Hemorrhoids

What are hemorrhoids?

Hemorrhoids, sometimes called piles, are inflamed or swollen veins (think varicose veins) either on the outside of the anus or inside it. They are often painless, but they may bleed, hurt, or itch when irritated. Sometimes hemorrhoids can become inflamed and engorged with blood, causing them to become quite painful. Occasionally, a blood clot can form in a hemorrhoid, making it difficult to achieve pain relief without minor surgery.

Unfortunately, hemorrhoids are a common complaint during pregnancy -- especially during the third trimester and immediately after childbirth. They're the result of the tremendous strain on the veins around the anus from carrying a baby and giving birth, as well as hormonal changes that cause these veins to expand and bulge. Hemorrhoids can also result from straining to pass hard, compacted bowel movements due to constipation. Chronic diarrhea is another culprit.

Fortunately, though, self-care measures and lifestyle changes often effectively treat or prevent this problem. If it's any consolation, for most pregnant women, hemorrhoids are just a temporary complaint, although they may return if you become pregnant again.

How do I know if I have hemorrhoids?

The signs and symptoms of this condition include:

  • One or more tender lumps or swellings near the anus
  • Anal ache or pain, particularly while sitting
  • Anal itching
  • Painful bowel movements
  • Stools with red blood, or evidence of red blood on toilet tissue or in the toilet bowl.

What can I do to treat them?

Self-care measures at home can often relieve the pain and discomfort of hemorrhoids. Try a sitz bath, a small plastic tub that fits over the toilet seat. You can usually find a sitz bath at drug stores. In the bathtub or sitz bath, sit in warm water for 10 to 15 minutes, several times a day if needed.

Frequent bathing to keep your anus clean may help. But be careful not to scrub the skin while washing, which can hurt. Soap isn't necessary and may just make the problem worse. Gently pat the area dry. After bowel movements, wipe gently but thoroughly. Avoid toilet paper with potentially irritating perfumes or colors. Try alcohol-free wipes or lightly moistened toilet paper.

You can dab external hemorrhoids with witch hazel pads or soothe them with a cold compress or an ice pack. To ease painful bowel movements, place some petroleum jelly inside and around the edge of the anus. If itching is an issue, resist the urge to scratch. This could make your condition worse. Instead, try wet or dry baking soda or over-the-counter hydrocortisone cream to get some relief.

Although it may seem like a good idea, don't use an inflatable doughnut cushion to pad your chair if you sit for long periods of time. It may feel good but it can actually increase the pressure in the veins around your anus. Instead, get up and move around a bit to bring some relief.

What can I do to prevent them?

Eat plenty of high-fiber foods such as fruit, vegetables, bran cereals, and whole grains, so you have soft, easily passed stools. You should drink lots of liquid too. Water and 100 percent fruit or vegetable juices are the best choices. You need at least eight large glasses of water a day. Prune juice often does the trick, as does unprocessed wheat bran added to whole-grain cereal. If you think it might help, talk with your healthcare provider about taking an over-the-counter fiber supplement.

If your job involves a lot of sitting, make sure you find time to walk, ideally at least 30 minutes a day. Exercise can also help ward off constipation by keeping the digestive system moving. Don't hold your breath or strain to pass a stool. When you feel the urge to have a bowel movement, don't wait long to use the bathroom; your stool could become dry and harder to pass if you delay.

When should I call the doctor?

If you're having bleeding or your pain persists for more than a day or two, call your doctor. See your doctor immediately if bleeding is heavy or you're passing stools that are black or maroon in color. This could be a sign of a problem more serious than hemorrhoids. If you have lasting or severe pain or discomfort, and self-care measures bring little relief, talk with your healthcare provider about what therapies may help.

References

National Institute of Diabetes and Digestive and Kidney Diseases. Hemorrhoids. http://digestive.niddk.nih.gov/ddiseases/pubs/hemorrhoids/

American Pregnancy Association. Pregnancy and Hemorrhoids. http://www.americanpregnancy.org/pregnancyhealth/hemorrhoids.html

March of Dimes. Hemorrhoids. http://www.marchofdimes.com/pnhec/159_15290.asp

Mayo Clinic. Hemorrhoids. http://www.mayoclinic.com/invoke.cfm?id=DS00096

PeaceHealth. Hemorrhoids: Medications. http://www.peacehealth.org/kbase/topic/major/hw213495/drugtrt.htm

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