DEAR DOCTOR K:
Please help — I have hemorrhoids. What’s the best way to treat them?
Hemorrhoids are clusters of veins in the lowest part of the rectum and anus that become swollen and distended.
You can have hemorrhoids without any symptoms. But hemorrhoids can also have very unpleasant symptoms — rectal pain, itching, soiling and bleeding. Hemorrhoids are rarely dangerous, however, and there are many treatment options.
Hemorrhoid symptoms can also be caused by other conditions, including anal warts and fissures, Crohn’s disease and (rarely) anal cancer. So if you have persistent bothersome symptoms that you think are caused by hemorrhoids, it’s wise to see your doctor.
There are several helpful home treatments. The first thing you should do is boost the fiber in your diet. Eat high-fiber foods (such as prunes, pears, beans, bran cereals and oatmeal), take a fiber supplement (there are many varieties available in drugstores), or both. Fiber softens stools and makes them easier to pass. This reduces pressure on hemorrhoids, which in turn reduces the risk of bleeding, inflammation and swelling. Make sure to take fiber with plenty of fluids.
Exercise is another important home remedy for hemorrhoids. Take a brisk walk for 30 minutes a day, at least five days a week. Not only does this have a powerfully positive effect on your health, it also is a great way to stimulate your bowels.
When you feel the urge, go to the bathroom immediately; don’t wait for a more convenient time. Waiting can cause your bowels to back up, leading to increased pressure and straining.
Sitz baths can relieve itching, irritation and muscle spasm. A sitz bath is a warm water bath for the buttocks. Sit in a regular bathtub with a few inches of warm water, or buy a small plastic tub that fits over a toilet seat. Try a 20-minute sitz bath after each bowel movement and an additional two or three times a day. (This works best if you’re retired.) Afterward, gently pat the area dry.
Over-the-counter pain-relief creams can temporarily soothe pain, irritation and itching. Witch hazel wipes (Tucks) are soothing and have no harmful effects. A small ice pack placed against the anal area for a few minutes may also help.
Finally, sitting on cushions rather than hard surfaces can help reduce swelling.
If the treatments I’ve discussed don’t help, talk to your doctor. You may benefit from a simple outpatient procedure to treat hemorrhoids. One procedure involves rubber rings tightened around the hemorrhoid. Other procedures, using lasers or infrared light, heat the hemorrhoids, causing them to shrink. Injecting a chemical into the hemorrhoids (called sclerotherapy) also can shrink them. If your symptoms continue despite these measures, you may need minor surgery to remove your hemorrhoids.
Hemorrhoids are among the most common “minor maladies of man.” The good news is that, most of the time, simple home remedies can give you great relief.