Hemorrhoids are a common condition involving swollen veins in the rectum or around the anus. While many resolve quickly, some can persist for weeks or even months. This article explores why some hemorrhoids have an extended duration.
Understanding Hemorrhoids
Hemorrhoids are swollen blood vessels, similar to varicose veins, classified into two main types: internal and external. Internal hemorrhoids develop inside the rectum, typically above the dentate line, where pain-sensing nerves are fewer. They often manifest with bright red blood during bowel movements but may not cause pain unless they protrude outside the anus.
External hemorrhoids form under the skin around the anal opening, an area rich in pain-sensing nerves. This often leads to noticeable symptoms like itching, discomfort, swelling, or a tender lump. Both types can cause bleeding, visible on toilet paper or in the toilet bowl.
Factors Influencing Hemorrhoid Duration
Several factors contribute to hemorrhoids lasting for months. The severity plays a significant role; larger, more inflamed, or prolapsed hemorrhoids (internal hemorrhoids bulging outside the anus) naturally take longer to heal. If an internal hemorrhoid prolapses and cannot be easily pushed back inside, or if a blood clot forms within an external hemorrhoid (a thrombosed hemorrhoid), pain and duration increase considerably.
Underlying issues causing increased rectal pressure can also prevent healing and prolong symptoms. Persistent straining during bowel movements, often due to chronic constipation or diarrhea, stresses the anal veins. Prolonged sitting, especially on the toilet, heavy lifting, or pregnancy pressure can similarly impede recovery.
A lack of consistent lifestyle changes or inadequate self-care can also extend hemorrhoid duration. If contributing habits, such as a low-fiber diet or insufficient fluid intake, continue, symptoms are likely to persist.
When to Seek Medical Attention
Consult a healthcare provider if a hemorrhoid persists, especially if symptoms do not improve after a week of home care. Persistent bleeding, particularly if heavy, continuous, or dark, warrants medical evaluation to rule out other conditions. Rectal bleeding can indicate more serious issues, such as colorectal or anal cancer, so a professional diagnosis is important.
Severe pain or discomfort that interferes with daily activities or does not respond to over-the-counter treatments indicates seeking medical help. If a prolapsed hemorrhoid cannot be gently pushed back inside, or if symptoms worsen, medical intervention may be necessary. Any new or unusual symptoms, or uncertainty about the issue, also justifies a doctor’s visit for an accurate diagnosis.
Management Strategies for Persistent Hemorrhoids
Managing persistent hemorrhoids involves lifestyle adjustments and, when necessary, professional medical interventions. Key lifestyle changes include increasing dietary fiber from fruits, vegetables, and whole grains to soften stools and reduce straining. Adequate hydration by drinking plenty of water is also crucial for soft bowel movements. Avoiding prolonged sitting on the toilet and regular physical activity can further reduce pressure and promote healing.
Home remedies can provide symptom relief while the hemorrhoid heals. Soaking the anal area in a warm bath or sitz bath for 10-15 minutes can help reduce itching and discomfort. Over-the-counter creams, ointments, or suppositories with ingredients like witch hazel or hydrocortisone can alleviate pain, itching, and swelling. Cold compresses can also reduce discomfort.
For chronic or severe cases, a healthcare professional may recommend medical interventions. Non-surgical options include rubber band ligation, where a band cuts off the hemorrhoid’s blood supply, causing it to shrink and fall off. Sclerotherapy involves injecting a chemical solution to shrink the hemorrhoid, and infrared coagulation uses heat to create scar tissue, cutting off blood flow. If these minimally invasive procedures are insufficient, surgical options like hemorrhoidectomy (removing the hemorrhoid) or stapled hemorrhoidopexy (repositioning the tissue) may be considered. Professional medical guidance is essential for determining the most appropriate treatment plan.