Hemorrhoids: When to Seek Medical Help and Treatment Options

Hemorrhoid issues

Hello, I have been suffering from hemorrhoids for 8 years.
I have seen doctors intermittently, but they only prescribed topical medications.
I haven't addressed it for the past five years.
Recently, I have been experiencing pain during bowel movements, and upon inspection, I found two hemorrhoids: one external and one that has prolapsed and cannot be pushed back in (the color of the hemorrhoids is purplish-red).
I maintain a light diet, exercise four times a week (for 2 hours each session), and have regular bowel movements daily.
My sleep schedule has only been disrupted for the past month, as I have been getting only 4-5 hours of sleep per night (previously, my sleep was normal).
Could my recent lack of sleep be the cause of this? Do I need to see a surgeon for an examination, or can I just buy an ointment from the pharmacy and combine it with warm sitz baths? Thank you for your response, doctor!

Xiao Yi, 20~29 year old female. Ask Date: 2013/02/28

Dr. Ke Fangxu reply Surgery

Hemorrhoids that are not accompanied by pain or bleeding do not necessarily require surgical intervention.
Even in the presence of these symptoms, it is recommended to first try medication treatment.
Surgery should only be considered if medication is ineffective or if the hemorrhoids are severely prolapsed and significantly impact daily life.
Otherwise, maintaining a healthy lifestyle is sufficient.

Reply Date: 2013/02/28

More Info

Hemorrhoids, commonly 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 hemorrhoids, which occur inside the rectum, and external hemorrhoids, which develop under the skin around the anus. Given your description, it seems you are experiencing both types, with one external hemorrhoid and one internal hemorrhoid that has prolapsed.

Your symptoms, particularly the pain during bowel movements and the presence of a purple-red colored hemorrhoid, indicate that your condition may have worsened. The pain you are experiencing could be due to several factors, including straining during bowel movements, prolonged sitting, or even the recent changes in your sleep patterns and lifestyle. Lack of sleep can contribute to stress and may lead to changes in bowel habits, potentially exacerbating hemorrhoid symptoms.

It is important to recognize when to seek medical help for hemorrhoids. You should consider consulting a healthcare professional if you experience any of the following:
1. Severe Pain: If the pain becomes unbearable or does not improve with over-the-counter treatments.

2. Bleeding: If you notice significant bleeding during bowel movements or if the bleeding persists.

3. Prolapse: If the hemorrhoid cannot be pushed back inside or if it becomes increasingly painful.

4. Changes in Bowel Habits: If you experience changes in your bowel habits, such as diarrhea or constipation, that persist.

5. Symptoms Persist: If your symptoms do not improve with home treatments after a week.

In your case, since you have not sought medical attention for five years and are now experiencing significant discomfort, it would be prudent to schedule an appointment with a healthcare provider, preferably a colorectal surgeon. They can perform a thorough examination to assess the severity of your hemorrhoids and rule out other potential issues, such as anal fissures or more serious conditions.

In the meantime, there are several home treatment options you can consider to alleviate your symptoms:
1. Warm Sitz Baths: Soaking in warm water for 10-15 minutes several times a day can help reduce swelling and relieve pain.

2. Over-the-Counter Creams: Hemorrhoid creams or ointments containing hydrocortisone or witch hazel can provide temporary relief from itching and discomfort.

3. Dietary Changes: Increasing your fiber intake through fruits, vegetables, and whole grains can help soften stools and reduce straining during bowel movements. Staying well-hydrated is also crucial.

4. Avoid Straining: Try to avoid straining during bowel movements, as this can exacerbate hemorrhoids. If you feel the urge to go, do so promptly.

5. Exercise: Regular physical activity can help promote healthy bowel function and reduce the risk of constipation.

While these home remedies can provide temporary relief, they are not a substitute for professional medical advice. If your symptoms persist or worsen, it is essential to seek medical attention. A healthcare provider may recommend additional treatments, such as rubber band ligation, sclerotherapy, or even surgical options if necessary.

In summary, while lifestyle factors such as sleep patterns can influence your symptoms, it is crucial to consult a healthcare professional for a proper diagnosis and treatment plan. Early intervention can help prevent complications and improve your quality of life.

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