no, I'm not a back door man

July 26, 2005 4:26 PM

I have haemorrhoids. Do I need to do anything about them?

They are not painful, just a dull ache sometimes. I've never had surgery for anything besides dental work, and the thought of surgery just scares the bejeezus out of me. If you've had surgery for haemorrhoids, what has your post-operative experience been like? And will my haemorrhoids stabilize over the long term or get progressively worse? Are there any serious risks (like mobile blood clots) that could result from just leaving them be? Any other advice?

posted by anonymous to health & fitness (14 answers total)

Well, they're not going to go away on their own, so yeah - I'd do something about them. Rather than going straight for the knife though, why not look at the causes and see if any of them apply to your lifestyle - low fibre content in diet perhaps?
posted by forallmankind at 5:08 PM on July 26, 2005

Surgery will not necessarily be a permanent solution - the hemorrhoids very likely will return. In any case, only the most serious cases require surgery.

You have a good chance of making your hemorrhoids regress if your stool is soft. You can create soft stool with a diet high in fiber (apples with peel, nuts, vegetables, others), drinking plenty of water (at least two quarts/liters per day, and/or stool softeners +/- laxatives. Colace (ducosate sodium) is an over-the-counter stool softener that is harmless (it is not absorbed by your body. If diet isn't doing the job, start with taking one 100 mg tablet of colace at bedtime. Increase the dosage by 100 mg until you have soft stool. If constipation is a problem, at Sennakot, a mild over-the-counter laxative. Sennakot also comes as Senna Plus, which contains 50mg Colace.

Unless your hemorroids are quite serious, there is no risk in treating them as above. If you're concerned, definitely have them examined by a physician just to be sure. I am a physician, but, as you know, discussing somthing online is not nearly as good as in person.
posted by cahlers at 5:26 PM on July 26, 2005

I agree that surgery doesn't sound necessary at this point. The best thing to do to try to keep them from getting worse is to avoid constipation by increasing your fiber and fluid intake. Here's a good chart of the fiber content of various foods as well as more info about different types of fiber. You can also get fiber supplements -- I prefer the psyllium husk capsules to the horrible gritty powder you mix into juice or water (yick!)
posted by scody at 5:35 PM on July 26, 2005

Dude, I just started taking fiber supplements and they went away in about a week. They haven't shown their faces in my neighborhood since.
posted by pornucopia at 6:34 PM on July 26, 2005

The standard fix for permanent submission is eating 1 Dill Pickle a day. Fiber clears away the cause and the dill shrinks them. A lot easier than surgery.
posted by ptm at 7:08 PM on July 26, 2005

I would keep in mind that hemerrhoids can have psychological causes, too, i.e., they can be caused by stress. I switched jobs at the end of April; two or three weeks later, I noticed with great surprise that I hadn't noticed any hemerrhoids since I had started my new job. They entirely disappeared.
posted by WCityMike at 7:33 PM on July 26, 2005

With me it wasn't the aching (didn't really have an ache), it was the ITCHING. OH GOD THE ITCHING! Apparently I had managed to develop a rash on top of 'roids.

This was not pleasant.

So anyway, if you do have some itching- don't scratch. That way lies a rash. Buy some Aveeno oatmeal bath, fill up the tub, and uh... submerge the affected area. It will do right by you.
posted by bobot at 7:41 PM on July 26, 2005

Just casually perused the medical literature - cahlers, scody, et al have an excellent point - increase fiber so your stool isn't putting excessive presure on the veins surrounding the anus.

(Excessive) Weight, in general, seems to be a potential contributor. Physical activity (the lack thereof, sitting a lot + being overweight seems to exacerbate the problem) may also play a role.

Primarily, though, increasing fibre and using preparation H locally should take care of the situation - if it doesn't, then maybe a visit to the doctor would be in order.

/never had 'roids until 2nd year in college - I had no idea how to deal with them... had to ask a friend how to take care of them - preparation H took care of it and I've never had another occurance
posted by PurplePorpoise at 8:16 PM on July 26, 2005

High fiber, yes. Also, never, ever strain on the toilet, and Tucks are your friend.
posted by carmen at 8:18 PM on July 26, 2005

I got them in 1993 after being horribly constipated (including emergency room trip, where the doctor with the x-ray said "you're full up to here", pointing to my solar plexus). Since then I've avoided being constipated through medicinal application of lots of chocolate, and haven't had serious trouble since.
IAA"D", but not of medicine!
posted by Aknaton at 8:31 PM on July 26, 2005

I notice you use the common UK spelling: the most conventional spelling is hemorrhoids - important only because if you decide to go searching for more information on the internet you will get a lot more hits using this spelling.

