Hemorrhoid symptoms are the most common reason that patients see a surgeon. What exactly are hemorrhoids? They are blood vessels that line the anal canal. Some of these vessels lie on the inside of the anal canal (internal hemorrhoids), and some of them are on the outside (external hemorrhoids) Everyone has hemorrhoids. We are born with them. They serve some important functions, likely helping with fecal continence.
In some people, hemorrhoids can cause symptoms. What are examples of these symptoms? Bleeding on the toilet paper or in the toilet bowl after bowel movements, feeling tissue come out when having a bowel movement, pain and itching. Risk factors for developing symptomatic hemorrhoids are: advancing age, pregnancy, diarrhea or constipation, sitting on the toilet for long periods of time, and straining to have a bowel movements.
What can you do to improve some symptoms from hemorrhoids or decrease your risk of developing symptoms? First, leave the phone out of the bathroom! Sitting or straining on the toilet bowl causes the blood vessels in hemorrhoids to fill with blood and get bigger. The goal is to spend less than three minutes on the toilet when you are having a bowel movement. Next, increase how much fiber and water you consume. Several studies have shown that daily fiber supplementation decreases bleeding and improves symptoms like pain and itching.
Which fiber should you take? I tell patients that whatever form they will take every day is the best one for them. Fiber supplements come in all kinds of varieties: flavored powders, unflavored powders, tablets, gummies and more. The goal is to get at least 25 grams per day.
There are many fibers available over the counter: psyllium (Metamucil, Konsyl), methycellulose (Citrucel), polycarbophil (FiberCon), and wheat dextrin (Benefiber). If you really want to do it with diet alone, make sure you keep a food diary or use a free app (MyFitnessPal works great). You may be surprised at how little fiber you actually eat. Did you know that 1 serving of prunes only has 3.8 grams of fiber?
Finally, there are times when you should be evaluated by a colorectal surgeon. If you are having regular or severe bleeding, you may need a colonoscopy to check for another source, especially if you have experienced changes in your bowel habits. If you have hemorrhoid symptoms that do not improve with the changes discussed above, you may benefit from a procedure to treat the hemorrhoids.
Learn more about colon and rectal surgery at Ochsner.