Hemorrhoids or piles are enlargement and inflammation of the veins of the lower rectum and anus. This problem is common, and nearly half of adults have experienced it at least once before the age of 50. Hemorrhoids are caused by increased pressure on the lower rectum and anus. This increased pressure on the hemorrhoidal veins causes them to swell. Symptoms you may experience include painless bleeding during bowel movements, pain in the rectum/anus, anal itching, and a painful lump near the anus. There are various options for dealing with hemorrhoids and their pain, both of which you can do at home or with the help of a doctor.
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Method 1 of 3: Treating Hemorrhoid Pain at Home
Step 1. Identify the type of hemorrhoid
Hemorrhoids can be internal or external. Painful symptoms are often associated with external hemorrhoids. However, you may also need to visit a doctor to be sure.
- Internal hemorrhoids occur in the lower rectum and are usually painless because there are no pain receptors in the rectum. Internal hemorrhoids may not even be noticed until blood appears to come out during bowel movements, or hemorrhoids prolapse (protrude from the anus).
- If you experience pain due to hemorrhoids, you may have external hemorrhoids, which form under the layer of skin around the anus. If a blood clot forms inside the hemorrhoid, it is called a thrombosis. Pain that accompanies thrombosis of hemorrhoids is generally severe and appears suddenly. Those who experience it may see or feel a lump around the edge of the anus. Blood clots will usually dissolve and leave a layer of skin around the anus.
Step 2. Use a sitz bath
This treatment can relieve pain and itching caused by hemorrhoids in a short time. Soak the anus in warm water for 10-20 minutes 2-3 times a day and after defecation. Small plastic tubs that can be inserted into the toilet are available at pharmacies. Alternatively, fill hip-deep warm water into the tub.
Gently pat the anal area dry with a towel or use a hairdryer after each treatment
Step 3. Apply a cold compress to the affected area
Cold therapy can relieve swelling and pain caused by hemorrhoids. You can apply ice cubes or a frozen water bag wrapped in a towel to the anus for 5-10 minutes, 3-4 times a day.
Gently pat the anal area dry with a towel or use a hairdryer after each treatment
Step 4. Try using over-the-counter medications
Nearby pharmacies provide a variety of over-the-counter medicines that are useful for relieving pain and discomfort due to hemorrhoids. Some of them are:
- You can apply a medicated cotton swab like Tucks to irritated hemorrhoids up to 6 times a day to relieve pain and itching. This product contains witch hazel which has calming and natural anti-inflammatory properties.
- Preparation H Cream is a topical anesthetic that can reduce the size of blood vessels (vasoconstrictor) as well as skin protection which is useful in the treatment of hemorrhoids. This cream will block pain signals from the nerve endings of the anus, and shrink the swollen and inflamed tissue.
- Over-the-counter creams or suppositories containing steroids such as hydrocortisone are also helpful in the treatment of hemorrhoids. Hydrocortisone is a powerful anti-inflammatory that can help relieve pain and itching caused by hemorrhoids. However, topical steroids such as hydrocortisone should not be used for more than one week because it can cause atrophy (thinning) of the skin layer around the anus.
- Pramoxine, which is available over-the-counter and prescription, is also an anesthetic for treating hemorrhoids.
Step 5. Use an oral pain reliever
Over-the-counter pain relievers such as paracetamol (Panadol), ibuprofen (Advil), or aspirin may be used to help relieve discomfort from hemorrhoids.
- Paracetamol can be taken as much as 650-1,000 mg every 4-6 hours, not to exceed 4 grams within 24 hours.
- Ibuprofen can be taken as much as 800 mg, a maximum of 4 times a day.
- Aspirin can be taken as much as 325-650 mg every 4 hours as needed, not to exceed 4 grams within 24 hours.
Step 6. Use a stool softener
Stool softeners are also helpful if you are constipated due to hemorrhoids. Over-the-counter stool softeners such as dokusat (Colace) can be used to soften stools and reduce constipation and straining. You may take 100-300 mg of docusate daily for up to one week.
Method 2 of 3: Undergoing Medical Treatment
Step 1. Visit a doctor
Sometimes hemorrhoids can get better with home treatments so they don't need medical treatment. However, you should consult your doctor if your hemorrhoid symptoms do not improve after one week of home remedies. The doctor may consider some prescription drugs or surgery.
- Immediately see a doctor if hemorrhoids cause pain.
- Your doctor may recommend that you change your diet and lifestyle before taking extreme measures. These changes include increasing fiber intake and exercising.
Step 2. Ask about prescription anesthetics
If your doctor doesn't think surgery is necessary, but wants to relieve the pain from your hemorrhoids, he or she may prescribe a prescription anesthetic such as lidocaine (Xylocaine) to help with the discomfort and itching.
Step 3. Talk about rubber band ligation
This is the most common action taken to cure hemorrhoids. A small rubber band will be placed around the base of the internal hemorrhoid to cut off blood circulation. Cessation of blood circulation will make the hemorrhoids shrink and shrink within one week.
Step 4. Talk about sclerotherapy with your doctor
In this procedure, the doctor will inject a chemical solution into the hemorrhoid so that the tissue shrinks and dies. However, sclerotherapy is less effective than rubber band ligation.
