Taking Care of Hemorrhoids
Frederick R. Jelovsek MD, MS
\"I have avoided going to the doctor for my hemorrhoids by using over the counter remedies, but it is becoming unbearable. I eat a high-fiber diet but that has not helped either. Is there anything else I can do before I make that embarrassing doctor\'s appointment?\" rf
Hemorrhoids are swollen veins just inside the anus. They produce pain if they come out of the anus with a bowel movement because they are constricted. Once they come out, the skin around them and the veins themselves can become inflamed.
It sounds as if you have tried diet modification to prevent constipation. What other creams or rectally applied compounds have you used? It would also be good to know what your occupation is and what your weight is. These can be factors that contribute to development of hemorrhoids.
What causes hemorrhoids and their symptoms?
Sometimes the veins just inside the anus become swollen if there is pressure on the vein itself to prevent blood flow from returning to the heart. The veins may become constricted by a large amount of stool that stays in the rectum just above the anus in someone who has constipation. A job in which a person sits all of the time can produce hemorrhoids just as a person who is on their feet may get varicose veins of the leg. Straining and sitting a long time on the toilet trying to have a bowel movement is also thought to produce hemorrhoids. Chronic diarrhea causes hemorrhoids by the same mechanism.
Heavy lifting or a chronic cough from asthma, smoking or any chronic lung disease causes hemorrhoids because of increased intraabdominal pressure. This increased pressure is just like straining at stool in that the pressure obstructs the flow of blood through the veins causing them to swell. Obesity can also cause an increased intraabdominal pressure just by the weight of the abdominal wall. It is associated also with hemorrhoids. Pregnancy produces swollen veins and hemorrhoids due to a moderately increased blood volume, and also because the pregnancy itself may slightly block some of the return venous blood flow from the lower pelvis and rectum. Rectoceles can also be associated with hemorrhoids when the rectal wall protrudes out of the vagina and obstructs the veins in the wall of the rectum below.