Managing and Caring for Mixed Hemorrhoids: Common Concerns and Solutions

Q: Managing and Caring for Mixed Hemorrhoids: Common Concerns and Solutions

Hello： In response to your question, hemorrhoids are composed of spongy tissue located at the anal opening, which helps maintain anal closure. <br>Prolonged congestion can lead to swelling. <br>Therefore, factors such as constipation, straining, prolonged sitting, or increased ab

Management and Care of Mixed Hemorrhoids

Dear Dr.
Ke,
Thank you for your response.
However, I still have some questions I would like to ask you.
Since I discovered I have mixed hemorrhoids about two to three months ago, I have been diligently following the doctor's instructions for care, including sitz baths after bowel movements.
Unfortunately, my condition seems to be worsening, and the external hemorrhoids are getting larger.

Could you please clarify if daily bowel movements and the constant use of the anal area could exacerbate hemorrhoids? Does occasional constipation worsen hemorrhoids, or is it only in the case of chronic constipation? Since external hemorrhoids are located outside the anus, could continuous friction from daily activities cause them to grow larger? If so, how quickly might this occur, and how large could they potentially become? At what size would surgery be necessary?
Additionally, how can I maintain my current condition and prevent further deterioration? I would also like to ask if supplementing with fiber can lead to dependency, and if stopping fiber intake could result in constipation.
Is hemorrhoid ligation a very safe procedure with no side effects? For patients who have undergone ligation and experience a recurrence, will the symptoms be more severe? What types of patients require hemorrhoid ligation? Does undergoing this procedure reduce the likelihood of needing surgery in the future?
I apologize for the numerous questions, but I hope to avoid surgery and maintain my current condition without further deterioration.
My lack of understanding about hemorrhoids has led to many inquiries.
If any of my questions seem ignorant, I appreciate your understanding, and I thank you for your patience in answering my concerns.

Best regards.

Miss Wang, 40~49 year old female. Ask Date: 2011/03/21

Dr. Ke Fangxu reply Surgery

Hello: In response to your question, hemorrhoids are composed of spongy tissue located at the anal opening, which helps maintain anal closure.
Prolonged congestion can lead to swelling.
Therefore, factors such as constipation, straining, prolonged sitting, or increased abdominal pressure can exacerbate hemorrhoids.
The rate and degree of enlargement are related to these contributing factors and are not associated with friction.
If there is no persistent bleeding or severe pain, surgery may not be necessary.
To prevent hemorrhoids from worsening, it is essential to maintain good lifestyle and bowel habits.
Increasing fiber intake can help alleviate constipation, but it will not "cure" it, nor will it lead to dependency; the body will revert to its original state of constipation once fiber intake is stopped.
Hemorrhoid ligation can be performed in an outpatient setting and may occasionally result in complications such as bleeding and pain.
Generally, it is a safe and convenient treatment method for internal hemorrhoids, showing certain effectiveness for bleeding and prolapse.
However, it cannot replace surgical treatment for patients with severe symptoms or those for whom ligation is ineffective; surgery remains the final option.

Reply Date: 2011/03/21

More Info

Managing and caring for mixed hemorrhoids can be a challenging experience, especially when symptoms seem to worsen despite following medical advice. It’s important to understand the nature of hemorrhoids, their causes, and the best practices for management to prevent further complications.

Firstly, mixed hemorrhoids consist of both internal and external hemorrhoids. Internal hemorrhoids are located inside the rectum, while external hemorrhoids are found under the skin around the anus. The symptoms can include pain, itching, swelling, and bleeding, which can significantly affect your quality of life.

Regarding your concerns about daily bowel movements and their impact on hemorrhoids, it is crucial to maintain regular and soft bowel movements. Straining during bowel movements can exacerbate hemorrhoids, leading to increased swelling and discomfort. If you are experiencing occasional constipation, it can contribute to the worsening of hemorrhoids, especially if it leads to straining. Chronic constipation is more likely to cause significant issues, as the repeated straining can put excessive pressure on the veins in the rectal area, leading to the formation or worsening of hemorrhoids.

You mentioned that your external hemorrhoids seem to be getting larger. This can indeed happen due to constant friction and irritation from daily activities, including sitting and wiping. The rate at which hemorrhoids grow can vary from person to person, but if they are consistently irritated, they may become larger over time. If external hemorrhoids become significantly enlarged, surgical intervention may be necessary, especially if they cause severe pain or complications such as thrombosis.

To prevent your condition from worsening, consider the following strategies:
1. Dietary Changes: Increase your fiber intake through fruits, vegetables, and whole grains. This can help soften your stool and reduce the need for straining. However, it’s essential to increase fiber gradually to avoid gas and bloating.

2. Hydration: Drink plenty of water throughout the day to help keep your stool soft.

3. Regular Exercise: Engaging in regular physical activity can help promote healthy bowel function and reduce constipation.

4. Sitz Baths: Continue with sitz baths after bowel movements to soothe the area and reduce inflammation.

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

Regarding your question about fiber supplements, while they can be beneficial for maintaining regular bowel movements, relying solely on them can lead to dependency. If you stop taking them suddenly, you might experience constipation. It’s best to incorporate fiber naturally through your diet.

As for hemorrhoid ligation (banding), it is generally considered a safe procedure with minimal side effects. However, like any medical procedure, it carries some risks. If hemorrhoids recur after ligation, symptoms may not necessarily worsen, but they can still be bothersome. Patients who have persistent symptoms despite conservative management or those with larger hemorrhoids that cause significant discomfort may be candidates for this procedure.

In conclusion, managing mixed hemorrhoids requires a combination of dietary changes, lifestyle adjustments, and possibly medical interventions. If your symptoms persist or worsen, it’s essential to consult with your healthcare provider for a tailored treatment plan. They can assess your specific situation and recommend the most appropriate course of action, which may include further evaluation or surgical options if necessary. Remember, proactive management is key to preventing complications and maintaining your quality of life.

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