Recurring Internal Hemorrhoids: Causes and Management Tips

Old disease internal mole~

Hello, Doctor: I apologize for bothering you.
I had an episode of hemorrhoids about two to three years ago, which was not severe at the time, so I recovered after seeing a doctor.
However, I have gradually noticed that the likelihood of recurrence has increased.
Initially, it would take a long time of consuming very spicy food and staying up late for it to recur, but now it seems that just a few days of staying up late can trigger problems.
Due to my work, I have to sit for long periods, and while I try to stay active, I still find it very easy to relapse.

Regarding my condition: I often experience rectal bleeding during bowel movements, and wiping can be painful.
I also feel a persistent discomfort inside my rectum, and during flare-ups, I tend to become constipated.
I have a few questions for you:
1.
Is it true that once someone has hemorrhoids, they are more likely to experience recurrences?
2.
Since I am prone to recurrences but need to sit for work and occasionally stay up late, what can I do to improve my condition or what soothing actions can I take when I feel an episode coming on? (My diet has always been normal, my bowel movements are regular, and I do not consume soft drinks or snacks.)
3.
Because I frequently experience flare-ups, I have developed a habit of not seeing a doctor.
Is it harmful to use over-the-counter ointments long-term?
4.
If I need to see a doctor, I live in a rural area without a general hospital, only small clinics that do not have a colorectal department, just general surgery.
Can I consult a general surgeon? Will there be any differences in treatment?

A-Jie, 20~29 year old female. Ask Date: 2007/06/29

Dr. Liu Nanshan reply Gastroenterology and Hepatology

Hemorrhoids are indeed prone to recurrence, and prolonged sitting, staying up late, and consuming spicy foods can easily trigger flare-ups.
These factors should be avoided.
Taking a warm sitz bath for 30 minutes after showering can help alleviate symptoms.
If topical ointments or suppositories are not effective, consider endoscopic treatment or surgical intervention, which can be performed by a colorectal specialist.
Some smaller hospitals may also have general surgeons who can manage these conditions.

Reply Date: 2007/06/29

More Info

Understanding recurring internal hemorrhoids can be quite challenging, especially when they become a persistent issue. Hemorrhoids are swollen veins in the lower rectum and anus, and they can be caused by various factors, including straining during bowel movements, prolonged sitting, obesity, and a low-fiber diet. Given your situation, let's address your questions and provide some management tips.

1. Recurrence of Hemorrhoids: Yes, once you have experienced hemorrhoids, you may be more prone to future episodes. This is due to the structural changes in the blood vessels and surrounding tissues that can occur after an initial episode. Factors such as lifestyle, diet, and even genetics can play a significant role in the likelihood of recurrence.
2. Managing Recurrence: Since your work requires prolonged sitting and occasional late nights, there are several strategies you can implement to help manage your symptoms and reduce the risk of flare-ups:
- Dietary Adjustments: Although you mentioned that your diet is generally normal, ensure you are consuming enough fiber (fruits, vegetables, whole grains) to help soften your stool and prevent constipation. Staying hydrated is equally important, so drink plenty of water throughout the day.

- Regular Movement: Try to incorporate short breaks to stand or walk around, especially if you are sitting for long periods. Simple stretches or exercises can also help improve circulation and reduce pressure on the rectal area.

- Warm Baths: Taking warm sitz baths can provide relief during flare-ups. This can help soothe the area and reduce discomfort.

- Over-the-Counter Treatments: While using topical ointments from the pharmacy can provide temporary relief, it’s essential to use them as directed and not rely on them long-term without consulting a healthcare provider.

3. Using Over-the-Counter Medications: While topical treatments can be effective for symptom relief, relying solely on them without professional guidance may not address the underlying issues. If your symptoms persist or worsen, it’s crucial to seek medical advice. Chronic use of topical medications can sometimes lead to skin irritation or other complications.

4. Consulting a Healthcare Provider: If you find yourself needing to see a doctor, visiting a general surgeon at a smaller hospital can be a good option. General surgeons are trained to handle a variety of conditions, including hemorrhoids. They can provide a thorough examination and recommend appropriate treatments. While you may not have access to a specialized colorectal surgeon, a general surgeon can still offer valuable insights and treatment options. In terms of costs, it typically depends on your insurance coverage and the specific services rendered, so it’s best to check with your insurance provider for details.

In summary, managing recurring internal hemorrhoids involves a combination of lifestyle modifications, dietary changes, and appropriate medical care. If symptoms persist, do not hesitate to seek professional help, even if it means consulting a general surgeon. They can guide you through the best treatment options available and help you find relief from your symptoms. Remember, early intervention can prevent more severe complications and improve your quality of life.

Similar Q&A

Understanding Recurring Internal Hemorrhoids: Causes and Solutions

I have dealt with several internal hemorrhoids over the past five months, but after four months, I experienced a recurrence because I found one or two more while using the restroom. Oh my! Is it growing too fast? I haven't been eating spicy food and have been consuming very ...

Dr. Ke Fangxu reply Surgery
Hello: In response to your question, I'm not sure what you mean by "treatment." For hemorrhoids, there are various outpatient treatment options in addition to surgical excision. Each of these treatment methods has its own advantages and disadvantages. Surgical trea...

Managing Recurring Hemorrhoids: Symptoms and Treatment Options

I had hemorrhoid surgery (circular excision) two years ago, and now it has recurred. After using the bathroom, it protrudes, and I have been using warm water baths to push it back in. Recently, I have developed another hemorrhoid, and there is bleeding. It has become more difficu...

Dr. Ke Fangxu reply Surgery
So, your main concern is what to do now? If the circumferential excision did not adequately achieve the disconnection of the hemorrhoidal arteries or if there was insufficient removal of the internal hemorrhoids and rectal mucosa, symptoms may quickly recur. However, due to the p...

Recurring Hemorrhoids: When to Consider Surgery and Causes Explained

Hello, doctor. For the past month, I've been experiencing hemorrhoids that keep changing positions; first at the 12 o'clock position, and then at the 6 o'clock position. Each time, the location is different. I've been applying a hemorrhoid cream for about two ...

Dr. Zhang Shuhao reply Surgery
The occurrence of hemorrhoids is related to lifestyle habits, diet, and individual constitution. Warm sitz baths and topical or oral medications can only alleviate symptoms; if the hemorrhoidal tissue is significantly enlarged, recurrence is inevitable. If hemorrhoid symptoms aff...

Managing Recurring Hemorrhoids: Expert Advice and Treatment Options

Hello, Dr. Hou. Several years ago, I underwent surgery for hemorrhoids, but in recent years, they have recurred. Two years ago, I was diagnosed at Zhongxiao Hospital in Taipei as not suitable for surgery (circumferential surgery) due to a narrowed anal canal. If surgery were perf...

Dr. Hou Yongji reply Surgery
Based on your description, it is not possible to make a definitive diagnosis. Please consult a colorectal surgeon for evaluation and treatment at Chang Gung Memorial Hospital or Taoyuan General Hospital. Dr. Hou Yong-ji.