Hemorrhoids

Medically reviewed by Aaron Wiegmann, MD, MS Plastic Surgeon February 15, 2024| Written by Shahid Bashir

Hemorrhoids

Hemorrhoids, also commonly known as “piles,” happen when there is a swelling of the veins around the anus or in the lower part of the rectum. They are generally classified into two groups depending on their location, i.e., internal and/or external hemorrhoids. 

When the engorged vein is inside the anus (in the rectum), it is called an internal hemorrhoid. But, in case hemorrhoids appear under the skin outside the anus, they are called external hemorrhoids. 

Hemorrhoids are very common. According to a study,50% chances of people 50 years of age or older will experience hemorrhoids. Symptoms may include severe discomfort, such as itching, pain, blood in stool, and difficulty sitting. The severity of these symptoms depends on the veins' location and degree of swelling. 

However, there are also cases where individuals with hemorrhoids may not experience any symptoms at all. 

Signs & Symptoms

The signs and symptoms of hemorrhoids entirely depend on the type of hemorrhoids you have. Also, the severity of the symptoms relates to the location and swelling of the veins.

In the case of internal hemorrhoids, the symptoms may include the following:

  • Pain during bowel movement
  • Blood in Stool
  • Prolapse of hemorrhoid out of anus

In the case of external hemorrhoids, the symptoms may include:

  • Painful swelling around the anus
  • Itching around anus
  • Pain while sitting upright

The above symptoms are not exclusive to hemorrhoids. For example, it is common to see blood in the stool resulting from other issues such asurinary tract infections. So, you must consult a healthcare professional for proper diagnosis when experiencing any symptoms including blood during bowel movement.

Though hemorrhoids can cause severe discomfort, they are not life-threatening. 

In fact, in many cases, a person may not experience any symptoms, and hemorrhoids can resolve without causing severe complications. 

Causes

Hemorrhoids result from persistent increased pressure in the veins around your anus or lower rectum. This increased pressure on the lower rectum may be caused by a variety of factors, including: 

  • Straining during bowel movement
  • Sitting on the toilet seat for extended periods
  • Extended periods of irregular bowel movements, i.e. diarrhea or constipation
  • Pregnancy
  • Consuming low-fiber diet
  • Frequent indulging in anal intercourse
  • Lifting heavy objects

Apart from these factors,aging also has a great influence on hemorrhoids. Veins gradually weaken with age; making them more prone to hemorrhoid development. This is evidenced by previously describedstatistics that show a high prevalence of hemorrhoids after the age of 50. 

Treatment

Treatment of most hemorrhoids does not need the involvement of a healthcare professional, and you can relieve the symptoms by practicing a few home remedies. For that, you should:

  • Consume a diet high in fiber
  • Drink sufficient liquid
  • Avoid straining during bowel movements
  • Avoid sitting on the toilet seat for extended durations

You can also try some over-the-counter stool softeners to regulate your bowel movements. 

However, if home remedies fail to relieve the symptoms and the condition worsens; then you must see a health professional. The physician may opt for one of the following medical interventions available for treating hemorrhoids:

1. Hemorrhoid Banding

Hemorrhoid banding orrubber band ligation is an effective technique for treating internal hemorrhoids. In this technique, a physician inserts a tool called a ligator from the anal route, reaching the hemorrhoids. With the help of a ligator, the physician places small special rubber bands around the base of the hemorrhoid. 

The rubber band cuts off the blood supply to the hemorrhoid, emptying it. This dried hemorrhoid then passes out with the bowel movement. This whole process usually takes around a week to complete. 

2. Sclerotherapy

Sclerotherapy is yet another simple and convenient practice that a physician performs for internal hemorrhoids. It involves injecting a solution into a hemorrhoid that induces scar tissue formation which then dries the hemorrhoid. 

These dried hemorrhoids then shed off from the location and pass through the body with bowel movement. 

3. Hemorrhoidectomy

Hemorrhoidectomy is a surgical procedure that requires the expertise of a surgeon and a hospital setup. It is done to eradicate hemorrhoids when other methods fail to relieve the symptoms. It is effective for both internal and external hemorrhoids. 

That said,post-hemorrhoidectomy pain is among the top complications of this surgery. 

4. Other Treatments

There are several other treatment options available for hemorrhoids, including:  

  1. Infrared photocoagulation
  2. Electrocoagulation
  3. Hemorrhoid stapling. 

That said, most hemorrhoid patients recover without any medical procedures - by simply opting for a healthy lifestyle.  

What Are the Self-help Tips For Hemorrhoid Flare-ups?

Hemorrhoids do not always need medical treatment or a visit to a hospital. For the most part, you can practice self-help tips for hemorrhoid flare-ups. 

Here are some effective tips to relieve hemorrhoid symptoms:

1. Increase Fiber Intake

A fiber diet helps soften the stool, making it easy to move through your body. Fiberincreases the stool volume and results in less strain during the bowel movements. 

You can conveniently include fiber in your diet by consuming vegetables, fruits, and whole grains. You can also opt for fiber powderextracted from plant sources

2. Increase Water Intake

Dehydration hardens the stool and ultimately, increases the strain during bowel movement. So, one must consume an adequate amount of liquid including water or natural juices, when experiencing the symptoms of hemorrhoids. 

The abundantwater softens the stool and makes defecation easier and less straining.

