What should you do if you suspect you have a hemorrhoid? Here’s advice from our Health After 50 newsletter.
Often sources of discomfort and embarrassment, hemorrhoids are inflamed veins in the tissue of the anus and rectum. They are usually caused by pressure from straining during bowel movements (from constipation or diarrhea), but genetics and prolonged sitting (including spending too much time on the toilet) also can play a role.
Hemorrhoids on the edge of or outside the anus typically feel like tender, itchy lumps. Often the first symptom of a hemorrhoid is bleeding, noticeable in the toilet or on toilet paper after a bowel movement. When you detect bleeding for the first time, you should see your doctor to rule out a more serious disorder, like ulcerative colitis or colon cancer (though, most likely, it will be a hemorrhoid).
The first-line treatment for hemorrhoids is to gradually add more fiber and fluids to your daily diet (aim for 25–30 grams of fiber daily and six to eight cups of fluid). This will soften your stool, making it easier to go to the bathroom. Over-the-counter hemorrhoid creams or suppositories also may alleviate symptoms, but these drugs are not long-term solutions. Soaking in warm water in a regular or sitz bath -- a small tub you can buy at the drugstore that is placed on the toilet bowl -- also may help. Also try to avoid sitting or standing for long periods.
For more severe symptoms (like persistent or severe pain or bleeding), your doctor may suggest rubber band ligation, in which a rubber band is tied around the base of the hemorrhoid, cutting off its circulation and causing the hemorrhoid and rubber band to fall off within a few days. There are few nerve endings inside the anal canal, so it is relatively painless.
Sclerotherapy -- an injection of chemicals that cause the area around the hemorrhoids to harden -- is another option, as is laser therapy to vaporize hemorrhoids. If these nonsurgical treatments fail to work, surgery may be necessary to remove the hemorrhoids.
