Healthy Living

Hemorrhoids: The Top 10 Questions

  • It is a very common condition affecting about 50% of adults by the age of 50. 75% of people will develop hemorrhoids at some point in their lives.
  • There are several reasons why external hemorrhoids develop, but the most common cause of hemorrhoids is straining while passing stool. 
  • Because the inside of the rectum does not have many pain-sensitive nerves, internal hemorrhoids do not hurt as much as external hemorrhoids. Bleeding may be the only sign indicating that you have hemorrhoids.

What are hemorrhoids?

Hemorrhoids, commonly known by the layman as piles, are when the veins in the lower rectum and anus swell and dilate. These dilated veins may bulge out of the anus and get irritated when you pass stool. It is a very common condition affecting about 50% of adults by the age of 50. 75% of people will develop hemorrhoids at some point in their lives.

Hemorrhoids

Have a question aboutHemorrhoids?Ask a doctor now

Hemorrhoids are one of the most common causes of rectal bleeding. They are not dangerous but can be, although rarely. Hemorrhoids can be classified into two types: internal or external. In internal hemorrhoids, the dilated veins are located within the anus or rectum whereas in external hemorrhoids, the dilated veins develop outside of the anus or rectum.

Hemorrhoids are not something nice to have. They are itchy, painful, and irritating and make it hard to sit. Luckily, hemorrhoids are a treatable condition.

Do hemorrhoids go away?

If your hemorrhoids are small, the symptoms may clear up on its own without any treatment. You will only need to make some changes in your diet and lifestyle.

In the severe form of hemorrhoids, they become so big that they pop out of the anus. These are called prolapsed hemorrhoids. This form of hemorrhoids requires treatment and may take a longer time to heal. Pregnant women are at a higher risk of developing hemorrhoids. The reason for this is that the enlarging abdomen increases the pressure inside their abdomen, especially during the last three months of their pregnancy. As a result the veins in the lower rectum and anus dilate, and this leads to hemorrhoids.. The hormonal changes during pregnancy contribute to this. So if you develop hemorrhoids during pregnancy, the symptoms may continue as long as the abdominal pressure is high and will only stop after you give birth to your baby.

So do hemorrhoids go away? Yes, they can and do, but how long they take in each case depends on the severity of the condition. If you want to get rid of them faster, you have to treat them sooner. If they are left untreated, they will get worse over time, increasing the time they will take to heal. 

How long do hemorrhoids last?

One cannot say definitely for how long hemorrhoids may last, because sometimes, the hemorrhoids may not actually go away without surgery. You never know what will happen. However, most people will feel better after about 2 weeks. The duration of the hemorrhoids depends on the various factors that affect healing.

If the external or internal hemorrhoid is small , it may take only up to about 7 days to heal. However, severe internal hemorrhoids, which enlarge and protrude out of the anus, may require at least 2 months to heal completely. A thrombosed hemorrhoid would need more time to heal--at least about 3 months.

If you have developed hemorrhoids for the first time, the time it will take for you to heal will be much shorter than for a person who has had several episodes of hemorrhoids in the past. People who have had recurrent episodes of hemorrhoids will take at least 2 weeks or more to completely recover.

The duration it takes for hemorrhoids to heal also depends on the underlying primary cause that led to the development of hemorrhoids in the first place. For example, if you developed hemorrhoids due to pregnancy, then the hemorrhoids may persist until the pregnancy is completed or terminated and there is no pressure being applied on the veins.  

What is an external hemorrhoid?

Dilated veins that develop outside of the anus or rectum are referred to as external hemorrhoids. They are found beneath the skin that surrounds the anus. This type of hemorrhoids is more painful than those that develop internally because there are many nerves that are sensitive to pain in the skin outside the anus. So they will hurt really bad and may even lead to bleeding.

There are several reasons why external hemorrhoids develop, but the most common cause of hemorrhoids is straining while passing stool. This is usually due to severe cases of constipation. When you strain, blood moves in and out of the lower rectum and anus and leads to the accumulation of blood and enlargement of the blood vessels in that location. Thus, dilated veins result beneath the skin outside of the anus. Another common cause of external hemorrhoids is pregnancy. Because of the enlarging gravid uterus applying pressure on these veins, pregnant women have a higher risk of developing hemorrhoids.  

An external hemorrhoid may last from a few days to a couple of weeks. However, the signs and symptoms of hemorrhoids will take about one week to disappear. If external hemorrhoids do not go away within a week or so, then you may require surgical intervention.

What is an internal hemorrhoid?

Internal hemorrhoids lie inside the rectum, and therefore, they are not seen or felt. Because the inside of the rectum does not have many pain-sensitive nerves, internal hemorrhoids do not hurt as much as external hemorrhoids. Bleeding may be the only sign indicating that you have hemorrhoids. The amount of bleeding will vary from one person to another. While some may have only mild spotting, others may develop continuous profuse bleeding. However, with time, internal hemorrhoids can get worse and produce those typical hemorrhoidal symptoms that are really hard to ignore.

