Hemorrhoids, or piles, are enlarged and inflamed veins located in the lower rectum and anus. They are common, and almost half of all adults have dealt with them at least once before age 50. Hemorrhoids result from increased pressure on the lower rectum and anus. The increased pressure within the hemorrhoidal veins causes them to swell. Symptoms you may notice include painless bleeding during bowel movements, rectal/anal pain, anal itching, and/or tender lumps near the anus. You have a wide array of options when it comes to treating hemorrhoids and hemorrhoid pain both at home and via your physician.
Treating Hemorrhoid Pain at Home
Identify the type of hemorrhoid. Hemorrhoids can be either internal or external. Pain is most often associated with external hemorrhoids. However, you may want to see your doctor for a positive diagnosis.
- Internal hemorrhoids develop in the lower rectum, and they are usually painless because the body doesn’t have any pain receptors in the rectum. You may not even know you have an internal hemorrhoid until you notice blood in your stool or the hemorrhoid prolapsing (protruding from the anus).
- If you have pain associated with your hemorrhoid, then it is likely an external hemorrhoid, which develops under the skin around the anus. If a blood clot forms inside the hemorrhoid, it is called a “thrombosed hemorrhoid,” and the pain is typically described as sudden and severe. Those afflicted might see or feel a lump in the vicinity of the anus. The clot usually dissolves and may leave a skin tag, or excess skin, in the anal area.
Use a Sitz bath. These baths can provide immediate relief of pain and itching from hemorrhoids. Soak the anal area in warm water for 10 to 20 minutes two to three times per day and following bowel movements. Pharmacies sell small plastic tubs that fit over the toilet seat. Alternatively, you can fill a bathtub to approximately hip level with warm water.
- Gently pat the anal area dry with a towel or use a hair dryer after each treatment.
Apply cold treatments to the area. Cold treatment can alleviate swelling and pain associated with hemorrhoids. You can apply a frozen, water-filled condom or ice cubes wrapped in a cloth to the anal area for 5-10 minutes 3-4 times per day.
- Gently pat the anal area dry with a towel or use a hair dryer after each treatment.
Try over-the-counter topical agents. Your local pharmacy will have a variety of OTC products designed to help with the pain and discomfort associated with hemorrhoids. Some of these products include:
- You can use pads such as Tucks as compresses on irritated hemorrhoids up to six times per day to relieve pain and itching. These have witch hazel, which is a soothing, natural anti-inflammatory agent.
- Preparation H cream is a topical anesthetic, constrictor of blood vessels (vasoconstrictor), and skin protectant useful in the treatment of hemorrhoids. The cream blocks pain signals coming from the nerve endings of the anal area and also shrinks swollen, inflamed tissue.
- OTC creams or suppositories containing the steroid hydrocortisone can also be helpful in the treatment of hemorrhoids. Hydrocortisone is a potent anti-inflammatory agent that can help ease the pain and itching of hemorrhoids. Topical steroids such as hydrocortisone should not be used for more than one week as they can lead to atrophy (or thinning) of the skin in the anal area.
- Pramoxine, available OTC and by prescription, is another topical anesthetic used to treat hemorrhoids.
Take oral pain relievers. OTC oral pain relievers such as acetaminophen (Tylenol), ibuprofen (Advil), or aspirin can be used to help relieve the discomfort of hemorrhoids.
- Acetaminophen can be taken 650-1000 mg every 4-6 hours, not to exceed 4 grams (0.14 oz) in a 24-hour period.
- Ibuprofen can be taken 800 mg up to 4 times per day.
- Aspirin can be taken 325-650 mg every 4 hours as needed, not to exceed 4 grams (0.14 oz) in a 24-hour period.
Take a stool softener. Stool softeners can be helpful if you are experiencing constipation from your hemorrhoids. OTC stool softeners such as docusate (Colace) can be used to keep stools soft and reduce constipation and straining. You can take 100-300 mg of docusate daily for up to one week.
Hemorrhoids – Reducing the pain and discomfort
Hemorrhoids are most often a short-term problem. Constipation is one of the main things that can lead to hemorrhoids.
- Include more fibre in your diet. Fibre helps soften stools. Fresh fruit, leafy vegetables, and whole-grain breads and cereals are good sources of fibre.
- Avoid low-fibre foods, such as ice cream, cheese, white bread and meat.
- Drink plenty of fluids (except alcohol). Eight glasses of water a day is ideal.
- Exercise regularly.
- Bulk-forming laxatives may be helpful. Bulk-forming laxatives include bran, psyllium (some examples are Metamucil, Fibrepur, Novo-Mucilax, Prodiem [plain]) and others (an example is Fibyrax). Other types of laxatives can lead to diarrhea, which can make hemorrhoids worse.
- Avoid laxatives for more than occasional use unless they’re bulk-forming.
- If you feel the need to have a bowel movement, don’t wait too long to use the bathroom. Your stool will get drier and harder the longer you wait.
In the meantime, you can follow these tips to reduce the pain caused by hemorrhoids. Although you’ll find many hemorrhoid medicines in the store, some haven’t been proven to work. Some may even be harmful if you use them too much. Talk to your family doctor about which products may be helpful for you.
Relieving the pain
- Take warm soaks (sitz baths) or regular baths three or four times a day.
- Clean your anus after each bowel movement by patting gently with moist toilet paper or moistened pads (such as Tucks), or baby wipes. Rinsing in the shower may also be helpful. Pat, don’t wipe, your anus clean.
- Use ice packs to relieve swelling.
- Acetaminophen (some examples are Panadol, and Tylenol), ibuprofen (some examples are Advil, Medipren, and Motrin) or aspirin may help relieve pain.
- Apply a cream that contains witch hazel to the area or use a numbing ointment. Creams that contain hydrocortisone can be used for itching or pain.
