Understanding HEMORRHOIDS

What are hemorrhoids?

Hemorrhoids are typically caused by repeated or constant External hemorrhoids are found beneath the skin of the
pressure to the anal or rectal veins. As pressure increases, anus and can be painful. External hemorrhoids looks and feel
blood begins to pool, causing veins to swell. The swollen like a hard lump in which occurs when the blood clots and
vein(s) begins to stretch the surrounding tissues, creating within a protruding external hemorrhoid. This can result in
a hemorrhoid. Although hemorrhoids can be painful, they a painful thrombosed external hemorrhoid which looks
are not serious and are quite common. Between 60 and bluish-purple and can bleed, but again tends to clear up on
70 per cent of Canadians will develop hemorrhoids at its own within a week or two.
some point in their lifetime, and at least half of people
over age 50 will experience them. What are the symptoms of hemorrhoids?
You may have a hemorrhoid if you notice:
There are • Small amounts of bleeding during bowel movements,
two types of especially if straining
hemorrhoids, • Itching or irritation from bulging hemorrhoids
internal (found
• Pain or discomfort in the rectum
in the lower
• Soreness or pain when cleaning the anal area
rectum) and
• A lump close to the anus, which may be painful or
external (found
sensitive
under the skin
• Stool leakage
around the anus).
It is possible
to experience What causes hemorrhoids?
external There are many factors that may increase your risk of
and internal developing hemorrhoids:
hemorrhoids at the same time. • Low fibre intake in your diet
• Obesity
Internal hemorrhoids are found inside the lining of the • Straining during a bowel movement
rectum. You cannot feel them unless they are unusually • Chronic constipation or diarrhea
large. Typically small and painless, internal hemorrhoids • Sitting for long periods of time on the toilet
can produce streaks of bright red blood, which you will • Rushing to complete a bowel movement
see on toilet paper or on stool after a bowel movement. • Pregnancy
Some people may experience larger internal hemorrhoids, • Anal intercourse
which sag and bulge from the anus, these are called • Alcoholism
prolapsed hemorrhoids. These larger hemorrhoids can • Illness; long-term heart or liver disease which can cause
cause some irritation, but often tend to recede into the blood pooling in the abdomen and pelvic area
rectum and resolve without treatment.
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HEMORRHOIDS
What are the risk factors for bran, and fresh fruits. However, be aware that increasing
fibre too quickly can cause bloating and gas, so start slowly
hemorrhoids? and increase your fluid intake at the same time. You should
Sometimes, although rare, complications may arise from
aim for a maximum of 25-30 grams of fibre a day.
bleeding hemorrhoids. Anemia occurs when the red blood
cell count is lower than normal, and can develop when
Exercising: Moderate exercise is good for your heart, bones,
you continually loose blood. Symptoms of anemia include
muscles, mental health and can help stimulate bowel
fatigue and weakness.
function. The recommended level of physical activity for
adults is 150 minutes of moderate-intensity aerobic physical
Another complication is a strangulated hemorrhoid. When
activity plus 2 hours of muscle training per week. The 150
the blood supply to a hemorrhoid is cut off, the hemorrhoid
minutes of weekly physical activity can be broken out into
may become strangled, which causes severe pain and tissue
shorter bouts, at least 10 minutes each, spread throughout
death.
the week: e.g. 30 minutes of moderate-intensity activity 5
times per week or no less than 20 mins a day.
If bleeding from hemorrhoids continues without
improvement for more than one week, you should contact
Hemorrhoid care: Should you have a hemorrhoid, try to
your physician.
avoid rubbing the area. You can clean the anus with a piece
of moist toilet paper and gently pat dry. Use non-fragrant
How are hemorrhoids diagnosed? soaps with no dyes, and wear cotton underwear to prevent
A doctor can diagnose hemorrhoids by taking your moisture build-up.
medical history and conducting a physical exam. This may
Home treatment
include a digital rectal exam (inserting a gloved finger
Quite often, treating mild cases of hemorrhoids can be
into the rectum) to check for internal hemorrhoids, as
done at home using over-the-counter products, compresses
well as conducting an anoscopy (inserting a small tubular
and baths. To speed up the healing process, these simple
instrument to examine the anus) or proctoscopy (inserting a
steps can help you ease and relieve the pain and swelling
small tubular instrument to examine the anal cavity, rectum
caused by hemorrhoids.
or sigmoid colon). If traces of blood are found in your
stool, your physician may request a flexible sigmoidoscopy
Home treatments include:
(a flexible tube that looks at the anus, rectum, and lower
intestine) or colonoscopy (a thin, flexible tube that looks
Sitz baths: A sitz bath is a warm, shallow bath that cleans
at the inner lining of the large intestine) to rule out other
the space between the rectum and the vulva/scrotum
possible conditions.
(perineum). A warm 20-minute sitz bath, after a bowel
movement, can help relieve itching, irritation and spasms
If hemorrhoids are present, your physician will evaluate
from the sphincter muscle. Be sure to gently pat dry (avoid
the location and size of the hemorrhoid(s) and develop a
rubbing) the anal area to avoid further irritation.
treatment plan, based on severity, and what’s best for you.

