Hemorrhoids, also called “piles,” are swollen tissues that contain veins. They are located in the wall of the rectum and anus and may cause minor bleeding or develop small blood clots. Hemorrhoids occur when the tissues enlarge, weaken, and come free of their supporting structure. This results in a sac-like bulge that extends into the anal area.
Hemorrhoids are unique to humans – no other animal develops them. They are very common – up to 86% of people will report they have had hemorrhoids at some time in their life, though people often use this as a catch-all label for any ano-rectal problem including itching. They can occur at any age but are more common as people get older. Among younger people, they are most common in women who are pregnant. They can be painful and annoying but aren’t usually serious. Hemorrhoids differ depending on their location and the amount of pain, discomfort, or aggravation they cause.
Internal hemorrhoids are located up inside the rectum. They rarely cause any pain, as this tissue doesn’t have any sensory nerves. These hemorrhoids are graded for severity according to how far and how often they protrude into the anal passage or protrude out of the anus (prolapse):
- Grade I is small without protrusion. Painless, minor bleeding occurs from time to time after a bowel movement.
- A grade II hemorrhoid may protrude during a bowel movement but returns spontaneously to its place afterwards.
- In grade III, the hemorrhoid must be replaced manually.
- A grade IV hemorrhoid has prolapsed – it protrudes constantly and will fall out again if pushed back into the rectum. There may or may not be bleeding. Prolapsed hemorrhoids can be painful if they are strangled by the anus or if a clot develops.
External hemorrhoids develop under the skin just inside the opening of the anus. The hemorrhoids may swell and the area around it may become firm and sore, turning blue or purple in color when they get thrombosed. A thrombosed hemorrhoid is one that has formed a clot inside. This clot is not dangerous and will not spread through the body, but does cause pain and should be drained. External hemorrhoids may itch and can be very painful, especially during a bowel movement. They can also prolapse.
Causes of Hemorrhoids
Hemorrhoids are caused by repeated or constant pressure on the rectal or anal veins. The most common cause of pressure usually results from straining or prolonged sitting during a bowel movement. Other factors that increase the risk for getting hemorrhoids include constipation, diarrhea, lifting heavy objects, poor posture, prolonged sitting, pregnancy, eating a diet low in fibre, anal intercourse, and being overweight. Liver damage and some food allergies can also add stress to the rectal veins. External hemorrhoids most often itch, burn, or bleed, and they can be painful, inflamed, and swollen. They’re the most common cause of bleeding during bowel movements.
A small, painless emission of very bright red blood just after a bowel movement is a sign of an internal hemorrhoid, where the blood will not be mixed in with the stool. In small amounts, it’s not a serious issue. If this is the first occurrence, see your doctor to confirm that hemorrhoids are the source. Visit your doctor if bleeding continues, as a constant loss of blood may lead to anemia (lack of oxygen reaching the tissues due to blood or iron shortage).
Watch for pain that lasts longer than a week, blood loss along with weakness or dizziness, or infection – these are all situations that should be brought to your doctor’s attention. Your doctor should also be consulted about bleeding not brought on by a bowel movement, blood that’s dark in colour, or bleeding that is recurrent. This can signal more serious problems higher in the colon, unrelated to hemorrhoids.
Also, children under 12 should be referred to a doctor if symptoms of hemorrhoids are present.
No examination for hemorrhoids is complete without a digital rectal examination, where the doctor will insert a gloved finger into the rectum to examine the hemorrhoids. This helps to determine if the hemorrhoid is external or internal, and to assess the grade of internal hemorrhoids.
An instrument called an anoscope or a proctoscope lets the doctor see internal hemorrhoids. The examination should also include questions about lifestyle. The doctor will probably try to isolate risk factors and suggest changes.
A high-fibre diet with large amounts of water is the answer for grade I internal hemorrhoids and painless external hemorrhoids. This will soften the stool, decreasing constipation and straining. It will also allow the inflamed veins to decrease in size. There are also a number of ointments and suppositories available without prescription that can help reduce pain and inflammation around the anus. These include topical hemorrhoidal preparations that contain local anesthetics for their soothing properties. Your pharmacist can help you choose a topical application that is appropriate for your circumstances. Prescription medications can include anti-inflammatory cortisone creams.
