Hemorrhoids and how to handle them:

By Dr. Kati Glockenberg

What are Hemorrhoids?

Hemorrhoids, also known as piles, are enlarged veins in the lower rectum and anus. They are one of the most common causes of rectal bleeding. Hemorrhoids come in two varieties, internal, which occur in the lower rectum, and external, which develop around the anus.

What are the most common causes of hemorrhoids?

Hemorrhoids often result from chronic constipation. They can also result from sitting too long on the toilet, being pregnant, having liver disease or obesity.

What are the symptoms of hemorrhoids?

Hemorrhoids often cause blood on the toilet paper or in the bowl. Depending on the location, they can be painful or painless and may cause anal itching. Patients may also note a bulge or lump protruding from the anus. Occasionally, hemorrhoids can become thrombosed or strangulated leading to sudden and severe anal discomfort.

How do I prevent hemorrhoids?

Use the following tips to prevent hemorrhoids from occurring:
  • Maintain an active lifestyle to help keep your body moving stools
  • Eat plenty of fiber
  • Drink plenty of water
  • Avoid sitting on the toilet for long periods
  • Avoid straining to pass stools
  • Use the restroom as soon as you have the urge

How do I treat hemorrhoids?

Some hemorrhoids are self-resolving. However, others require either homecare or minorprocedures. The first line of treatment is usually dietary modifications and medicated creams/ointments.First line treatment includes:
  • High fiber diet: Aim to have around 20-35g of fiber a day through the diet and/or addition of a fiber supplement such as psyllium husk, wheat dextrin or methylcellulose.
  • Stool softeners or gentle laxatives may also be helpful in managing hemorrhoids related to chronic constipation.
  • Over the counter remedies such as PrepH or witch hazel may be helpful. Your doctor may also prescribe an ointment or cream.
  • Sitz baths: soaking the area in warm water for 10-15 minutes, 2-3 times a day may be helpful.
If these treatments are not effective, your doctor might recommend one of the following hemorrhoid medical treatments:

When Should I See a Doctor for Hemorrhoids?

You should see a doctor for hemorrhoids if you experience bleeding with bowel movements, significant pain with bowel movements or if the hemorrhoids fail to get better after a week of care at home. You should seek immediate attention if you have severe rectal bleeding or lightheadedness. For more information or to book an appointment with Gotham Gastroenterology, contact our office at 212-794-0240. Our team of experts strives to provide excellence in gastroenterology for patients in NYC. You can also make an appointment by filling out a form.

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