Hemorrhoids symptoms, causes & treatment

07/03/2024
Woman in shorts with hand on waist.

Hemorrhoids, whether occasional or chronic, are one of the most common medical conditions in the general population [1][3][4].

According to recent data, they seem to affect 1 in 10 people, according to research in intermational level [3].

What are hemorrhoids?

The term derives from the Greek words “blood” (hema) and “flow” (reo). They are a complex of vessels located in the lower part of the large intestine and are found normally in all people. Their physiological role concerns correct and controlled defecation, as well as the protection of other tissues around from possible injury during the passage of faeces.

 They are essentially swollen normal tissues and small masses, mainly due to venous congestion [1][4].

Generally, they are categorized to:

  • external hemorrhoids, which are located in the anus, and
  • internal hemorrhoids, which are located in the last part of the large intestine (rectum).

External ones usually do not require special treatment, unless hemorrhoid thrombosis occurs or severe discomfort is caused [1][4].

Although it is not a serious health problem and rarely leads to complications, the intense discomfort and pain they may cause often affects the quality of life and makes it important to find solutions to the problem [1][3][4].

 

Hemorrhoids symptoms

Hemorrhoidopathy is accompanied by a series of unwanted symptoms, which significantly degrade the quality of life. The main ones are listed below:

  • Itching, irritation and/or pain
  • Painful bowel movements
  • Painful bumps
  • Blood in the stool or after a bowel movement
  • Mucus secretion

The appearance of blood is the most common symptom of internal hemorrhoids. Usually the blood is light red in color and appears immediately after a bowel movement (on the toilet paper or in the basin).

It is worth noting, however, that in the case of bleeding after defecation, a visit to a doctor should follow, as it may have been caused by other factors.

 

 

What causes hemorrhoids?

Generally talking, hemorrhoids occur when there is too much pressure on the veins around the anus. More specifically, they can be caused by a variety of factors, such as [1][3][4]:

  1. Straining during defecation
  2. Chronic constipation or diarrhea
  3. Sendetary life/ Sitting for a long time
  4. Family history of hemorrhoids
  5. Insufficient physical activity
  6. Age over 50
  7. Obesity or overweight
  8. Pregancy or birth
  9. Unbalanced diet (e.g. low in fiber)
  10. Aggravating dietary factors (e.g. hot foods, alcohol)
  11. Engaging in weight lifting or other activities that strain the body
  12. Anal intercourse
  13. Chronic severe cough

 

What kind of doctor treats them?

A gastroenterologist or general surgeon should make a visual examination, which may be enough to diagnose hemorrhoids. Depending on your risk factors for gastrointestinal disease, your doctor may order further testing (eg, sigmoidoscopy, colonoscopy).

 

Hemorrhoids treatment

Most hemorrhoids go away on their own. Treatments usually focus on relieving symptoms and include lifestyle changes .

1. Self-care

Some basic steps that we can follow ourselves at home are:

  • Good hygiene: cleanse the anus with lukewarm or warm water during a shower or bath on a daily basis. It is recommended, however, not to use soap, as it seems to worsen the condition. Also, avoid dry or rough toilet paper when wiping the area.
  • Hot baths. It is a fact that warm water relaxes muscles and blood vessels, thus helping circulation
  • Be careful with toilet visits: the body should not be strained during them, and defecation should not be postponed. Its delay can lead to constipation and contribute to hemorrhoids appearance. Prolonged stay in the toilet area is equally aggravating.
  • Use a cold compress: this can help reduce swelling in the anal area and relieve swollen hemorrhoids.
  • Exercise & avoid sitting. If you have a mostly sedentary life, it’s time to change that, as there is much pressure in that area. Also avoid sitting on hard surfaces.
  • Weight loss: recommended in case of increased body weight or obesity to improve the condition [1][2][4].
  • Special suppositories and cream for hemorrhoids
  • Consuming plenty of water & more fiber

 

2. Diet and hemorrhoids

There are certain foods that help reduce the symptoms but also prevent the appearance of hemorrhoids, as well as some types of food that seem to worsen the symptoms  [1][5][7].

The most basic rule from a nutritional point of view, is the sufficient consumption of plant fibers (25-30g daily), both soluble and insoluble, as they contribute to the smooth formation, normal volume and density of stools, in order to facilitate the emptying process [1][5].

Good dietary sources are whole grains, seeds, legumes, pears [5][7]. Alternatively, a dietary fiber supplement (eg psyllium) can be taken.

foods rich in fiber around wooden cutting board that writes fiber

High fiber foods for hemorrhoids

1. Dried plums: They are nature’s traditional laxative and are widely used to treat constipation. They improve bowel movements, thanks to the plant fibers and sorbitol they contain.

