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When Should I Worry About Hemorrhoids?

Woman speaking to a doctor about hemorrhoid symptoms
Hemorrhoid symptoms that require a doctor visit include bleeding before, during, or after bowel movements; hemorrhoid persists for more than a week, symptoms continue to worsen, you notice a bulge, or you don’t know whether your discomfort is caused by hemorrhoids.

Hemorrhoids are swollen veins in the anal region. Hemorrhoids are a common, painful and uncomfortable condition that can affect anyone. 

Symptoms of hemorrhoids include: 

  • Rectal bleeding
    • Bright red
    • Tends to be a small amount
    • Painless 
    • Noticed especially after bowel movements
    • Visible blood on toilet paper after wiping following a bowel movement
  • Tissue bulging from the anal area
    • May appear dark blue to purple in color if there is a blood clot
  • Anal itching or burning sensation 
  • Pain and pressure in the rectal area
  • Feeling a need to have a bowel movement
  • Leakage of feces 
  • Difficulty cleaning after a bowel movement

See a doctor for hemorrhoids if:

  • Bleeding occurs before, during, or after bowel movements
  • Hemorrhoid persists for more than a week
    • Different treatment may be needed
  • Symptoms continue to worsen
    • Different treatment may be needed
  • You notice a bulge
    • May be a prolapsed hemorrhoid 
  • You don’t know whether your discomfort is caused by hemorrhoids

How Do You Get Hemorrhoids?

Causes of hemorrhoids include: 

  • Straining during bowel movements
  • Prolonged sitting (especially sitting on the toilet)
  • Chronic constipation or diarrhea
  • Inadequate fiber intake
  • Weakening of the supporting tissues in the anus and rectum that occurs with aging
  • Lifting heavy objects frequently
  • Pregnancy
  • Tumors

How Are Hemorrhoids Diagnosed?

Hemorrhoids are diagnosed with a patient history and a physical examination of the rectum and anus, which may involve a digital rectal exam, in which a medical professional inserts a gloved finger into the rectum. External hemorrhoids are visible on examination. 

Other tests may include: 

  • Anoscopy to examine the anus
  • Rigid proctosigmoidoscopy to examine the lining of the rectum and lower colon
  • Sigmoidoscopy or colonoscopy to examine the colon

What Is the Treatment for Hemorrhoids?

Mild cases of hemorrhoids may resolve on their own in a few days. 

Home treatments for hemorrhoids include: 

  • Drink plenty of water
  • Don’t strain during bowel movements
  • Don’t sit on the toilet for long periods 
  • Warm sitz baths 
    • Available in drugstores
    • Soak the buttocks in 2 to 3 inches of warm water for 10 to 15 minutes, two to three times daily
    • Do not use soap, bubble bath, or other additives in the water
  • Increase fiber intake 
    • To prevent constipation and to help soften stools
    • The recommended amount of dietary fiber is 20 to 35 grams per day
    • Fruits and vegetables are high in fiber
    • Fiber supplements
      • Psyllium (Konsyl, Metamucil)
      • Wheat dextrin (Benefiber)
      • Methylcellulose (Citrucel)
      • Polycarbophil (Fibercon)
  • Topical treatments 
    • Over-the-counter (OTC) pain-relieving creams and hydrocortisone rectal suppositories may help temporarily relieve pain, inflammation, and itching
      • Do not use topical treatments for more than one week, unless recommended by a doctor
  • Laxatives
    • Use only if increased fiber intake does not relieve constipation
  • Over-the-counter (OTC) pain relievers 
    • Ibuprofen (Advil, Motrin)
    • Naproxen (Aleve)
    • Aspirin
    • Acetaminophen (Tylenol)

Medical treatments for hemorrhoids include: 

  • Rubber band ligation
  • Laser, infrared, or bipolar coagulation 
  • Sclerotherapy 
  • Surgery
    • Hemorrhoidectomy (surgical removal of excess hemorrhoidal tissues)
    • Stapled hemorrhoidopexy 
    • Hemorrhoidal arterial ligation

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References
Image Source: iStock Images

https://www.uptodate.com/contents/hemorrhoids-beyond-the-basics?search=Hemorrhoids&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2

https://www.niddk.nih.gov/health-information/digestive-diseases/hemorrhoids/definition-facts

https://www.medstarhealth.org/blog/5-signs-its-time-to-seek-care-for-hemorrhoids