I distinctly remember the nurse’s reaction to my question. A few weeks after giving birth to my first child, I asked when my hemorrhoids would go away. She could barely hold back a laugh when she said “Never!” She wasn’t entirely correct, but her remark made me do everything I could to avoid hemorrhoids after that.
What Are Hemorrhoids?
Hemorrhoids are swollen, inflamed veins in the anus and lower rectum that are caused by excessive pressure. Internal hemorrhoids are found inside the rectum and external hemorrhoids occur under the skin that surrounds the anus.
Hemorrhoids are relatively common, as I came to find out as a new mom. They affect about 5% of Americans overall, and about 40% of pregnant women have hemorrhoids in their third trimester. Pregnant women are likely to have hemorrhoids because the weight of the baby compresses blood vessels near the rectum and anus. Constipation, also common in pregnancy, can contribute to having hemorrhoids. Hemorrhoids usually improve after delivery, but they can also come and go throughout life.
Aging is a risk factor for hemorrhoids, and about half of those over age 50 develop them. The likelihood of hemorrhoids increases with time because tissues that support veins in the rectum and anus get weaker and stretch more easily.
Hemorrhoids and Other Health Problems
Hemorrhoids can lead to other health issues. For the most part, you can’t see or feel internal hemorrhoids, but straining during a bowel movement may cause an internal hemorrhoid to push through the anal opening. Internal hemorrhoids can become “strangulated” when their blood supply is cut off. Strangulated hemorrhoids are often painful.
External hemorrhoids, which are under the skin around the anus, may be itchy, irritating, and painful. It’s possible for blood to collect in external hemorrhoids and form a clot which is known as a “thrombosed” hemorrhoid.
Iron deficiency anemia – when there aren’t enough healthy red blood cells to carry oxygen to other cells in the body – may also be a result of having hemorrhoids that bleed during bowel movements. With time, ongoing blood loss could lead to iron loss from the body and result in anemia.
Risk Factors for Hemorrhoids
Hemorrhoids typically develop from increased pressure in the lower rectum, which can be caused by several factors:
• Pregnancy
• Having obesity
• Regularly lifting heavy items
• Sitting or standing for long periods of time
• Constipation or straining to have a bowel movement
• Ongoing diarrhea
How to Prevent Hemorrhoids
You can lower the likelihood of hemorrhoids by reducing pressure in your lower rectum. Prevent straining on the toilet with a balanced, high-fiber eating plan that includes plenty of plant foods, such as whole grains, fruits, and vegetables. Gradually add fiber to your diet until you’re eating about 25 to 30 grams daily.
Fluid works with fiber to add bulk to stools, making them easier to pass. Sip about 64 ounces of water and other liquids daily (coffee, tea, milk, juice, and other soft drinks count as fluid).
Regular physical activity reduces pressure on the veins in the rectum and anus. Exercise and other physical activity can also help with easier weight control. Physical activity helps you avoid long periods of sitting, which helps relieve pressure. However, you may need to avoid lifting heavy objects on a regular basis.
How to Treat Hemorrhoids
Smaller internal hemorrhoids may go away without treatment within a few days. Large external hemorrhoids may take longer to heal.
Sitz baths can provide relief from hemorrhoids. A sitz bath sounds fancy but it’s nothing more than sitting in warm, shallow water for 10 to 20 minutes at a time. Sitz baths relieve pain and itching caused by hemorrhoids and keep the area clean to limit irritation. They can also increase blood flow and help relax muscles.
Over-the-counter hemorrhoid creams may contain ingredients that reduce pain and irritation by temporarily numbing nerves in the affected area. Witch hazel is often used for hemorrhoid relief.
Surgery may be an option for hemorrhoids that won’t go away, but it’s usually reserved for difficult internal hemorrhoids or if there are complications from hemorrhoids.
When to See Your Doctor about Hemorrhoids
If your hemorrhoids have not disappeared or diminished after a few days, or if you have bleeding during bowel movements, it’s best to see your doctor, who will likely examine you and determine a plan of action. Rectal bleeding can also be a sign of other conditions, such as colorectal cancer and anal cancer. Always seek emergency care immediately if you have large amounts of rectal bleeding, lightheadedness, dizziness, or faintness.
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