2. Legumes: lentils, peas, fava beans, beans of all kinds and chickpeas. They are rich in vegetable fiber – mainly soluble.

3. Cruciferous vegetables: include broccoli, cauliflower, Brussels sprouts and cabbage. It has been shown by a number of studies that they have a beneficial effect on the intestinal flora, while they also contain large amounts of plant fiber.

4. Root vegetables: this type includes sweet potatoes, beets, potatoes (with the skin) and radishes.

5. Whole grains & seeds: they are rich in insoluble fiber, contributing to better digestion.

6. Artichokes: research has shown that inulin, a soluble fiber found in artichokes, helps increase the friendly bacteria in the gut and, consequently, relieve hemorrhoids.

7. Celery, peppers, cucumber, pumpkins: they are rich in both water and fiber, two characteristics that facilitate bowel movements and relieve unpleasant symptoms.

8. Raspberries: they are rich in fiber, compared to their small size, as well as rich in water (85% water). They help in cases of constipation and contain a multitude of micronutrients.

9. Apples & pears: they are rich in fiber and also contain pectin which contributes to the smooth density and texture of the stools.

10. Bananas: maybe not the first thing that comes to mind, but thanks to resistant starch and pectin, two ingredients that have been shown to help reduce flare-ups.

Foods tho avoid with hemorrhoids

There are also certain foods and drinks, which should be avoided, especially when we have hemorrhoids in a flare-up. The main ones are mentioned below:

  • Fried food
  • Hot/spicy foods
  • Red or processed meats
  • Salty foods
  • Caffeinated drinks (e.g. greek coffee)
  • Alcoholic beverages (eg red wine)
  • Dairy products
  • White flour

3. Hemorrhoids cream

Hemorrhoids are characterized by blood stagnation and, because of this, the various creams used to treat them contribute to good blood circulation.

Creams for hemorrhoids are used as local treatment, have an analgesic, regenerating, soothing and rejuvenating effect and usually contain herbal extracts that contribute to blood circulation and/or soothe the unpleasant symptoms e.g. horse chestnut, red vine, chamomile, witch hazel, calendula, aloe etc.

Some of the best creams for hemorrhoids:

  1. Honora Anaroid-H
  2. Vidermida MD Rectal Lipogel
  3. Aboca FitoroiD
  4. Ripaderm gel
  5. Frezyderm Rectanal Aid

 

4. Treatment with oil

Among the many home remedies for hemorrhoids, balsam oil stands out! Known for its emollient and soothing action, balsam oil is a good solution for natural treatment at home, as long as the condition is in its initial stage and has not worsened. Other oils that many people use are coconut oil and chamomile oil.

 

5. Dietary supplements

Regarding nutritional supplements that help to treat hemorrhoids, antioxidant formulas containing bioflavonoids and polyphenols are widely used [1][2][4]. Flavonoids are the most common phlebotonic agent used to treat hemorrhoids [4].

According to a research concerning the use of phlebotonic substances in the treatment of hemorrhoids, it appeared that there were significant positive effects in terms of bleeding, itching, but also the general symptomatology [4].

Other nutritional supplements that significantly help improve circulation and therefore reduce symptoms include herbal extracts such as [1][8]:

  • horse chestnut
  • vitis vinifera
  • butcher’s broom
  •  bilberry
  • ginkgo biloba

Finally, it is worth mentioning that dietary fiber supplements, such as psyllium, are often taken, which help alleviate symptoms by combating constipation [6].

 

Complications

Complications from hemorrhoids are rare and include:

  • hemorrhoids thrombosis
  • iron deficiency anemia (because of blood loss)

Hemorrhoid thrombosis involves the formation of blood clots in the swollen vein, and they are more common when they are external. They are characterized by constant and severe pain that increases during defecation as well as when walking. Symptoms may subside after a few days, but the condition requires examination by a doctor.

 

Summary

In conclusion, hemorrhoids are not, in most cases, a dangerous health condition. However, they can negatively affect the quality of life and cause intense discomfort in everyday life.

For this reason, it is good to treat them in time with the help of a health professional or, ideally, to prevent their appearance.

Maria Malteza

Malteza Maria, MSc, BSc Dietitian - Nutritionist, specializing in Clinical Nutrition, Nutritional Evaluation and Nutritional Supplements.

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Disclaimer

The content of this blogspot is not and can not be considered as medical advice, diagnosis or treatment. All information is provided to readers solely for informational purposes. There is no intention to substitute this content for personalized medical advice, diagnosis, prognosis or treatment.

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