Hemorrhoids are a common condition affecting veins in the rectum and anus. Many wonder if they are permanent, a widespread concern given that about half of all people will experience them by age 50. Understanding their nature and management is important for relief.
What are Hemorrhoids?
Hemorrhoids, also known as piles, are swollen and inflamed veins located around the anus or in the lower rectum. This condition arises when increased pressure causes these veins to bulge.
There are two primary types: internal and external hemorrhoids. Internal hemorrhoids form inside the rectum, above a point less sensitive to pain, and may not be felt unless they prolapse or bleed. External hemorrhoids develop under the skin around the anus, in an area with many pain-sensing nerves, often causing discomfort, itching, and swelling.
Do Hemorrhoids Resolve?
Hemorrhoids are not a permanent condition and often resolve on their own, especially with conservative measures. Smaller hemorrhoids can clear up within a few days, while larger external hemorrhoids might take longer to heal and cause significant pain. Most cases improve without specific treatment through lifestyle and dietary changes, though they can recur. Factors influencing resolution include the severity and type of hemorrhoid, with persistent or severe cases sometimes requiring medical intervention.
Managing Hemorrhoid Symptoms
Alleviating hemorrhoid symptoms often begins with simple, non-invasive methods and over-the-counter (OTC) treatments. Increasing dietary fiber intake to 25-35 grams per day can soften stools, making them easier to pass and reducing straining that aggravates hemorrhoids. Drinking plenty of fluids, such as 6 to 8 glasses of water daily, is equally important to keep stools soft and prevent constipation.
Warm baths, often referred to as sitz baths, provide relief from pain, itching, and inflammation by increasing blood circulation to the affected area. Soaking in a few inches of warm water for 15 minutes, two to three times a day, and after bowel movements. Topical treatments like hemorrhoid creams or suppositories containing hydrocortisone, witch hazel, or numbing medicines ease discomfort and itching. Oral pain relievers like ibuprofen or acetaminophen manage soreness.
Medical Interventions for Persistent Hemorrhoids
When hemorrhoids do not respond to home care or are severe, medical interventions become an option. Office-based procedures are common for internal hemorrhoids, with rubber band ligation being a common treatment. This procedure involves placing tiny rubber bands around the base of an internal hemorrhoid to cut off its blood supply, causing it to wither and fall off within about a week. Sclerotherapy involves injecting a chemical solution into the hemorrhoid tissue, which causes it to shrink over time by hardening the tissue and reducing blood supply. Infrared photocoagulation uses an intense beam of infrared light to create scar tissue, cutting off blood flow to the hemorrhoid and causing it to shrink.
For advanced or persistent cases, surgical options might be considered, especially when other treatments have failed. A hemorrhoidectomy, the surgical removal of hemorrhoids, is an effective treatment for severe cases. While it offers definitive resolution, it is generally reserved for situations where less invasive methods are insufficient.
Preventing Recurrence
Preventing hemorrhoid recurrence involves adopting lifestyle modifications that promote regular, soft bowel movements and reduce pressure on rectal veins. Consuming a high-fiber diet, rich in fruits, vegetables, and whole grains, helps soften stool and increases its bulk, minimizing straining. Fiber supplements can be considered if dietary intake is insufficient, but they require adequate fluid consumption to prevent constipation.
Drinking 6 to 8 glasses of water daily helps keep stools soft and ease passage. Avoiding prolonged sitting, especially on the toilet, helps reduce pressure on the anal veins. Regular physical activity, such as walking, stimulates bowel function and prevents constipation, lowering the risk of hemorrhoids. Responding promptly to the urge to have a bowel movement and avoiding straining are important.