Are hemorrhoids wreaking havoc on your rear?


by Baylor Scott & White Health

Mar 1, 2019

They may be embarrassing to talk about, but about 5 percent of American adults overall, and as many as half of those over the age of 50, will suffer from the irritating symptoms related to hemorrhoids at some point in their lifetime.

Deciphering your symptoms and choosing the right treatment options are key to getting quick relief. Melvin Lau, MD, a gastroenterologist with Baylor Scott & White – Round Rock, explains what hemorrhoids are and what to do if you suspect you have them.

“Hemorrhoids are normal blood vessels inside and outside of the anal canal,” said Dr. Lau. “They are a problem when they become swollen and painful. The exact cause of symptomatic hemorrhoids is not clear, but the correlation with constipation and straining during a bowel movement is very strong.”

How do I know if I have hemorrhoids?

So, how do you know if you have them?

Dr. Lau said there are three main symptoms: itching, bleeding and pain before, after or during a bowel movement.

If you have these symptoms and are wondering whether or not you have hemorrhoids, most family medicine doctors can examine the area and see if there are any external hemorrhoids.

“The internal ones require some sort of instrumentation, either an anal scope, which they can do in the clinic, or during a colonoscopy,” Dr. Lau said.

Is there a treatment for hemorrhoids?

The good news for hemorrhoid sufferers is that 80 to 90% of hemorrhoid cases can be treated conservatively with these steps:

  1. Increase fiber intake to 25 to 30 grams of fiber a day, through high fiber foods or a supplement.
  2. Avoid straining when having a bowel movement.
  3. Increase water intake to six to eight glasses a day.

“Most people don’t drink enough water,” Dr. Lau said. “If the mouth is thirsty, then the anus is also dry.”

Gastroenterologists like Dr. Lau can also teach patients better bowel movement techniques to decrease pressure on the anal veins.

“We tell them not to sit there and read the magazine or the newspaper,” he said. “It also helps to wipe gently and if you have the urge, go. Don’t wait a long time.”

The doctor said Sitz baths, which are warm or lukewarm baths, can also help relieve symptomatic hemorrhoids.

But not all over-the-counter remedies are helpful. Dr. Lau warns against overusing hemorrhoid creams.

“Some of those creams contain steroids, which can dry out the anus and can even cause more itching,” he said.

When should I see a doctor about my hemorrhoids?

If the home treatments aren’t relieving your symptoms, it may be time to seek medical attention.

“For the internal hemorrhoids, you don’t have pain fibers, so we can do something called band ligation, which decreases the size of the surface area of the hemorrhoids,” Dr. Lau said.

But if painful, external hemorrhoids are the issue, then having them surgically removed may be your best option.

For most patients, these procedures won’t be necessary. But Dr. Lau said if you are having hemorrhoid symptoms, especially rectal bleeding, it is best to consult with your doctor.

“Colorectal cancer is the third leading cause of cancer in the United States, and sometimes hemorrhoid bleeding can mimic other, dangerous diseases,” he said.

And if you are over age 50 and having rectal bleeding, he strongly recommends having a colonoscopy to make sure nothing else is going on.

For more information about hemorrhoids and other conditions, make an appointment with your primary care physician. If you don’t have one, we can help you find a doctor near you today

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