Cold compress: Applying an ice pack to the anal area on

How are hemorrhoids treated? and off for 10-15 minutes, 5-times a day can help reduce
Treating and preventing hemorrhoids can often be done on the swelling.
your own by making simple lifestyle and dietary changes,
these include: Topical relief: Hemorrhoid creams containing
hydrocortisone or witch hazel provide soothing, temporary
Increasing fibre: Too many of us don’t eat enough fibre. relief from pain and itching. It is important to use these
Eating a diet rich in fibre, along with adequate, non- products as directed. Over-use can cause the skin integrity
caffeinated fluids, will help soften stools and make them to weaken.
easier to pass. High fibre foods include: beans, broccoli, oat
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Treatment interventions for hemorrhoid • Symptoms that you are experiencing
In most instances, hemorrhoids can be treated quite • How often you are experiencing symptoms
effectively at home. However, when hemorrhoids do • Streaks of blood in the toilet, on toilet paper or on stool
not respond to lifestyle changes and over-the-counter • Location and severity of pain or discomfort, if any
treatments, are large and continue to bleed, your physician • Changes to your bowel movements
may recommend one of the following procedures: • A list of medications you are taking and why you are
taking them
Rubber band ligation: A safe procedure where a small
• Questions you want answered during the appointment
rubber band is placed around the bottom of an internal
hemorrhoid. This will cut off circulation and cause the
hemorrhoid to fall of within a week. Partnering for best health
Working collaboratively with your health care professional
Sclerotherapy: A safe procedure where a solution is injected
will help you protect your body from digestive problems
into the hemorrhoid, causing it to shrink.
and maximize your digestive health. When you report your
Coagulation therapy: A safe procedure where infrared light health status completely, concisely and accurately, your
is used to harden the hemorrhoid, cutting off circulation to physician can provide you with the best care and treatment
the vein. plan. Be sure to stay informed on ways to maintain your
health and well-being, track and record your symptoms, and
Hemorrhoidectomy: Is the surgical removal of hemorrhoids.
write down questions and concerns to discuss at your next
This safe procedure is given under general anesthesia with
appointment.
one advantage being that multiple hemorrhoids can be
treated at once. However, it has a disadvantage in removing
most of the network of small veins that provide a natural
cushion to the mucosa protecting the anal canal.

How can I prevent hemorrhoids?

To help protect you against developing hemorrhoids, try
incorporating the following lifestyle changes:

Don’t hold it: Use the washroom when you have the urge
to go, avoid straining, prolonged sitting or reading on the
toilet, and don’t rush; all these will help avoid the build-up
of pressure.

Inactivity: Avoid sitting or standing still for long periods of

time, inappropriately lifting heavy items or holding your
breath while lifting. This increases pressure on the anus
causing local blood vessels to swell. If pregnant, sleeping on
your side can reduce pressure on the blood vessels in your
pelvis, preventing hemorrhoids from increasing.

Preparing for your appointment

Good communication with your doctor is an important part
of any effective health management strategy. Before you
visit your doctor, write down:

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