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Hemorrhoids – a more common condition than we think
Dr Zulfikar Bux
Assistant Professor of Emergency Medicine
Worldwide over 10% of our population is estimated to have hemorrhoids (piles) and it is anticipated that one
Dr Zulfikar Bux
in every two persons will be affected by hemorrhoids in their lifetime.
Given the nature and privacy associated with hemorrhoids, it is often not picked up early by sufferers or they keep it as a secret because of fear of discrimination. Doing this leads to evolution and complication of the hemorrhoid and it is then when patients often present to the doctor for help. Knowing if you have hemorrhoids and presenting to your doctor early are vital steps in its management and this will help to prevent it from becoming more complicated.
WHAT ARE HEMORRHOIDS?
Hemorrhoids are swollen veins in the rectum which causes its walls to become swollen and narrow your rectum or anal canal. They can cause itching and pain. Sometimes they can also make you bleed during a bowel movement. In some cases, you can see or feel hemorrhoids around the outside of the rectum. In other cases, you cannot see them because they are hidden inside the rectum.
WHAT CAN I DO TO KEEP FROM GETTING MORE HEMORRHOIDS?
The most important thing you can do is to keep from getting constipated. You should have a bowel movement at least a few times a week. When you have a bowel movement, you also should not have to push too much. Plus, your bowel movements should not be too hard.
Being constipated and having hard bowel movements can form hemorrhoids or make existing hemorrhoids worse. Here are some steps you can take to avoid getting constipated or having hard stools:
Ï% Eat lots of fruits and vegetables. They have fiber, which helps to increase bowel movements.
Ï% Take fibre powders, wafers or pills. You should get 20 to 35 grams of fibre a day.
Ï% Take medicines called stool softeners such as docusate sodium (sample brand names: Colace, Dulcolax) or bulk-forming laxatives. Bulk-forming laxatives include psyllium seed (sample brand names: Metamucil, Konsyl), methylcellulose (brand name: Citrucel), calcium polycarbophil (sample brand name: FiberCon), and wheat dextran (brand name: Benefibre). These medicines increase the number of bowel movements you have. They are safe to take and they can prevent problems later.
WHAT CAN I DO TO REDUCE MY SYMPTOMS?
Some people feel better if they soak their buttocks in 2 or 3 inches of warm water. You can do this up to 2 to 3 times a day for 10 to 15 minutes. Do not add soap, bubble bath, or anything to the water.
There are also medicines that you can get without a prescription. They are usually creams or ointments that you rub on your anus to relieve pain, itching, and swelling. Some hemorrhoid medicines come in a capsule (called a suppository) that you put inside your rectum. Others are in the form of a cream that comes in a bottle with a nozzle that you put inside your rectum. It is okay to try these medicines. But do not use medicines that have hydrocortisone (a steroid medicine) for more than a week, unless your doctor approves.
WHAT IF THE SELF-CARE STEPS DO NOT WORK?
You should see a doctor if you have any bleeding or if your bowel movements look like tar. Bleeding could be caused by something other than hemorrhoids, so you should have it checked out. You should also visit your doctor if you are not sure what’s going on or you are having painful defecation.
If you still have symptoms after trying the steps listed above, you might need treatments to destroy or remove the hemorrhoids. One popular treatment is called “rubber band ligation.” For this treatment, the doctor ties tiny rubber bands around the hemorrhoids. A few days later the hemorrhoids shrink and fall off. The doctor can also use lasers, heat, or chemicals to destroy hemorrhoids. But if none of these options works, there is always surgery to remove the hemorrhoids.
A diet low in fibre and rich in meats and carbohydrates increases our risk of straining when defecating and hence increases our chances of having hemorrhoids. Having hemorrhoids is a natural consequence of poor eating. We should not be ashamed to seek help. The more we embrace it and seek help, the easier life will be with hemorrhoids.
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