Warning: time to get grossly biological.

Anyway: in case you don't know hemorrhoids are inflamation and swelling of blood vessels around the anus or lower rectum. They are often caused by straining while shitting, not to put too fine a point on it, which is why all the fiber suggestions. Anything which may irritate the rectum or anus can induce them as well. They can be internal or external, external hemorrhoids can usually be seen and felt as lumps around the anus.

The exception to the don't worry about it advice are thrombosed hemorrhoids: these clotted hemorrhoids are very hard, have a smooth black or purple surface, and feel like a growth coming from the anus. They are extremely painful and require a doctor's care. They will not go away with self-treatment.

However, most hemorrhoids will go away by themselves. Surgery is truly the last resort for only the most extreme of cases. While you wait for them to go away, a topical cream can help. Mostly they are just 1% hydrocortisone to tame the topical pain and itching. In the past I had recurrent hemorrhoids for several years. I found the application of vitamin e oil and a triple antibiotic cream effective for topical treatment and faster and more complete healing, but you may not want to be sitting around rubbing half the medicine cabinet onto your asshole.

Prevention is the key. Supplemental fiber is a good idea, particularly if you have sort of chronic issues in this area. Hemorrhoids are a frequent side issue of colitis, where often the afflicted individual has a problem feeling like they have not full evacuated their bowel, resulting in fruitless straining or pushing. Fiber may help resolve that feeling. Try not to spend a long time on the toilet. I know, I know, but seriously: if you're the type that tens to take a book in and spend twenty minutes in there, cut it out. Fiber will again make shitting faster and more efficient. The toilet is the worst place for the hemorrhoid sufferer - sitting on that ring, you're basically putting all this pressure on your anus, encouraging further swelling of the affected vessels. In addition to the fiber, increasing fluid intake and reducing caffeine, nicotine, and alcohol may help. Hemorrhoids are a common complaint of alcoholics and heavy drinkers, incidentally.

Another thing to consider, particularly during an actual outbreak - get a supply of wet naps, or whatever they're called in your locale - those moist towlette things like for cleaning a baby's bottom. Get both the big pack for home and travel packs you can carry with you. Use these instead of toilet paper and be extremely gentle. Gentle, thorough cleaning with a wet wipe will speed healing. If you're having a particularly bad time consider taking a couple of warm baths a day, preferrably after you use the toilet. Baths sooth and help reduce swelling and cleanliness promotes healing. Make sure to cleanse yourself very thoroughly before going to sleep.

Things that may contribute - sitting a lot. Make sure you take frequent breaks, if you do, getting up and moving around. They are known as a problem of professional drivers. They sell special "donut" pillows that are supposed to help with the sitting thing: I don't know about these.

So, the bottom line is: fiber, hydrate, be extra nice to your asshole, if they don't get significantly better within a few days and go away completely within a few weeks consult your doctor. Moderate lifestyle changes as suggested should eliminate or drastically reduce outbreaks (down to less than one a year or so).

Finally, please don't let embarassment prevent you from dealing with these i.e. buying products at the pharmacist or consulting your doctor. Fifty percent of people experience this unpleasant but generally minor condition before they get to middle age.
posted by nanojath at 8:55 PM on July 26, 2005

So, the bottom line is:

I seriously didn't write that on purpose. Oh, well.
posted by nanojath at 8:59 PM on July 26, 2005

Kuro5hin article that scared the bejeezus out of me a couple of years ago. It's all fresh fruit and veg, wholegrain cereal with All-Bran and high-fibre multi-grain bread for me these days.
posted by obiwanwasabi at 9:09 PM on July 26, 2005

CAUTION: If you increase your fiber, make SURE you increase your water intake. Fiber without water causes, rather than relieves, constipation!

Sometimes nothing more complicated than a bit of vaseline can bring some relief when your problem gets a bit sore. Preparation H or Anusol are better, but if the problem is just irritation from rubbing, simple lube helps.
posted by Goofyy at 2:58 AM on July 27, 2005