As the internal hemorrhoids progress, they may protrude out of the anus. This condition is known as prolapsed hemorrhoids. This can be similar to an external hemorrhoid in that they may produce symptoms like swelling and itchiness. Because prolapsed hemorrhoids and external hemorrhoids look similar, it is really hard to tell which is which without a professional doctor’s diagnosis.

Do hemorrhoids bleed?

Yes, they do. Bleeding from the rectum is one of the most common symptoms of hemorrhoids. However, bleeding while passing stool cannot lead to a definite diagnosis of hemorrhoids, because there are other conditions that may cause bleeding while passing stool. Bleeding while passing stool is a major cause for concern, and therefore patients who have this symptom should seek medical advice as soon as possible.

The commonest cause for bleeding while passing stool is hemorrhoids. However, it can be seen in life-threatening conditions like anal and colorectal cancers. This is why you should seek medical advice if you notice blood in your stool.

Bleeding in hemorrhoids can be different from person to person. The amount of bleeding will vary. While some may have only mild spotting, others may develop continuous profuse bleeding.

How do you know you have hemorrhoids?

You can tell that you probably have hemorrhoids if you have the following signs and symptoms.

Bleeding while passing stool – If you experience bleeding every time you pass stool, or if you notice blood after passing stool, it could be a sign of hemorrhoids. The blood is usually bright red in color, but the amount of blood will vary from one person to another. Some may only have mild spotting whereas the others may have continuous bleeding through the anus.

Itching around the anus – Itchiness is generally seen in both types of hemorrhoids (internal and external), but it is more prominent with external hemorrhoids. Itching causes great discomfort in the anal region.

Feeling lumps around the anus – This is typically noticed with external hemorrhoids and prolapsed internal hemorrhoids. These lumps are usually painful to the touch. They are usually pink in color, but sometimes, these lumps can give a purple or bluish discoloration indicating that there has been thrombosis of your hemorrhoids. If you have thrombosed hemorrhoids, they will be a lot more painful and uncomfortable.

How do you prevent hemorrhoids?

There are many ways you can avoid hemorrhoids. Most of them are just making changes to your lifestyle and diet, things you can do immediately.

Dietary changes

Eat more fiber-rich food such as fruits like mangoes, apples, pears, and raw strawberries, and vegetables like broccoli, peas, Brussels sprouts, black beans, lentils, and split peas. Doing this will increase the amount of soluble fiber in your diet. Fiber helps food material to move through your digestive system and softens and bulks up stool, thus helping patients with constipation. Fiber also helps you have more regular bowel movements.

It is also important that you drink plenty of water every day. This will help maintain consistent bowel movements.

Increase your physical activity

Do not spend your sitting and lying down on the bed the whole day. Move around and exercise more. This is an important and very helpful tip to avoid hemorrhoids. Also, obesity increases your risk of developing hemorrhoids. therefore, maintain a healthy body weight. This way, you can avoid the development of hemorrhoids.

Do not strain

If you are constipated, do not strain to pass the stool. This will only add more pressure to the dilated veins in the anus and cause them to swell even more. Therefore, relax and allow the stool to pass naturally. You can also apply some petroleum jelly to the anal sphincter to make the passage of stool smoother, with less discomfort and irritation.

What is a thrombosed hemorrhoid?

A thrombosed external hemorrhoid is when blood pools within the engorged veins and leads to the formation of a thrombus, also known as a blood clot under the skin. This is a really painful condition that results in a firm lump in the anal region. Due to thrombosis, the lump develops a bluish or purplish discoloration.

You may be at a higher risk of developing a thrombosed external hemorrhoid, if you have recently had an episode of constipation or a traumatic vaginal delivery. It is quite a common condition experienced by many people.

The symptoms can be reduced by conservative management, which includes the use of stool softeners, increased intake of fiber in the diet, increased consumption of fluids, topical medications, and warm baths. However, surgical intervention is the only thing that can put a complete stop to it. In surgery, the entire thrombosed external hemorrhoid will be excised. This has lower recurrence rates as well as lower complication rates. Not only that, but patient satisfaction and acceptance are high as well.

What does hemorrhoid cream do?

The pain and itchiness of external hemorrhoids can be relieved with the use of creams or ointments. One cream used for hemorrhoids is 1% hydrocortisone, which should be applied on the outer surface of the skin of the hemorrhoid (not inside). Hydrocortisone is a steroid drug, and therefore should not be used for more than a week unless your doctor tells you to.

You can also apply some petroleum jelly to the area so your sphincter opens more easily.