Prevention and Treatment of Hemorrhoids

Hemorrhoids are usually caused by straining with bowel movements, the increased pressure from pregnancy, or straining with lifting. Even after a hemorrhoidectomy, new hemorrhoids can form if straining continues. It is important that you develop a routine so that you are not constipated and do not have to strain.

The most natural way to achieve this is to eat a high fiber diet. Unfortunately, not everyone is used to this type of diet, and sometimes it is necessary to use laxatives. Some laxatives are safe to use every day on a long term basis, but others are not recommended for this.

High Fiber Diet
Foods rich in fiber include:
-Whole grains such as wheat bran, corn bran, brown rice.
-Vegetables especially carrots, broccoli and peas.
-Nuts and Beans especially peanuts, lentils, kidney beans.
-Fruits such as apples & raisins.

Many breakfast cereals are a good source of fiber. Many experts consider a "high fiber diet" to contain 25-50 grams of fiber per day. Keep this in mind when you read the labels of various cereals.

It is best to use a psyllium seed bulk laxative such as Metamucil, Effer-Syllium, Fiberall, FiberCon, Serutan, Citrucel or Perdiem. These actually add fiber to your diet. A usual starting dose of Metamucil would be two teaspoons in juice or water twice daily. The dose can be adjusted as needed. It is also acceptable to use a stool softener, such as Colace, Surfak, Dialose on a daily basis; or a bowel stimulant plus a softener, such as Senekot-S. It is also safe to use a stool lubricant, such as mineral oil periodically.

On occasion, it is safe to use a bowel stimulant such as a Dulcolax suppository, Milk of Magnesia, Ex-Lax etc.; or to use an enema. However, it is not recommended that these be use on a regular, daily basis.

Relieving Hemorrhoid Symptoms
Almost all acutely swollen hemorrhoids will shrink up, and stop hurting after a week or two with the proper care. Things that you can do to improve symptoms and promote healing are:
-Avoid constipation, this is the most important thing you can do. Take a bulk laxative as mentioned above. Do not strain on the toilet, and don't put off the urge to go.
-Apply an ice pack for a few minutes to a protruding hemorrhoid right after it appears to decrease swelling.
-Take sitz baths in warm water, or use a handheld shower after bowel movements. This will keep the area clean, and will often provide immediate relief from discomfort.
-Local medications such as anesthetic ointments, or Tucks pads may be helpful. However, prolonged use of ointments can cause irritation, so they should only be used for a short period of time.

Pain medication can be used if the other measures are not enough to relieve symptoms. Most narcotic pain medications cause some degree of constipation, so it is best if they are used sparingly. It is best to try Tylenol or ibuprofen (Motrin, Advil etc.) first. If these are not strong enough, you should contact your physician for a stronger prescription.

If you have had an acutely enlarged, painful hemorrhoid you will not necessarily need surgery. You should follow the instructions above, and in many situations this hemorrhoid will shrink and disappear. If it does not shrink up enough for you to be comfortable, or if the problem keeps recurring, I would recommend that you see a surgeon. If you have any degree of rectal bleeding, even if you think the bleeding is coming from a hemorrhoid, then you should see a surgeon, your medical doctor, or a gastroenterologist.