Hemorrhoids: Symptoms, Treatment, and Lifestyle Tips

Hello, Dr. Chang, I would like to ask some questions?

I am the one sending these two images: https://imgur.com/a/u4AZ5bq and https://imgur.com/a/Xm8FuM4.
I would like to ask the following:
1.
Regarding the hemorrhoids shown, can second-degree hemorrhoids be caused by my incorrect bowel movements (mistaking it for hard stool)? Does this mean it could be thrombosed? I mistakenly thought it was stool that was stuck at the anal opening and had been hard for several hours...
Until I realized something was wrong and took a picture with my phone, only to find out it wasn't stool.
Recently, I have been under a lot of work pressure at home, along with anxiety, staying up late, and having an irregular diet, which may have triggered the urge to defecate.
Or could it be that the swelling of the hemorrhoids made me feel like I still had the urge to go, leading to a worsening perception of the situation?
2.
Will this condition worsen, or if I normalize my diet and lifestyle, along with doing warm sitz baths, will it remain at the second-degree level? (It has already subsided, and I have no other discomfort.
After returning home, I had a good meal, took my medication, and slept, and when I woke up, the swelling had decreased.) You previously mentioned the possibility of surgical intervention.
Does surgical intervention mean using a needle to drain the blood, or does it involve excision?
3.
I plan to start cycling soon.
Will this activity have any negative effects? Or, as mentioned online, as long as I ride correctly and take moderate breaks every 30-40 minutes while maintaining proper care, even though the hemorrhoids won't disappear, can I prevent them from worsening?
4.
Currently, my bowel movements are normal, with well-formed stool that is neither too hard nor too soft (my last meal was a moderately moist porridge with mushrooms, eggs, and seaweed sauce).
However, regarding the image, is the watery stool I passed a result of me straining too much, combined with the effects of the stool softener I previously took, leading to such a bowel movement (the one that caused the hemorrhoids to prolapse due to excessive straining)?
5.
Lastly, if I confirm that I have finished my bowel movement but still feel the urge at the anal opening, is this an illusion caused by the hemorrhoids? Should I stop trying to defecate, clean myself, and then do a warm sitz bath? If I do experience constipation, should I avoid straining? What should I do if I can't pass stool? Also, I haven't been passing gas much these days; could this be because my incorrect bowel movements have expelled all the gas?
Thank you for your response, doctor.
I appreciate your hard work.

Mr. Chen, 30~39 year old female. Ask Date: 2022/09/13

Dr. Zhang Shuhao reply Surgery

1.
Enlarged hemorrhoids almost always have thrombosis due to bleeding, which is caused by straining during bowel movements.
Therefore, it is recommended to minimize the duration of straining.
Severe swelling of hemorrhoids can also lead to a sensation of urgency.

2.
Improving lifestyle habits can prevent the worsening of hemorrhoids and reduce the frequency of flare-ups.
Surgery can be performed to remove the thrombosis during acute episodes, or a complete excision of both internal and external hemorrhoids can be chosen.
The latter involves removing the prolapsed hemorrhoidal tissue to prevent recurrence.
3.
Cycling is permissible, but it is advisable to avoid hard and narrow racing saddles, and the duration should not be excessive.
Riding should also be avoided if there is discomfort from prolapsed hemorrhoids.
4.
If constipation is not an issue, one can temporarily stop using stool softeners and gradually increase dietary fiber intake to ensure well-formed stools that are easy to pass.
5.
The time spent on the toilet should be minimized; one can first stop the bowel movement, increase fluid intake, and engage in moderate exercise to promote gastrointestinal motility, then try again when there is a sensation of urgency.

Reply Date: 2022/09/13

More Info

Understanding hemorrhoids, particularly in the context of your symptoms and experiences, is crucial for managing this condition effectively. Hemorrhoids, also known as piles, are swollen veins in the lower rectum and anus that can cause discomfort, pain, and bleeding. They can be classified into two types: internal and external. Internal hemorrhoids are located inside the rectum, while external hemorrhoids are found under the skin around the anus.

1. Symptoms and Causes
From your description, it seems you may be experiencing second-degree hemorrhoids, which can protrude during bowel movements but retract on their own afterward. The symptoms you mentioned, such as the feeling of a hard stool and the mistaken belief that you were unable to pass stool, can indeed contribute to the worsening of hemorrhoids. Straining during bowel movements can lead to increased pressure in the rectal veins, resulting in swelling and potential thrombosis (formation of a blood clot) in external hemorrhoids.

