Hemorrhoids.  What are they? What can you/we do to make them better?

Hemorrhoids are when the veins near the anus are filled with blood.  Hemorrhoids are the most common benign condition that causes anal bleeding.  You do need to see your physician for diagnosis.  And you may need a work up for other causes of bleeding like anal fissures (a tear in the anal sphincter) or colon cancer. 

What is the initial treatment? Add water and fiber! Take 25 to 35 grams of insoluble fiber (like OTC psyllium).  Increase water intake to 64 ounces per day.  If you are dehydrated, the stool is also dehydrated and this makes it more difficult to pass.  Straining with a bowel movement sends more blood into those already engorged anal blood vessels.  The goal is to pass a daily soft stool, with no straining.  Sitz baths, sitting in lukewarm bathwater, also helps hemorrhoids.  Topical treatments (steroids, antiseptics and analgesics) are often used, but the research does not show overwhelming success.

What if the pain is excruciating and you cannot sit down?  Call your physician.  You may have an acute thrombosed hemorrhoid and this needs medical attention.  The pressure within the hemorrhoid is the uncomfortable part and your physician can incise (cut) the hemorrhoid and take out the blood clot within the hemorrhoid.  This gives most patients instant relief.

What if all of the above does not work?  Then I would send you to a surgeon.  They may perform an office procedure like rubber band ligation to get rid of the problem blood vessel, or they may inject sclerotherapy into the problem blood vessel.  A small number of patients need to be taken to the operating room for an excisional hemorrhoidectomy. 

How to avoid hemorrhoids?  Eat insoluble fiber (vegetable and fruit peels and whole grains) and adequate water intake.  Do not strain with bowel movements.  For occasional constipation, add OTC fiber or polyethylene glycol to your diet.

I hope this has helped.