By Eduardo Gonzales, MD
How common are hemorrhoids? Are there effective home remedies that can relieve them? How can they be prevented from recurring? Are hemorrhoids caused by eating spicy foods? Can they become cancerous? —firstname.lastname@example.org
Hemorrhoids or piles, which refer to swollen or varicose veins in the anal canal, the terminal three to four inches of the large intestine, are rather common. In fact, experts estimate that as many as 75 percent of all adults will suffer from them at some point in their lives. They are most common among adults aged 45 to 65. Aside from advancing age, the risk factors for hemorrhoids include overweight, family history of the condition, and diet that is low in fiber.
Definition of hemorrhoids
Contrary to a common Filipino belief, eating spicy or hot food does not cause hemorrhoids. Hemorrhoids develop when frequent excessive pressure is exerted on the veins in the pelvic and rectal areas, which pools the blood in the veins and makes them swell. This pressure is usually brought about by straining during bowel movements—which can be aggravated by chronic constipation or diarrhea, pregnancy, and frequent heavy lifting.
Types and symptoms of hemorrhoids
Hemorrhoids are classified into two types. Those that are visible from the outside are called external hemorrhoids while those that are not are called internal hemorrhoids. It is however not unusual for both types to co-exist.
The most common sign of hemorrhoids is bleeding, which usually comes during or after a bowel movement resulting in stool that is tainted or streaked with fresh blood, or blood in the toilet bowl or toilet paper. Although the sight of blood can be scary, the blood loss from bleeding hemorrhoids is generally minimal; rarely does it lead to anemia. Itching is another common symptom. Sometimes hemorrhoids become painful, which occurs when they get abraded or thrombosed (i.e., when blood clots form in the veins). Hemorrhoids also occasionally give rise to a mucoid discharge from the anus.
Hemorrhoids do not become cancerous but their symptoms are similar with those of rectal cancer and a few other diseases. That is why it is important to seek medical consultation when the symptoms of the condition first appear, if only to rule out a graver disorder.
Effective conservative remedies for hemorrhoids
In general, hemorrhoidal symptoms resolve with home remedies. Small external or internal hemorrhoids heal within seven days, but large internal hemorrhoids that prolapsed out of the anus may need at least two months to improve. Effective home treatment includes:
- hot sitz bath, which involves sitting in a tub of warm water for 20 to 30 minutes two to three times a day.
- application of an over the counter (OTCs) topical medications in the form of ointments or suppositories, which contain analgesics, corticosteroids, topical vasoconstrictors, moisturizers, and astringents.
Ways to prevent hemorrhoids from recurring
The recurrence rate of hemorrhoids is high, but recurrence can be prevented by:
- shifting to a fiber-rich diet while increasing one’s daily water intake. These will promote regular (daily) bowel movement that is characterized by well-formed but soft stools that pass out without straining.
- not straining when using the toilet. Straining creates pressure in the veins in the anal region.
- going to the toilet when needed. The longer the wait, the drier the stools will be.
- keeping one’s body weight down. Overweight is a risk factor for hemorrhoids.
Medical treatments or procedures for hemorrhoids
Hemorrhoids not controlled by conservative means are treated by more invasive procedures such as injection sclerotherapy, which entails injection of a substance that obliterates the veins and replace them with scar tissue; and, rubber band ligation, which is performed by tying the enlarged veins with rubber band until they wither and drop off spontaneously. As a last recourse, surgical removal of the swollen veins (hemorrhoidectomy) is resorted.