Chronic Hemorrhoids

Chronic Hemorrhoids

Hemorrhoids, also called piles, are swollen veins in your anus and lower rectum, similar to varicose veins. Hemorrhoids have a number of causes, although often the cause is unknown. They may result from straining during bowel movements or from the increased pressure on these veins during pregnancy. Hemorrhoids may be located inside the rectum (internal hemorrhoids), or they may develop under the skin around the anus (external hemorrhoids).

Hemorrhoids are very common. Nearly three out of four adults will have hemorrhoids from time to time. Sometimes they don’t cause symptoms but at other times they cause itching, discomfort and bleeding.

What are Chronic Hemorrhoids?

In one sense, everyone has hemorrhoids (or piles), the pillow-like clusters of veins that lie just beneath the mucous membranes lining the lowest part of the rectum and the anus. The condition most of us call hemorrhoids (or piles) develops when those veins become swollen and distended, like varicose veins in the legs. Because the blood vessels involved must continually battle gravity to get blood back up to the heart, some people believe hemorrhoids are part of the price we pay for being upright creatures.

There are two kinds of hemorrhoids: internal ones, which occur in the lower rectum, and external hemorrhoids, which develop under the skin around the anus. External hemorrhoids are the most uncomfortable, because the overlying skin becomes irritated and erodes. If a blood clot forms inside an external hemorrhoid, the pain can be sudden and severe. You might feel or see a lump around the anus. The clot usually dissolves, leaving excess skin (a skin tag), which may itch or become irritated.

Internal hemorrhoids are typically painless, even when they produce bleeding. You might, for example, see bright red blood on the toilet paper or dripping into the toilet bowl. Internal hemorrhoids may also prolapse, or extend beyond the anus, causing several potential problems. When a hemorrhoid protrudes, it can collect small amounts of mucus and microscopic stool particles that may cause an irritation called pruritus ani. Wiping constantly to try to relieve the itching can worsen the problem.

In some cases, hemorrhoids occur temporarily and go away naturally. A few applications of the right ointment to treat symptoms and your hemorrhoids are nothing but an unpleasant memory. Unfortunately, this is rare. In most cases, if the hemorrhoids are causing enough discomfort for you to take notice, chances are they won’t go away easily. Many of the cases our physicians treat are chronic hemorrhoids, meaning they last more than a couple of weeks and tend to flare up again and again.

Living With Chronic Hemorrhoids

External chronic hemorrhoids rarely go away on their own. You can relieve symptoms by applying hemorrhoid creams, changing your diet, or increasing your fiber intake, but you won’t find true, long-lasting relief until you find the right doctor-prescribed treatment.

How do I know if my hemorrhoids are chronic?

Chronic external hemorrhoids are swollen veins, often seen or felt under the skin just around the rim of the anus. In most cases, external hemorrhoids are accompanied by internal hemorrhoids as well. In addition to the itching or burning sensation of piles, chronic hemorrhoids will also cause bleeding and sometimes secrete mucus. If you notice blood on the toilet paper and your hemorrhoids have gone from uncomfortable to painful, it’s time to see a doctor.

If you are reading this and still aren’t sure if you have chronic hemorrhoids – go ahead and call a CRH O’Regan partner doctor near you and make an appointment. Whether your hemorrhoids are chronic or not, seeing a doctor means you’ve already taken the first step towards complete hemorrhoid relief.

What are the causes of hemorrhoid problems?

Factors that can lead to the development of hemorrhoid problems include:

  • Straining during bowel movements or heavy lifting or vigorous activity.
  • Hard or watery bowel movements.
  • Sitting on the toilet for a long time (for example, while reading or playing video games).
  • A low-fiber diet.
  • Pregnancy and vaginal deliveries.
  • Aging.

What are the symptoms of chronic hemorrhoidal disease?

The symptoms of internal hemorrhoidal disease include:

  • Rectal bleeding, usually bright red, during and occasionally between bowel movements.
  • Anal pain, especially during or after bowel movements.
  • Anal itching or burning.
  • Anal area is hard to clean.
  • Bulging (prolapse) of the internal hemorrhoids during bowel movements. The hemorrhoids may go back in on their own, or can be pushed back inside the anus by hand.
  • Drainage.

Prevention of Chronic Hemorrhoids

The best way to prevent hemorrhoids is to keep your stools soft so they are easy to pass and don’t require straining. Eating a high-fiber diet and drinking plenty of fluids (six to eight glasses each day) can help you stay regular and keep your stools soft, and may reduce constipation and the need to strain on the toilet, lowering your risk of developing new hemorrhoids.

To prevent hemorrhoids and reduce symptoms of hemorrhoids, follow these tips:

  • Eat high-fiber foods. Eat more fruits, vegetables and whole grains. Doing so softens the stool and increases its bulk, which will help you avoid the straining that can cause hemorrhoids. Add fiber to your diet slowly to avoid problems with gas.
  • Drink plenty of fluids. Drink six to eight glasses of water and other liquids (not alcohol) each day to help keep stools soft.
  • Consider fiber supplements. Most people don’t get enough of the recommended amount of fiber — 25 grams a day for women and 38 grams a day for men — in their diet. If you use fiber supplements, be sure to drink at least eight glasses of water or other fluids every day. Otherwise, the supplements can cause constipation or make constipation worse.
  • Don’t strain. Straining and holding your breath when trying to pass a stool creates greater pressure in the veins in the lower rectum.
  • Go as soon as you feel the urge. If you wait to pass a bowel movement and the urge goes away, your stool could become dry and be harder to pass.
  • Exercise. Stay active to help prevent constipation and to reduce pressure on veins, which can occur with long periods of standing or sitting. Exercise can also help you lose excess weight that may be contributing to your hemorrhoids.
  • Avoid long periods of sitting. Sitting too long, particularly on the toilet, can increase the pressure on the veins in the anus.
Reviewed by the QSota Medical Advisory Board

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