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Guide Health: The embarrassment of hemorrhoids

It’s easy to understand why no one likes to talk about hemorrhoids, but at the very least you need to know when to get checked

Hemorrhoids are common, with anywhere from 50 to 80 per cent of Canadians having experienced them. It is difficult to determine the number more accurately, however, because many people do not report having hemorrhoids or, alternatively, they successfully self treat.

Hemorrhoids are anal cushions which become inflamed and swollen. Internal ones remain within the anal canal; external ones protrude. So now you know why no one talks about their hemorrhoids!

Hemorrhoids affect men and women equally, with the exception of women during pregnancy. An increase in abdominal pressure, especially during the last months of pregnancy, usually accounts for these hemorrhoids, and they often resolve after delivery.

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People 45 years and older are more often affected, although there seems to be no family tendency, with the exception of similar low-fibre diets among family members.

Heavy lifting, prolonged standing or sitting, prolonged sitting at toilet, and severe pushing or straining when defecating are contributing factors. Hard, dry stools are difficult to pass and worsen hemorrhoids, which is why diets low in fibre and fluids can also be contributing factors.

Often, however, no one cause can be identified. Instead, hemorrhoids result from a combination of factors.

Usually, the first sign of hemorrhoids is bright red blood on used toilet tissue as the result of a stool scraping across the surface of hemorrhoids and causing the bleeding. They are classified according to the degree of severity, with the most severe associated with the risk of thrombosis or blood clots and even gangrene.

Yes, it may be embarrassing, but if you see signs of hemorrhoids, or for that matter any colour of blood on used toilet tissue, you need to get it checked.

The characteristic symptoms of hemorrhoids include itching, pain, swelling, burning, and discomfort, but internal hemorrhoids are not painful because there are no pain receptors in the anal canal.

Ideally, you want to treat the symptoms so you are more comfortable and so that healing occurs. Creams, ointments and suppositories are available. Ointments are greasier, but remain on tissues longer. Suppositories may have limited use because they slip too far into the anal canal, past the site of the hemorrhoids. You may still want to use a suppository due to their ease of use, but to reduce their movement too high, after insertion lie on your side for about five minutes.

Hemorrhoid remedies are usually a combination of local anesthetics for pain, topical steroids like hydrocortisone for inflammation, astringents to promote healing, and protectants to provide a physical barrier against further damage.

Remember to cleanse the area thoroughly before applying any remedy and to wash your hands before and after application.

None of these products are recommended for children 12 and younger, who should have their symptoms evaluated. And, if your symptoms don’t improve within seven days, you also need your symptoms to be checked.

For pain, consider acetaminophen. Avoid any narcotic pain relievers because they can contribute to constipation and the worsening of symptoms. With severe hemorrhoids, injections, rubber band ligation, and even surgery may be needed.

You most likely would prefer prevention. Don’t sit for more than one to two minutes on the toilet. Also make sure your diet is high in fibre and fluids, and to prevent complications, cleanse well after defecating.

If you have hemorrhoids, try a Sitz bath, sitting in a tub of warm water for about 15 minutes.

You don’t want to talk about your hemorrhoids at the dinner table, but don’t ignore them.

About the author

Contributor

Marie Berry is a lawyer/pharmacist interested in health and education.

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