Sclerotherapy may also be discouraged by some doctors because several studies have shown that although it is effective in the short term, most patients experience hemorrhoids that recur
Step 5. Research coagulation techniques
Coagulation techniques are performed using a laser, infrared light, or heat. This will stop the bleeding in the small hemorrhoid and cause it to shrivel and die. Coagulation has a higher recurrence rate of hemorrhoids than rubber band ligation.
- This technique is often used on small hemorrhoidal tissue that cannot be treated with rubber band ligation, or used in conjunction with rubber band ligation because the combination of the two has a 97% success rate.
- The recovery period after undergoing this technique is also shorter than hemorrhoid surgery, which is one or two weeks.
Step 6. Consider removing the hemorrhoids
This procedure is known as hemorrhoidectomy. In this procedure, the annoying external or internal hemorrhoids are surgically removed. This option is most effective in treating severe or recurrent hemorrhoids, and can cure 95% of patients and has a low complication rate.
- This procedure is generally performed in cases of internal strangulation hemorrhoids, a combination of internal and external hemorrhoids, or pre-existing anorectal conditions requiring surgery. This option is also known to cause more pain and a longer recovery period.
- The recovery period after undergoing this procedure is between two to three weeks and is accompanied by a follow-up examination by the surgeon.
Step 7. Consider options for hemorrhoid stapler surgery
In a hemorrhoid staper (or stapler hemorrhoidopexy), the doctor will use a clamp to return a bleeding or prolapsed hemorrhoid back to its normal place. The stapler action will stop the blood flow to the hemorrhoid, causing it to shrink.
Compared with hemorrhoidectomy, stapler surgery is at a higher risk of causing recurrence and rectal prolapse (protrusion of the rectum from the anus). However, the postoperative pain of this procedure is known to be less severe for the patient than standard hemorrhoidectomy
Method 3 of 3: Preventing Hemorrhoids
Step 1. Increase the intake of fiber in the diet
Increasing your fiber intake can help prevent constipation, which is a major cause of hemorrhoids. Fiber is found in fruits, vegetables, and whole grains. An increase in fiber intake will soften stools so they are easier to pass and reduce the need to strain during a bowel movement (which is a major cause of hemorrhoids).
- The recommended daily fiber intake varies between 20-35 grams per day according to your age and gender. Women under the age of 51 need 25 grams of fiber daily, while women over 51 need 21 grams of fiber daily. Men over the age of 51 need 38 grams of fiber per day, while men under 51 need 30 grams of fiber per day.
- You can also use a fiber source such as psyllium husk (Metamucil, Citrucel) as a supplement.
- Increase the intake of fiber in the diet gradually to avoid flatulence.
- If increasing your fiber intake doesn't help with constipation, you may want to consider using a stool softener like Colace as a short-term solution.
Step 2. Drink more water
Adequate fluid needs can also help prevent constipation. Try to drink 6-8 glasses of water with a volume of 240 ml every day. The intake of water will soften the stool and help facilitate its elimination. Water intake is very important especially for those who use fiber supplements because lack of water along with increased fiber can actually cause constipation and make the constipation you already have.
Step 3. Exercise regularly
Regular exercise can increase intestinal motility thereby preventing constipation. Exercise can also help with weight loss, thereby reducing pressure on the lower rectum and anus, and preventing hemorrhoids.
- Try to exercise for 30 minutes at least 5 days a week. You can divide your exercise sessions into shorter ones. For example, exercise for 15 minutes twice a day, or for 10 minutes 3 times a day if that feels easier for you.
- Find an activity that you enjoy to increase the likelihood that you will continue to do so. Try taking a walk after dinner, cycling to work, or taking an aerobics class a few times a week.
Step 4. Immediately defecate when you feel the need
Delaying bowel movements can make constipation worse, and in turn, will make hemorrhoids worse. Try to be around the toilet when you normally have a bowel movement so that you can do it right away when you need to.
If you can't have a bowel movement after five minutes of sitting on the toilet, stop and try again later. Sitting on the toilet for too long can also make hemorrhoids worse
Step 5. Avoid sitting too long
Sitting too long will increase the pressure on the veins in the lower rectum and anus, causing hemorrhoids. If your job requires you to sit for long periods of time, try to get up and walk around for a few minutes each time you take a break.
Warning
- While providing information regarding hemorrhoids, this article should not be construed as medical advice. Always discuss the best way to manage your condition with your doctor.
- Emergency medical examination is required for those who experience anorectal bleeding while taking blood thinning (anticoagulant) medications such as warfarin (Coumadin), clopidogrel (Plavix), enoxaparin (Lovenox), rivaroxaban (Xarelto), dabigatran (Pradaxa), or apixaban (Eliquis).
- Medical care should be given immediately if the anorectal bleeding is accompanied by abdominal pain. Hemorrhoids do not cause abdominal pain.
- Anorectal bleeding accompanied by symptoms of dizziness, lightheadedness, or fainting (syncope) should also be checked immediately. These symptoms may indicate a large amount of blood loss that requires a transfusion.
- Internal hemorrhoids that prolapse and cannot be pushed back through the anus require emergency medical attention.
- Thrombosed hemorrhoids can cause severe pain and may require a medical examination and removal of blood clots if necessary.
