Managing Persistent Hemorrhoids: Tips for Relief and Prevention

Prolapsed hemorrhoids?

I have been suffering from hemorrhoids for a long time.
After having a bowel movement, the hemorrhoids habitually protrude.
If I don't take a nap, they don't retract on their own, and I feel some pain when walking or sitting, which causes me to move slowly.
If I don't take a nap, they don't retract well.
When I go out with friends, I sometimes experience slight bleeding from my rectum, and occasionally it seeps onto my pants, although the amount is not significant.
This makes me hesitant to have a bowel movement when I am out or even before leaving home.
If I go a few days without a bowel movement, it can lead to hard stools, making the hemorrhoids protrude even more severely.
I use water to clean myself after using the toilet to avoid irritating the area, but I still experience minor bleeding or clear discharge.
I consulted a doctor who prescribed an ointment, but applying it has not been effective, and I continue to be troubled by this issue.

Fengyu, 20~29 year old female. Ask Date: 2018/10/09

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, you can visit the general surgery or colorectal surgery outpatient clinic for an evaluation to determine if surgical treatment for hemorrhoids is necessary.
Changhua Hospital cares about your health.
Chen Shidian

Reply Date: 2018/10/09

More Info

Managing persistent hemorrhoids can be a challenging and uncomfortable experience, but there are several strategies that can help alleviate symptoms and prevent further complications. Hemorrhoids, which are swollen veins in the lower rectum and anus, can cause pain, discomfort, and bleeding, especially during bowel movements. Here’s a comprehensive guide to managing this condition.

Understanding Hemorrhoids
Hemorrhoids can be classified into two types: internal and external. Internal hemorrhoids are located inside the rectum and are usually painless, but they can cause bleeding. External hemorrhoids are located under the skin around the anus and can be painful, especially when they become thrombosed (clotted). Symptoms often include pain during bowel movements, itching, swelling, and sometimes bleeding.

Tips for Relief
1. Dietary Changes: One of the most effective ways to manage hemorrhoids is to increase your fiber intake. A diet rich in fruits, vegetables, whole grains, and legumes can help soften stools and make bowel movements easier. This can prevent straining, which is a major contributor to hemorrhoid flare-ups. Aim for at least 25-30 grams of fiber per day.

2. Hydration: Drinking plenty of water is crucial. Staying hydrated helps keep stools soft and reduces the risk of constipation, which can exacerbate hemorrhoids.

3. Regular Bowel Habits: Establish a routine for bowel movements. Try to go at the same time each day, and don’t ignore the urge to go. Delaying bowel movements can lead to harder stools and increased straining.

4. Sitz Baths: Soaking the affected area in warm water for 10-15 minutes several times a day can provide relief from pain and discomfort. This can also help reduce inflammation.

5. Over-the-Counter Treatments: There are various creams and ointments available that can provide temporary relief from itching and pain. Look for products containing hydrocortisone or witch hazel.

6. Cold Compresses: Applying a cold pack to the affected area can help reduce swelling and numb the pain.

7. Avoid Straining: When using the bathroom, avoid straining or holding your breath, as this can increase pressure on the hemorrhoids. If you find it difficult to pass stools, consider using a stool softener or a fiber supplement.

Prevention Strategies
1. Maintain a Healthy Weight: Excess weight can put additional pressure on the pelvic veins, contributing to the development of hemorrhoids. Regular exercise and a balanced diet can help manage weight.

2. Exercise Regularly: Physical activity can help stimulate bowel function and reduce the risk of constipation. Aim for at least 30 minutes of moderate exercise most days of the week.

3. Avoid Prolonged Sitting: If your job requires long periods of sitting, take breaks to stand and move around. This can help reduce pressure on the rectal area.

4. Proper Toilet Posture: Consider using a footstool to elevate your feet while sitting on the toilet. This can help align the rectum for easier bowel movements.

When to See a Doctor
If you experience persistent symptoms, such as significant pain, bleeding, or if the hemorrhoids do not improve with home treatment, it’s important to consult a healthcare professional. They may recommend additional treatments, such as rubber band ligation, sclerotherapy, or even surgical options in severe cases.

Conclusion
Managing persistent hemorrhoids requires a combination of lifestyle changes, dietary adjustments, and proper care. While it can be a frustrating condition, understanding the underlying causes and implementing preventive measures can significantly improve your quality of life. If symptoms persist or worsen, seeking medical advice is essential to rule out other potential issues and to explore more advanced treatment options.

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