When to See a Doctor for Hemorrhoids

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It’s not unusual to hear jokes about hemorrhoids, a condition marked by swollen veins in the anus and lower rectum. But if you’re one of the millions of people who have hemorrhoids, particularly severe hemorrhoids, you know they’re not funny. Also called piles, they affect about 1 in 20 people in the United States, and about half of people over age 50 have hemorrhoids. They can be internal (inside your anus or rectum) or external. But are hemorrhoids dangerous and how long do they last? Here is some information to help you learn more about this common infliction.

Common Causes of Hemorrhoids

Hemorrhoids are caused by pressure in the lower rectum or anus or trauma to the area. This blocks or slows down blood flow from your rectal area and causes the veins to bulge and push out. Hemorrhoids can be caused by:

  • Straining while moving your bowels

  • Chronic constipation or diarrhea

  • Pregnancy

  • Obesity

  • Sitting for extended periods

  • Eating a low-fiber diet

  • Frequent heavy lifting

  • Anal intercourse

  • Anal infections

Hemorrhoids are also more obvious as we age because the connective tissue that holds internal hemorrhoids inside the rectum may weaken, allowing the veins to bulge (prolapse) through the anus.

Hemorrhoid Treatment at Home

Hemorrhoid symptoms can be quite uncomfortable but there are several treatments you can do at home that may help relieve the pain and discomfort.

  • Take a warm bath or sitz bath for 10 to 15 minutes after each bowel movement.

  • Clean around your anal area gently each day with warm water.

  • Do not use alcohol-based or perfumed cleaning wipes around your anus. These cause drying and irritation.

  • Moisten toilet tissue before using it to clean after a bowel movement.

  • Apply cold compresses to your anus.

  • Use stool softeners.

  • Take over-the-counter pain relievers, including acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen or naproxen.

You may help prevent hemorrhoids from forming or from worsening with some lifestyle changes as well. They include:

  • Don’t strain while moving your bowels.

  • Limit the amount of time sitting on the toilet.

  • Increase fiber in your diet. Fiber helps give stool bulk so it can be moved through your intestines, and it also helps water remain in the stool so it doesn’t get too dry and difficult to pass.

  • Increase fluid intake. Drink 6 to 8 glasses of water and other liquids to help keep your stool soft.

  • Exercise regularly. This will help regulate and stimulate your bowels.

  • Apply topical ointments. Over-the-counter creams and suppositories can help relieve pain and reduce swelling.

When to See a Doctor for Hemorrhoids

How long do hemorrhoids last? The answer to this is variable. Treatment for small hemorrhoids may work within a few days, while larger hemorrhoids may last much longer. Most hemorrhoids can be managed at home but if the pain or bleeding is severe; you are soiling yourself with stool; the hemorrhoids keep returning; or you are experiencing pain, bleeding and itching from the hemorrhoids after a week, consider seeing your doctor for assessment and treatment.

Although not common, if you experience dizziness, fainting, or large amounts of bleeding from your rectum, this is an emergency and you should seek medical help immediately.

Who to See for Hemorrhoids

In most cases, your family doctor or primary care physician can help you manage hemorrhoids. However, if the hemorrhoids are severe, you may need to see a hemorrhoid doctor, such as a colorectal surgeon or a gastroenterologist. These providers can provide more advanced hemorrhoid treatment, such as:

  • Rubber band ligation: A surgeon places a special medical-grade rubber band round the base of the hemorrhoid to cut off blood circulation. Within a week, the end of the hemorrhoid shrivels and falls off, leaving behind scar tissue.

  • Hemorrhoidectomy: This is an out-patient surgical procedure to remove the hemorrhoids.

  • Hemorrhoid stapling: Used primarily for internal hemorrhoids, this procedure uses a stapling tool that removes tissue.

  • Sclerotherapy: This involves an injection of a chemical solution directly into the hemorrhoid to shrink it.

  • Infrared photocoagulation: Used only for internal hemorrhoids, this procedure directs an infrared light towards the hemorrhoid tissue to cause scars, which block blood flow to the hemorrhoids.

  • Electrocoagulation: Similar to infrared photocoagulation, this procedure uses electric current to cause scar tissue.

Some people may be embarrassed to speak with their doctor about hemorrhoids, but the condition is so common that your doctor won’t be surprised if you bring it up. There’s no need to live with the pain and discomfort of hemorrhoids. Prompt treatment will allow you to live your life more comfortably.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Aug 11
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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