Hemorrhoids

General

Hemorroids are common.  Most women who have been pregnant have had hemorrhoids.  They commonly cause rectal burning, itching, and bleeding.  If they become clotted, they are called 'thrombosed', and they will become exquisitely painful.

Treatment

• Frequent hot baths, up to 3 or 4 times a day.   Sitz baths work well if you have a device for doing this.  This is a mainstay of treatment when they are really acting up.

• Treat Constipation

  • Increase Fiber in the diet with fiber containing foods or supplements such as metamucil taken once or twice a day.

  • Consider a stool softener such as Colace taken 100mg either two capsules once a day or one capsule twice a day.

  • If you are remarkably constipated consider something to get your bowels moving such as Milk of Magnesia, 2 Tbsp at a time.

  • Drink plenty of water, perhaps 8 good glasses a day.   This could be as juices, too.

• Avoid

  • Sitting on the toilet for prolonged periods reading or doing other contemplative activity.

  • Excessive wiping of the rectal area.

  • To little cleanliness of the rectal area.

  • Tight fitting underware, consider wearing boxer style underware in place of the brief style.

  • Sitting in chairs with poor support in the center of the chair, i.e., excessively soft easy chairs, worn out car or truck seats.

  • Prolonged walking, such as shopping in the mall may make pain worse.

  • Use of caffeine seems to make some people worse.

  • Keep up regular bowel movements, avoid "holding it" or waiting when you need to have a bowel movement.

  • Avoid straining when having bowel movements.

  • Avoid irritant laxatives, they can cause dependence resulting in straining.

• Topical Treatments

  • Lidocaine containing compounds such as Ungentine Plus can give brief temporary relief.  A prescription product that works for about 6 hours is Dibucaine ointment, it numbs the area.

  • Consider pads such as Anusol or Tucks.

  • Topical Hydrocortisone 1% cream, applied 2 or 3 times a day, can be quite helpful to relieve inflammation.  Steroid suppositories are available, also .

• Thrombosed Hemorrhoid

  • You will need to see the doctor most likely.

  • Apply ice packs to the inflammed tissue.

  • Lie face down to help blood drain from the effected area.

  • You may well need a prescription pain reliever.

  • Soften your stools as noted above

  • If there is no relief in a few days you may need referral to a surgeon.

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