Hemorrhoids are abnormally swollen veins in the rectum and anus. When these veins are irritated, they cause surrounding membranes to swell, burn, itch, become painful, and even bleed.
Hemorrhoids bleed when the blood vessels rupture, such as from straining during a bowel movement. Because bleeding can be a sign of colon cancer or colon polyps, you should consult with your doctor whenever you have bleeding from the rectum, blood on your stools, or blood in the toilet after a bowel movement.
Hemorrhoids are a very common problem. Most men and women will get them as they get older. Trauma to the anus and any type of straining can make hemorrhoids worse.
Risk factors and causes in addition to constipation and straining with bowel movements include constant sitting, diarrhea, severe or chronic coughing, pregnancy and childbirth, or heavy lifting.
Conservative measures are successful in alleviating symptoms for most patients with hemorrhoidal disease:
Bleeding: Clinical trials have demonstrated that adding fiber to the diet through supplementation with psyllium or appropriate commercially available fiber preparations may significantly reduce bleeding episodes associated with hemorrhoidal disease. Psyllium as well as methylcellulose adds bulk to stools, making them softer and easier to pass.
Irritation and itching (pruritus): Irritation and pruritus associated with hemorrhoids may be treated by various measures including the following:
Warm sitz baths – During sitz baths, the rectal area is immersed in warm water for approximately 10 to 15 minutes two to three times daily. Sitz baths are available in most drugstores; in addition, portable bowls are commercially available that allow for their use in the workplace. The effectiveness of warm sitz baths may be due in part to relaxation of the internal anal sphincter.
Fiber supplementation may help to alleviate itching potentially related to fecal soilage, since their bulking effect may reduce leakage of rectal contents.
Application of various pain-relieving (analgesic) creams:
Creams and suppositories, particularly hydrocortisone, should not be used for longer than one week unless directed by your doctor, since they may result in certain side effects, such as skin rash and inflammation (contact dermatitis) with pain-relieving creams or skin wasting (atrophy) with steroid creams.
Patients who continue to have symptoms despite the conservative measures described above may be candidates for one of various techniques developed to treat symptomatic hemorrhoids. This can include rubber band ligation, sclerotherapy, cryotherapy, laser coagulation or surgery.