3. Improve Bathroom Habits

Avoid sitting on the toilet seat for longer durations. Also, don’t force the bowel movements to happen and allow the stool to pass naturally out of the body. Don’t use rough toilet paper as it may facilitate irritation by friction. Instead, try using soft and moistened wipes to clean the anal area. 

4. Sitz Baths

Sitz baths or sitting in warm shallow water canameliorate discomfort in your perineal area. It works by increasing the blood flow and facilitating the healing process. 

So, if you’re experiencing hemorrhoid flare-ups, you should take a sitz bath several times a day—especially after bowel movements. 

5. Choose Comfortable Clothing

A tight or rough cloth over the hemorrhoid area may promote inflammation and worsen the condition. Wear loose cotton underwear that will allow the air to pass through easily, minimizing the chances of moisture and thereby, irritation.

6. Painkillers

To relieve the pain from hemorrhoids, you can take over-the-counter painkillers such as aspirin or ibuprofen. Just be careful about the dosage as these drugs do cause side effects.

That said, it’s crucial to figure out the root cause of symptoms before opting for any treatment. So, I advise you to seek professional help for proper diagnosis.  

Role of Plant-based Diet and Lifestyle Changes in Preventing Reoccurrence

There is a direct relationship between our diet and lifestyle and the overall functioning of our body. It is evident through studies that asedentary lifestyle may lead to a wide variety of medical issues, and hemorrhoids are no exception. If you are looking for a healthy food source to prevent the reoccurrence of hemorrhoids, look no further than a plant-based diet.

Plant-based Diet in Preventing Hemorrhoid Reoccurrence

Studies show that a plant-based diet can be important for improving digestive health. Constipation is a major risk factor for developing hemorrhoids as it results in straining during bowel movements.Scientific data shows that a plant-based diet high in fiber effectively prevents and manages constipation, resulting in a lower risk of developing hemorrhoids. 

Here are several other ways by which a plant-based diet can prevent hemorrhoid recurrence:

a. High-Fiber Content

Plant-based products such as vegetables, fruits, whole grains, and nuts are high in fiber. A high-fiber diet adds volume to the stool by softening it, thus minimizing the strain during bowel movements. 

Less strain during bowel movements reduces the chance of developing hemorrhoids.

b. Anti-Inflammatory Function 

One of the important aspects of consuming a plant-based diet is the antioxidant and anti-inflammatory factors they contain. 

For instance, flavonoids are plant-based chemicals that promote tissue repair. According to several studies, a flavonoid-based productmicronized purified flavonoid fractionis beneficial in treating symptoms related to hemorrhoids.

c. Reduced Fat 

If you mostly consume a plant-based diet, the odds are that your body doesn’t have highcholesterol and lipid levels. It’s because a plant-based diet is low in saturated fats. That’s why it alsoimproves cardiovascular health

d. Hydration

Dehydration can lead to hard stool formation, a risk factor for developing hemorrhoids. Plant-based foods, especially fruits, have significantly more water and help fulfill the body's liquid requirements. 

e. Nutrients

A healthy body experiences less discomfort when suffering from any disease, including hemorrhoids. Plant-based foods are high in complex nutrients such as minerals and vitamins. Consuming a balanced plant-based diet promotes overall health and well-being. 

Lifestyle Changes in Preventing Hemorrhoid Reoccurrence

There are some risk factors for any disease that you cannot simply eradicate. For example, aging is a prominent risk factor in developing several health conditions, including hemorrhoids.

Fortunately, there are some lifestyle changes that you can adopt to manage hemorrhoids and prevent their recurrence. 

1. Eating Habits 

As important as it is to achieve your calorie count, it is equally important to analyze what you eat. If your diet plan does not have fiber in it, you are at risk of developing hemorrhoids along with several other digestive diseases. 

A fiber-rich diet helps the digestive tract in forming soft stool which eases the strain for bowel movement. 

You can get adequate fiber from whole grains, fruits, vegetables, nuts, and seeds. The easiest way to reach the optimum fiber count of30 to 38 grams for adult males and20 to 25 grams for adult females is by simply increasing the amount of fiber in your diet.  

2. Toilet Habits 

Your bathroom habits, such as the frequency and duration for which you sit on the toilet seat, play a key role in managing risk factors for hemorrhoids. When you feel the need to go to the toilet, don’t wait for a long time. 

This is because delaying may cause stool to become hard and increase straining during the bowel movement. Hard stool and straining contribute to the development of hemorrhoids. 

Taking breaks also reduces the time you sit on the toilet seat. Sitting on the toilet seat for a longer duration increases strain on the anal and lower rectum veins, possibly causing hemorrhoids. 

3. Exercise 

It is evident from research thatexercise improves overall health and promotes optimum body functioning. Similarly, exercises or physical activities help prevent the reoccurrence of hemorrhoids in many ways. 

Physical activity stimulates bowel movement, which lowers the chances of developing constipation. Exercise also helps inregulating body weight

A combination of constipation and increased body weight can result in extreme strain during bowel movements, leading to hemorrhoids.  

Conclusion

Hemorrhoids have a variety of risk factors. You can control certain factors, such as avoiding lifting heavy objects or sitting on a toilet seat longer. But you can’t control aging or pregnancy. 

A plant-based diet and lifestyle changes may play a significant role in preventing hemorrhoids and improving overall health.

If you do get hemorrhoids, there is nothing to stress about. You can manage hemorrhoids at home with home remedies such as an increased fiber diet, sufficient water, and a sitz bath. But if you feel no relief in symptoms, you should seek help from a medical professional.