If you have significant pain, bleeding, or a prolapsed hemorrhoid and are unable to contact your doctor, then you should be evaluated in the hospital.
If you have prolapsed hemorrhoids that will not go back through the anus, or you have significant pain from your hemorrhoids
What are hemorrhoids Hemorrhoids are enlarged, painful veins in your rectum. The internal veins can become swollen to form internal hemorrhoids. Internal hemorrhoids, unless they are severe, cannot be seen or felt, unlike external hemorrhoids. Likewise, the external veins can swell to form external hemorrhoids. External hemorrhoids can be seen around the outside of the anus and, many times, can be felt. Hemorrhoids are associated with constipation and straining at bowel movements as well as pregnancy. It is thought that these conditions lead to increased pressure in the hemorrhoid veins, thus causing them to swell. Liver disease can also cause increased pressure in the veins and also cause hemorrhoids. Hemorrhoids are very common and have been estimated to occur in up to half the population by age 50 years Hemorrhoid Symptoms The most common complaint from internal hemorrhoids is painless bleeding. You will see bright red blood on the outside of your stool, on the toilet paper, or dripping into the toilet. The bleeding usually does not last long. Hemorrhoids may lead to a condition called prolapsed hemorrhoids. This occurs when the internal hemorrhoids swell and then extend through the anus. You then can feel the hemorrhoids, at your anus, from the outside. Many times you can gently push the hemorrhoids back through the anus and solve the problem. If the hemorrhoids cannot be pushed back, then they may swell even more and become trapped outside of the anus. If your hemorrhoids become entrapped, then you will need to see a doctor. You may develop itching in your anus from prolapsed hemorrhoids. This condition is called pruritus ani. When to call the doctor If you are over age 40 years or have a family history of colon cancer, you should see your doctor for rectal bleeding.
- If you develop bleeding between bowel movements or have a moderate amount of bleeding from hemorrhoids, you should consult your doctor.
If you have a large amount of bleeding from your rectum, become weak, or experience dizziness, you should go to your hospital’s emergency department
Exams and Tests
Almost always the doctor will only need a history and physical exam to evaluate your hemorrhoids. Sometimes you may need anoscopy for your exam. In anoscopy, a small, lighted scope is placed into your anus to fully see the anus and lower rectum. The procedure is slightly uncomfortable but is easily performed in a doctor's office and does not require sedation. If you have had significant bleeding or symptoms of severe blood loss, then your doctor may order a complete blood count to ensure that you are not anemic.
Self-Care at Home
The treatment for hemorrhoids is different depending on the severity of the problem. Most of the time, the treatment is conservative and performed at home.
Hot sitz baths
- A sitz bath is recommended 3 times a day and after each bowel movement for at least 15 minutes.
- For a sitz bath, sit in a few inches of warm water in a tub.
- This is the best way to lessen the swelling and the pain.
- Be sure to thoroughly dry the skin around your anus after each bath so that it doesn't rub and become torn.
- Drink more liquids and eat more leafy green vegetables, which will make stools bulkier and softer to relieve constipation.
- Some people with constipation or hard stools may benefit from increasing the amount of bran and fiber in their diet.
- Stool softeners might also help.
- You should be cautious in choosing a laxative for your constipation.
- If a laxative causes watery, runny stools, it could cause an infection in the anus and should not be used.
- Some doctors also recommend people with hemorrhoids not sit for a long period of time.
- Some people feel more comfortable sitting on an air doughnut.
Many creams, ointments, and suppositories are sold as pain relievers and medicines for hemorrhoids.
These medications are of little help and sometimes might even cause the hemorrhoids to take longer to heal, so consult with your doctor first.
Prolapsed internal hemorrhoids
If you have prolapsed internal hemorrhoids, which you are unable to push back through the anus, then your doctor may need to reduce them. Many times the doctor is able to gently push the hemorrhoids back into place.
If the hemorrhoids are too swollen to be pushed back through the anus, then you may need a surgical procedure to relieve the swelling. If the hemorrhoids remain swollen and trapped through the anus and nothing is done, then the hemorrhoid will not receive enough blood and start to die. If this occurs, the hemorrhoid will become infected, and the infection can spread throughout the blood, making you very sick.
If you have continued bleeding, prolapsed hemorrhoids that cannot be pushed back into place, uncontrollable pain, or severe rectal itching, surgery is needed. The surgeon might inject the hemorrhoids with a medicine to shrink them or place small rubber bands around the hemorrhoids to cut off the blood supply so they will die. These procedures are usually done in the office and don't require you to be put to sleep or admitted to a hospital. Less commonly used treatments are cryotherapy in which the hemorrhoid is essentially frozen off, or laser therapy, in which the hemorrhoid is burned off. Sometimes, it is necessary for the surgeon to actually cut the hemorrhoids off. In this case you will need to be put to sleep or have a spinal anesthetic
Warm sitz baths 3 times a day and after each bowel movement along with increasing the amount of liquids and leafy vegetables in your diet are beneficial.
Any pain from hemorrhoids should be managed with over-the-counter pain relievers.
You may receive prescriptions for stool softeners, and these should be taken as directed by your doctor.
If you develop worsening pain, bleeding, fever, abdominal pain, or vomiting after being treated for hemorrhoids, then you should contact your doctor or go to the emergency department.
No definite way has been found to avoid hemorrhoids. Eating a high-fiber diet and avoiding straining at bowel movements is thought to aid in preventing hemorrhoids, but there is no way to completely eliminate the risk.
Most people with hemorrhoids have an excellent prognosis. You may have flare-ups of bleeding or slight discomfort from time to time, but they don't last long and can be relieved with care at home.
Certain people may worsen to the point of needing surgery. This surgery is fairly minor, and most will have significant improvement.
post edited by Lynx100 -
If you want to keep the hemorrhoids under control, NO straining. that means on the toilet AND in the gym. Any increase in intra-abdominal pressure can cause internal hemorrhoids to prolapse and you dont want that.
If youre up for it, request the doctor if you can get them banded and see what he has to say. Its a minor procedure. It will get rid of the hemorrhoids however any straining or pressure will most probably make them come back again.
Exercises that you must take it VERY easy on are Leg exercises. Things such as Leg press, Squats, Lunges all have the potential to cause hemorrhoids and make existing ones even worse - prolapsing or even thrombosing them. However, having said this, it applies to any body part that you are training in the gym. Its a very unlucky thing to have my friend, especially if you love your weights.
Take it easy.