The stress and anxiety you mentioned, along with irregular eating habits, can exacerbate constipation and lead to straining, which is a common trigger for hemorrhoids. It’s essential to maintain a balanced diet rich in fiber, stay hydrated, and manage stress to prevent further complications.

2. Management and Treatment
If your hemorrhoids have subsided and you are not experiencing any discomfort, it is a positive sign. Maintaining a healthy lifestyle, including a high-fiber diet, regular hydration, and proper bowel habits, can help keep hemorrhoids from worsening. Warm sitz baths can also provide relief and promote healing.

If you notice any recurrence or worsening of symptoms, it may be necessary to consult a healthcare provider. Surgical options for hemorrhoids typically include procedures like rubber band ligation, sclerotherapy, or hemorrhoidectomy, depending on the severity and type of hemorrhoids. The procedure does not involve simply draining blood but may require the removal of the hemorrhoid tissue.

3. Exercise Considerations
Regarding your plan to engage in cycling, it is generally safe to exercise with hemorrhoids, provided you take precautions. Proper bike fit and posture can help minimize pressure on the pelvic area. Taking breaks during long rides and avoiding excessive strain can also help. However, if you experience pain or discomfort while cycling, it may be wise to reduce the intensity or duration of your rides.

4. Bowel Habits
It’s important to listen to your body when it comes to bowel movements. If you feel the urge to defecate but are unsure if you have fully emptied your bowels, it’s best to avoid straining. Instead, you can try to relax and allow your body to naturally pass stool. If you find that you are unable to pass stool after several attempts, consider using a stool softener or consulting a healthcare provider for further advice.

5. Gas and Bloating
The absence of flatulence could be related to your recent bowel habits and dietary changes. If you have been straining or experiencing discomfort, it may affect your digestive process. Ensuring a balanced diet and allowing your body to adjust can help restore normal digestive function.

In conclusion, managing hemorrhoids effectively involves a combination of lifestyle changes, dietary adjustments, and proper bowel habits. If symptoms persist or worsen, seeking medical advice is crucial for appropriate treatment. Remember, maintaining a healthy lifestyle is key to preventing future issues.

Similar Q&A

Dealing with Suspected Hemorrhoids: Symptoms and Next Steps

Hello. I have noticed a protrusion near my anus that appears to be a hemorrhoid, and it has been bleeding frequently for the past three days. I have been using tissue to cover it, otherwise, the blood stains my underwear. What should I do?

Dr. Yuan Hongdao reply Gastroenterology and Hepatology
Hello: Based on your description, it is most likely hemorrhoids; however, other benign tumors and anal inflammation could also present similar symptoms. It is recommended to eat more fruits and vegetables, avoid staying up late, and refrain from consuming irritating foods. After ...

Identifying and Managing Hemorrhoids: Symptoms and Treatment Options

Hello, doctor. I'm not quite sure when it started, but after wiping following a bowel movement, I noticed fresh blood on the toilet paper. After researching online, it seems to be hemorrhoids. However, every time I shower, I feel a small soft lump around the anus, which does...

Dr. Chen Shidian reply Gastroenterology and Hepatology
It is likely internal hemorrhoid bleeding. You can use ointment, wash and dry the area after bowel movements, avoid prolonged sitting, engage in regular exercise, and prevent hard stools.

Managing Hemorrhoids: Symptoms, Treatments, and Lifestyle Factors

Hello, doctor. Recently, after using the restroom, my hemorrhoids have been protruding and are difficult to push back in. I also experience pain during bowel movements and have noticed external hemorrhoids (which I didn't have before). Will applying ointment and taking warm ...

Dr. Ke Fangxu reply Surgery
Topical ointments combined with warm sitz baths can provide some improvement; however, it is still important to avoid constipation and prolonged straining during bowel movements. If there is no improvement or if symptoms worsen, medical consultation should be sought to consider s...

Understanding Bowel Issues: Pain, Irregularities, and Treatment Options

Hello Doctor: Recently, I have been experiencing a sharp pain near my anus and perineum while walking. The shape of my stools is sometimes regular and sometimes irregular, and they have become thinner than before, though not as thin as a pencil—about the thickness of a ten-dollar...

Dr. Cai Yaozhou reply Gastroenterology and Hepatology
Consulting a proctologist for the application of ointment can quickly alleviate symptoms. ## How are hemorrhoids formed? Hemorrhoids are clusters of veins located near the anus that become distorted and engorged due to the degeneration of the supportive tissues of the anal cana...