October 13, 2021
Clinical Contributors to this Story
Kulvir S. Nandra, M.D. contributes to topics such as Colorectal Surgery.
Sameet Shah, D.O. contributes to topics such as Gastroenterology.
Near the top of the list of health issues people avoid talking about is hemorrhoids, even to doctors. They’re uncomfortable, they’re unattractive, they bleed, and they make going to the bathroom a challenge. They’re also very common. In fact, about half of people have had a bout with hemorrhoids by the time they reach 50 years old.
What Is a hemorrhoid?
Hemorrhoids can be inside or outside your body. With external hemorrhoids, you can see them and they tend to hurt. With internal hemorrhoids, you don’t see or feel them, but a symptom might be bleeding during a bowel movement.
The most common cause of hemorrhoids is due to constipation or straining while using the toilet. Women are prone to hemorrhoids during pregnancy and after giving birth because of the increased pressure on the pelvic floor and hormonal changes that can lead to constipation. Children and adolescents can also get hemorrhoids.
At-home Hemorrhoid Remedies
“I tell my patients that the most important thing they can do for a hemorrhoid is to let it heal by not straining when having a bowel movement and avoiding constipation,” says Dr. Shah. Straining increases pressure and prevents the hemorrhoid from shrinking.
To deal with the underlying problem of constipation and straining, Kulvir S. Nandra, M.D., a colorectal surgeon at Mountainside, offers a few tips:
- Eat foods high in fiber, such as bananas, pears, strawberries, avocados, carrots, beets, broccoli, spinach, legumes, lentils, oats, nuts, seeds and sweet potatoes.
- Increase your water intake.
- Consider taking an over-the-counter fiber supplement.
- Soak in a sitz bath – a warm and shallow bath – by filling a tub with a few inches of warm water and sitting in the water for 15 or 20 minutes.
If you see a doctor for hemorrhoids, they might prescribe hydrocortisone that can be applied directly or in the form of a suppository. “For most of my patients, a high-fiber diet plus sitz baths and hydrocortisone works,” says Dr. Shah. The bleeding stops, the sensation goes away and that’s usually the end of it.
The Three Worst Things You Can Do
- Spend too much time on the toilet. “Having good bowel habits means eating a healthy diet and spending no more than five minutes on the toilet,” says Dr. Nandra.
- Over-wipe or wipe aggressively. Use plain, unscented, hypoallergenic wipes; wet tissue; cotton balls; or a bidet to clean yourself.
- Not call your doctor when it could be something more serious. “Any kind of rectal bleeding should be checked out by a doctor, especially if it is associated with unintended weight loss or anemia,” says Dr. Shah. These symptoms could be a sign of something more serious. It’s important to listen to your body, and if something doesn’t feel right, it’s best to get evaluated by a medical professional.
If you’ve exhausted at-home remedies and medical options, and still have issues related to hemorrhoids, the next step may be to see a colorectal surgeon. Many procedures can be performed in the office, such as what’s called hemorrhoid banding or hemorrhoid sclerotherapy:
- Banding involves wrapping a small rubber band around the hemorrhoid, which causes it to shrink and fall off. “This procedure is painless, quick and done in the office,” says Dr. Nandra.
- Sclerotherapy is similar but involves a special injection that cuts off blood supply to the hemorrhoid, which causes it to fall off.
If hemorrhoids are severe and keep coming back, several outpatient, same-day procedures are available that involve undergoing sedation similar to a colonoscopy:
- Hemorrhoid ligation, which is similar to rubber-banding but with a suture.
- Hemorrhoidectomy, which is where the hemorrhoid is cut out.
- Stapled hemorrhoidectomy, which involves using a stapler device for larger hemorrhoids.
- Transanal hemorrhoidal dearterialization (THD), which is an ultrasound-guided minimally invasive technique to target the blood supply to a hemorrhoid.
Your medical team will work with you to decide which procedure is right for you.
The Bottom Line
“The sooner we treat the issue, the sooner you will feel better,” says Dr. Nandra. It is possible to treat hemorrhoids with simpler methods, but waiting too long could lead to surgery.
Next Steps & Resources:
- Meet our sources: Sameet Shah, D.O., and Kulvir S. Nandra, M.D. To make an appointment with a doctor near you, visit our website.
- Learn more about comprehensive gastrointestinal services at Mountainside Medical Group
- How gut health is linked to mental health
- Does your child have digestive issues?
The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.