Other useful measures include stool softeners or bulking agents, or a sitz bath, used 3 or 4 times daily for 15 minutes at a time. A sitz bath is a container filled with warm water that fits over a toilet bowl. Ice packs alternated with warm packs on the affected area can help dissolve a blood clot in an external hemorrhoid.
More severe hemorrhoids may require a doctor’s intervention. Ahemorrhoidectomy is a type of surgery done under anesthesia and involves complete removal of internal hemorrhoids. It’s reserved for severe cases. External hemorrhoids can be removed or drained with local anaesthetic and a scalpel by a doctor if they have thrombosed (developed a clot) within the previous 72 hours.
Sometimes, a hardening agent is injected into internal hemorrhoids to make them smaller and firmer. Grade II and III internal hemorrhoids may be tied off with a rubber band via rubber band ligation. This stops the blood flow and the hemorrhoids eventually die and drop off. Electricity, lasers, heat, cold, or infrared light are also used to destroy hemorrhoids. These procedures can involve some discomfort.
Here are a few tips on preventing hemorrhoids:
- Don’t delay bowel movements, because the stool can harden.
- Avoid straining to have a bowel movement, and don’t stay sitting on the toilet for long periods.
- Drink at least 8 glasses of water a day.
- Eat foods that are high in fibre and bulk, such as whole grain foods, fresh vegetables, and fruit – especially prunes and bran.
- Get plenty of exercise and don’t sit for prolonged periods of time. Try to go for walks.
- Lose excess weight.
Natural Home Remedies for Hemorrhoids
Fortunately, most hemorrhoids respond well to home remedy treatments and changes in the diet, so these kitchen cures should help you keep this sore point under wraps.
Home Remedies from the Cupboard
Potato. A poultice made from grated potato works as an astringent and soothes pain. Take 2 washed potatoes, cut them into small chunks, and put them into a blender. Process until the potatoes are in liquid form. Add a few teaspoons water if they look dry. Spread the mashed ‘taters into a thin gauze bandage or clean handkerchief, fold in half, and apply to the hemorrhoids for five to ten minutes.
Warning! Some folk remedies will have you placing raw potato pieces in places that don’t see the light of day. Using potatoes or any other food as a suppository to help hemorrhoids should first be discussed with your physician.
Prunes. If you haven’t eaten a prune since your mother tried to force one down your throat at age five, then it’s time to try again. As mama knew, prunes have a laxative effect and help soften stools. Try to eat 1 to 3 a day, and look at it as pleasure, not punishment.
Vinegar. Applying a dab of apple cider or plain vinegar to hemorrhoids stops itching and burning. The vinegar has astringent properties that help shrink swollen blood vessels. After dry wiping, dip a cottonball in vinegar and apply.
Home Remedies from the Freezer
Ice. Now here’s a remedy guaranteed to wake you up and soothe hemorrhoid pain. Sit on a cold compress. That’s right, literally freeze your rear end. Break ice into small cubes (easier for the ice to shape itself around certain regions), and place it in a plastic, reclosable bag. Cover with a thick paper towel and sit on it! The cooling works twofold: First, it numbs the region, and second, it reduces blood flow to those distended veins.
Home Remedies from the Refrigerator
Oranges. Vitamin C plays a role in strengthening and toning blood vessels, so eat lots of vitamin C-rich fruits and vegetables.
Home Remedies from the Sink
Water. Think of water as the plumber of the digestive tract, without the $85-an-hour fee. Water keeps the digestive process moving along without block-ups — one of the main causes of hemorrhoids. Reaping the benefits requires a minimum of 8 large glasses of water each day. Drinking other fluids, such as juice, and eating plenty of water-loaded fruits and vegetables can help the flow of things.
Home Remedies from the Windowsill
Aloe vera. Versatile aloe vera comes to the rescue once again as a hemorrhoid healer. The very same anti-inflammatory constituents that reduce blistering and inflammation in burns also help reduce the irritation of hemorrhoids. Break off a piece of the aloe vera leaf and apply only the clear gel to the hemorrhoids.
These home remedies should help to keep hemorrhoids away and ease the discomfort of a hemorrhoid flare-up. However, don’t hesitate to seek your doctor’s advice if home remedies aren’t enough to get the problem under control.
This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.
Resources: Med Broadcast Clinical Team & David J. Hufford.