Hemorrhoids are swollen veins in the anal canal. Of course, everyone has veins in this area, but when they become enlarged they can bleed, itch, and cause pain. Hemorrhoids can be located internally, externally, or both. While rarely a serious condition, hemorrhoids certainly cause a lot of discomfort and concern. This blog is a guide to the treatment of hemorrhoids at home.
When Should I See My Doctor?
Before assuming that your condition is hemorrhoids, it is a good idea to see your doctor for an examination. After all, it is difficult to take a look for yourself. And please, no "selfies"! If there is any bleeding, severe pain occurs, or there is fecal incontinence (loss of bowel control) you should definitely see the doctor. A large amount of bleeding or the sudden onset of severe pain means you should see the doctor immediately.
At Home Treatments
- Water – make sure you are well hydrated. When you do not have enough water intake, your bowel movements can become hard and difficult to pass. This increases pelvic pressure and that makes the hemorrhoids get enlarged.
- Fiber – an adequate fiber intake is important to ensure that you don’t get constipated and that the bowel movements remain soft and easy to pass.
- Sitz baths – this means sitting in warm water for about 20 minutes at a time. No additives are needed. While some people buy special sitz bath seats from the pharmacy, all you need is a bathtub and some warm water. You can do this about 2 or 3 times a day. Remember to gently pat dry the anal area to avoid irritation.
- Moist wipes – cleaning your anal area after bowel movements is important, as left over fecal material is irritating to the skin. While moist toilet paper or a wash cloth will work, many people prefer the pre-packaged wipes (Preparation H medicated wipes or Cottonelle flushable wet wipes are examples). These wipes often have witch hazel and aloe in them, which are soothing. Avoid baby wipes, as they are not usually flushable and can clog the toilet. Tucks (witch hazel pads) can be soothing, but are small and may be hard to apply.
- Avoid rubbing too much – this can irritate the skin and hemorrhoids. The rougher toilet papers are the biggest problem, but any toilet paper can feel like sandpaper if you rub too hard or too much.
- Heed the urge – get to the bathroom as soon as possible when you have an urge to pass a bowel movement. "Regularity" is overrated.
- Don't sit too long on the toilet – this engorges the hemorrhoidal veins and can make the situation worse. Take care of business and move on.
- Avoid sitting for long periods – while everyone knows that pregnancy increases the risk of having hemorrhoids, sitting for a long time (like long distance truck drivers) can increase hemorrhoids, too. Get up and walk around frequently if your job requires a lot of sitting.
- Ice packs – some doctors recommend this, but I don't. I think the treatment itself may be more uncomfortable than the disease.
- Ointments, creams, and suppositories – these can help in several ways. Most of them contain emollients – medications to soften and soothe the skin. Some contain hydrocortisone. This topical steroid reduces inflammation. Other products contain anesthetics such as 5% lidocaine. Be careful not to confuse hemorrhoidal suppositories with laxative suppositories. For example, while glycerin is good to soften your hands, a glycerin suppository is a laxative and will not help hemorrhoids. Don't use these products for more than 10 days unless under the instructions of a doctor. They can make the situation worse with prolonged use.
What If All This Fails?
Most people will get relief from the treatments listed above. However, sometimes these remedies do not work, or don't work well enough. In that case, there are treatments that the doctor can provide, ranging from pills, to prescription creams, to minimally invasive procedures, and even to hemorrhoid removal surgery. We will discuss these in an upcoming blog.
In the meantime, if you have more questions or feel your condition is urgent, contact your Temple physician or healthcare provider.