- For very painful flare-ups, stay off your feet and in bed for a full day.
- Avoid heavy lifting and straining.
Don’t use hemorrhoid medicine without talking to your family doctor first.
Will I need surgery?
Most hemorrhoids heal and stop hurting on their own in a week or two. Hemorrhoids tend to come back unless you do what you can to prevent them. If yours keep causing problems, talk with your doctor about your options.
Internal hemorrhoids can also be destroyed by injection sclerotherapy (injecting them with chemicals), infrared coagulation, or by electrocoagulation (burning them). Rubber band ligation can be used to treat internal hemorrhoids. It involves placing a small rubber band around the base of the hemorrhoid. This stops the flow of blood to the area. The hemorrhoid then withers away.
A hemorrhoidectomy (surgical removal of the hemorrhoids) may be needed if internal hemorrhoids are prolapsed or very large. You need to inform your surgeon about any medications you take that may lead to excessive bleeding during surgery, such as Coumadin and Plavix. He or she may ask that you stop taking those medications a few days before the procedure.
Painful external hemorrhoids that contain blood clots can be treated by removing the clot in a simple procedure. This works best when it’s done within the first 24 hours to 72 after the clot forms and pain starts.
Hemorrhoids: 19 tips to cure the pain in the butt
Hemorrhoids (also called piles) is a very common problem affecting people in their 20s and older. Did you know that by the age of 50, almost half of the population would have some form of hemorrhoids?
What are hemorrhoids? Normally, the inside of our anus (the hole where you defecate) has blood vessels surrounding it. However, through years of straining, poor diet, or childbirth, these swollen veins may slowly protrude out of your anus. These are called hemorrhoids and they may get entangled and bleed when you move your bowel.
Preventing And Treating Hemorrhoids Pain
- Eat high-fiber foods. To soften your stool, eat lots of fruits like papaya, watermelon, and grapes, as well as high-fiber vegetables like cabbage, kangkong and okra. Try to drink eight to 10 glasses of water every day.
- Don’t rely on certain drugs. Laxative medicines like Bisacodyl tablets are not a cure for constipation. It will help you with one bowel movement, but it will leave you more constipated afterwards.
- Consider fiber supplements (like Metamucil) to soften your stool, especially if you’re not fond of vegetables. However, you need to drink eight glasses of water daily if you take these supplements.
- Lose weight. If you are overweight, there is an increase in the pressure in your abdominal and waist area. This will also translate to more pressure in the veins in the anus.
- Reduce salt intake. Too much salt in your food can lead to swelling of the body, including swelling of the hemorrhoids. Salt is also bad for your blood pressure.
- Avoid spicy and hot foods (as in chili). These spices are irritating to the hemorrhoids. Some doctors say you should also avoid drinking too much coffee, beer, and soft drinks.
- Important tip: Avoid straining in the bathroom. Don’t force yourself to defecate when you still don’t feel like it. Try walking and exercising first to facilitate your bowel movement.
- Don’t read newspapers, magazines, and novels while sitting on the toilet bowl waiting for your stool to arrive. Choose to sit on the bowl when you already have a great urge to move your bowel.
- Don’t lift heavy objects. The stress of lifting heavy objects is equivalent to the stress of straining in the bathroom.
- Avoid sitting or standing too long, because this will put increased pressure on the hemorrhoids. Sit and stand alternately throughout the day.
- Try using petroleum jelly. According to Dr. Edmund Leff, a colon and rectal surgeon, you can try applying some petroleum jelly around the anus before you defecate. This can help smoothen the passage of hard stools, and hopefully avoid injuring the hemorrhoids.
- Never use dry tissue paper. Use very wet tissue or running water to wash yourself after moving your bowel. Scraping with rough paper can make the hemorrhoids bleed.
- Keep your anal area clean. Clean yourself meticulously so as not to infect the hemorrhoids. A bacterial infection can lead to an abscess in the anal area. Be clean and careful, too.
- Don’t scratch it. Sometimes hemorrhoids can be itchy, but try to avoid the urge to scratch it.
- If you’re pregnant, lie on your left side often. According to Dr. Lewis Townsend, an obstetrician, the enlarging uterus may impinge on the blood vessels of the hemorrhoids. To lessen the pressure, Dr. Townsend advises pregnant women to lie on their left side for 20 minutes every five hours or so.
- Soak in a warm tub or basin. Fill a bathtub with 6 to 12 inches of lukewarm water. Then, sit on the bathtub with your knees raised. Do this several times a day. According to Dr. Byron Gathright, a colorectal surgeon, the lukewarm water improves blood flow in the area and reduces pain and swelling. If you don’t have a bathtub, try using a large basin. You can also buy a hot sitz bath from a medical equipment store.
- Alternately, you can try an ice pack. If the hemorrhoids is itchy or painful, placing an ice pack beside it may reduce the symptoms. Wrap a towel around the ice pack so it won’t be too cold. Apply the ice pack for a maximum of 20 minutes, three times a day. Don’t overdo it.
- Consider some creams. There are ointments and suppositories available such as Proctosedyl or Ultraproct. These won’t cure your hemorrhoids, but they can numb the pain. Don’t use these for more than a week.
- Try gently pushing the hemorrhoids inside. According to Dr. Townsend, if the hemorrhoids is not too big, you may still try to push it inside the anus. This will lessen the risk of injury and bleeding.
When should you see a surgeon? There are certain situations to watch out for:
- If there is any sudden increase in pain;
- if you feel any new mass in the area, which could be a wart or an abscess;
- if there is a non-healing wound in the area.
Although we usually blame hemorrhoids as the cause of bloody stools, you should also consult a surgeon to make sure there are no other serious causes.