less painful options available.
- Hemorrhoid stapling, in which a surgeon uses a special stapler to cut off the blood supply to the hemorrhoid. This kind of hemorrhoidectomy is thought to be less painful.
Which treatment is best will depend on yoursymptoms and your expectations, Dr. Zutshi says, and those should be discussedwith your doctor.
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End Your Restroom Visit With Hemorrhoid Wipes
Rubbing too hard with toilet paper can make a mild hemorrhoid problem worse, but it may be inconvenient to do a sitz bath soak after every bowel movement. Its important, however, to avoid a lot of wiping because that process can irritate sensitive skin, and rough toilet paper does the most damage.
You may be considering a toilet wipe marketed specifically for problem hemorrhoids, and while it may sound counterintuitive, I actually recommend my patients to stay away from most medicated hemorrhoid wipes. Many wipes contain chemicals that can further inflame hemorrhoids.
Hemorrhoid sufferers just need a consistent way to get the irritated area of the anus clean in order to apply an ointment or other treatment like a no-touch hemorrhoid spray. A chemical free wipe like Doctor Butlers hemorrhoid wipes are not medicated, are soft enough for sensitive skin, and are filled with natural ingredients to first get skin clean, and then soothe the skin after use.
What Are Hemorrhoids Symptoms Causes Diagnosis Treatment And Prevention
Hemorrhoids are enlarged and swollen veins around the outside of the anus or in the lower rectum. The rectum is the last part of the bowel and leads to the anus, the opening at the end of the bowel where fecal matter leaves the body.
Everyone has hemorrhoidal tissue in this area thats made up of blood vessels, connective tissue, and some muscle. These cushions dont always become enlarged or distended, but as we age, this phenomenon becomes more common causing what we call hemorrhoids, also known as piles.
Hemorrhoids can be caused in a number of ways, most commonly by straining to make a bowel movement. Lifting heavy objects, along with other activities that may cause straining, can also lead to hemorrhoids. Experiencing increased pressure during pregnancy and being overweight are other contributing factors.
Hemorrhoids may be painful and particularly bothersome if they are recurrent, but they’re not dangerous or life-threatening, and symptoms usually go away within a few days. There are plenty of effective ways to treat them, as well as options for the less common types of hemorrhoids that may be more problematic.
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