Preventing Hemorrhoids: Tips for Long Hours of Standing and Treatment Options

Regarding the prevention of hemorrhoids and an external hemorrhoid?

Hello, doctor.
I am an international student in a healthcare-related field, and my internship requires prolonged standing (at least 5 hours).
I have previously been treated for internal hemorrhoids.

1.
Will wearing compression garments help in preventing hemorrhoids? Or do you have any recommendations for what to wear?
2.
Recently, I had a cold and cough for almost a month (not pneumonia, so no worries), and after a day of prolonged walking, I noticed a small bump at the anal opening.
I check daily while showering, so it was quite sudden.
Could this be a thrombosed external hemorrhoid? It seems to fluctuate in size depending on my posture.
Does this mean it is not classified into different grades of hemorrhoids?
3.
Are there different hemorrhoid ointments for internal hemorrhoids, external hemorrhoids, and thrombosed external hemorrhoids? If so, what are the main ingredients for each? (This would help me when purchasing at a pharmacy abroad.) Thank you, and I apologize for asking so many questions at once.

Shou Si Lang, 20~29 year old female. Ask Date: 2020/07/24

Dr. Ke Fangxu reply Surgery

1.
Compression garments are known to be effective in preventing lower extremity varicose veins, but there is no evidence to suggest they are effective in preventing hemorrhoids.

2.
It is possible, but a medical examination is necessary to determine the grade of hemorrhoids, which is useful for the physician's classification; patients generally do not need to be concerned about this.

3.
Hemorrhoid ointments are generally the same and are not specifically categorized for internal or external hemorrhoids.
The main active ingredients typically include anti-inflammatory, anti-edema, analgesic, and astringent properties.
You can simply purchase a hemorrhoid ointment at the pharmacy.

Reply Date: 2020/07/24

More Info

Preventing hemorrhoids, especially for individuals who spend long hours standing, is a significant concern. Hemorrhoids, which are swollen veins in the lower rectum and anus, can be exacerbated by prolonged standing, straining during bowel movements, and other lifestyle factors. Here are some tips and treatment options to consider:
1. Compression Garments: Wearing compression garments, such as compression stockings or shorts, can help improve blood circulation in the lower body. This may reduce the risk of developing hemorrhoids by preventing blood from pooling in the veins of the rectal area. While there is limited specific research on the effectiveness of compression garments solely for hemorrhoid prevention, they can be beneficial for overall venous health, especially for those who stand for extended periods. It is advisable to choose garments that provide graduated compression, which is tighter at the ankle and gradually loosens towards the knee or thigh.

2. Identifying Symptoms: The sudden appearance of a small bump near the anus, especially after prolonged standing or straining, could indeed indicate a thrombosed external hemorrhoid. These can appear as a painful lump and may fluctuate in size depending on body position and pressure. If the bump is painful, tender, and changes size, it is likely a thrombosed hemorrhoid rather than a more serious condition. However, it is essential to consult a healthcare professional for an accurate diagnosis and appropriate treatment.

3. Understanding Hemorrhoid Types and Treatments: Hemorrhoids are classified into internal and external types. Internal hemorrhoids are located inside the rectum and are usually not visible, while external hemorrhoids are under the skin around the anus. Thrombosed external hemorrhoids occur when a blood clot forms in an external hemorrhoid, leading to significant pain and swelling.

- Medications: Over-the-counter hemorrhoid creams and ointments often contain ingredients like hydrocortisone or witch hazel, which can help reduce inflammation and discomfort. Some products are specifically formulated for internal or external hemorrhoids, so it’s important to read labels carefully. For example, creams for external hemorrhoids may contain local anesthetics to relieve pain, while those for internal hemorrhoids may include soothing agents to reduce irritation.

- Active Ingredients: Common active ingredients in hemorrhoid treatments include:
- Hydrocortisone: Reduces inflammation and itching.

- Witch Hazel: A natural astringent that can soothe and reduce swelling.

- Lidocaine: A local anesthetic that helps relieve pain and discomfort.

- Phenylephrine: A vasoconstrictor that can reduce swelling and discomfort.

4. Lifestyle Modifications: To prevent hemorrhoids, consider the following lifestyle changes:
- Stay Hydrated: Drink plenty of water to keep stools soft and prevent straining during bowel movements.

- Dietary Fiber: Increase fiber intake through fruits, vegetables, and whole grains to promote regular bowel movements.

- Regular Exercise: Engage in regular physical activity to improve circulation and reduce pressure on the rectal veins.

- Avoid Prolonged Sitting or Standing: If your job requires long periods of standing, take breaks to walk around and relieve pressure.

5. When to Seek Medical Attention: If you experience severe pain, bleeding, or if the bump does not improve with home treatment, it is crucial to seek medical advice. A healthcare provider can offer treatments such as rubber band ligation, sclerotherapy, or surgical options for more severe cases.

In summary, wearing compression garments may help with circulation and potentially reduce the risk of hemorrhoids. If you suspect you have a thrombosed external hemorrhoid, it is best to consult a healthcare professional for an accurate diagnosis and treatment plan. Additionally, maintaining a healthy lifestyle with adequate hydration, fiber intake, and regular movement can significantly help in preventing hemorrhoids.

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