Hemorrhoids are a common condition characterized by swollen veins in the lower rectum or anus. Internal hemorrhoids, located inside the rectum, are a specific concern as they may not always be immediately apparent. Many individuals seek over-the-counter treatments to manage their symptoms.
Understanding Internal Hemorrhoids
Internal hemorrhoids are swollen blood vessels situated inside the rectum, typically above the dentate line. Unlike external hemorrhoids, they are usually not visible or felt from the outside and often cause no pain. The most common symptom is painless bright red blood, which may appear on toilet paper, in the toilet bowl, or on the surface of stool after a bowel movement. Sometimes, an internal hemorrhoid can protrude or prolapse through the anal opening, which may lead to discomfort, itching, or a feeling of a lump.
These hemorrhoids develop from increased pressure on the veins in the lower rectum. Common causes include straining during bowel movements, chronic constipation or diarrhea, and prolonged sitting. Pregnancy, obesity, and regularly lifting heavy objects can also contribute. A low-fiber diet is another contributing factor, as it can lead to harder stools and increased straining.
How Preparation H Addresses Internal Hemorrhoids
Preparation H products are designed to alleviate symptoms associated with internal hemorrhoids through various active ingredients. Phenylephrine HCl, a vasoconstrictor, temporarily narrows blood vessels in the affected area. This action helps to shrink swollen hemorrhoidal tissue, reducing discomfort and inflammation.
Pramoxine HCl, a local anesthetic, temporarily relieves pain, itching, and burning sensations. Many Preparation H formulations also contain protectants like glycerin, mineral oil, and petrolatum. These form a soothing barrier over irritated tissues, reducing friction and irritation, making bowel movements less painful and promoting healing.
For internal hemorrhoids, these products often include an applicator for proper rectal insertion. Users should cleanse the affected area, attach the applicator to the tube, lubricate it, and gently insert it about half an inch into the rectum. The product is typically used up to four times daily, especially after bowel movements. Phenylephrine HCl is an FDA-approved ingredient for over-the-counter hemorrhoidal relief, recognized for its symptomatic treatment.
Beyond Preparation H: Other Approaches and When to See a Doctor
While Preparation H offers symptomatic relief, managing internal hemorrhoids often benefits from lifestyle adjustments. Increasing dietary fiber intake to 25-38 grams per day, through foods like fruits, vegetables, and whole grains, can soften stools and reduce straining. Adequate hydration by drinking plenty of water also helps keep stools soft and easier to pass. Regular physical activity and avoiding prolonged sitting on the toilet can further promote healthy bowel function and reduce pressure on rectal veins.
Other over-the-counter options, such as fiber supplements or stool softeners, can aid in preventing constipation. Warm sitz baths, where the anal area is soaked in warm water for 10-20 minutes, provide soothing relief from discomfort and itching. Topical treatments containing witch hazel or hydrocortisone may also help reduce irritation and inflammation.
Seek medical attention if symptoms persist or worsen after about a week of home treatment. Consult a doctor for persistent rectal bleeding, especially if the blood is dark or tarry, or for significant changes in bowel habits. Severe pain, unexplained weight loss, or a prolapsed hemorrhoid that cannot be gently pushed back inside also warrant professional medical evaluation. These symptoms could indicate other, more serious conditions.