11 Things Every Woman Should Know
11 Things Every Woman Needs To Know About Hemorrhoids
About a month ago, at an event for health journalists, I heard a colorectal surgeon say something that nearly made my eyeballs bug out of my face. "All of us have hemorrhoids, all the time," she said.
Uh, no, nope. There's no way. All these healthy-looking people sitting comfortably on their bums around me have hemorrhoids?! (Here are 5 things your butt is trying to tell you.)
So I called her up after the event and asked her what she meant by that inflammatory (sorry) comment. Never in my life did I think I'd spend 45 minutes on the phone casually throwing around phrases like "anal canal." I also didn't know there was so much to learn about hemorrhoids. Here are the dirty details everyone should know.
Something has to go very, very wrong for that normal anal tissue to become the angry, itchy, painful protrusions you're probably picturing by now. The key culprit is abdominal pressure, Grucela explains, whether that's from straining to go to the bathroom because of chronic constipation, excess belly weight, pregnancy, or even lots of long-distance running. (Lose stubborn pounds, lower your cholesterol, and .) "We think the pressure causes the tissue to stretch out and weaken over time," Grucela says. That stretching causes the blood vessels in hemorrhoids to dilate, bringing more blood to the area, which causes hemorrhoids to swell and potentially bleed.
That would be internal and external, and they're pretty much exactly what they sound like. External hemorrhoids occur right at the anal opening, Grucela says, and they're covered with skin. Because they're covered with skin, they also have nerves, which means external hemorrhoids are the ones that can come with sensations like pain, itching, and burning. Internal hemorrhoids on the other hand are inside the anal canal. You (obviously) can't see them, and because they're not covered with skin, you won't feel any symptoms from them, either. However, internal hemorrhoids are more likely to bleed, and, if the situation gets really dire, they can prolapse, or fall out of the anus.
People are quick to think any symptoms back there must be hemorrhoids, then grab an OTC treatment and deal with the pain. But don't write off a visit to a doc just yet, Grucela says. "Especially with internal hemorrhoids, where you can't see where the blood is coming from, it could be something more serious," she says. "Anybody with new bleeding or blood in the stool should talk to their doctor. We hope it would be something basic like a hemorrhoid, but the symptoms can be similar in colorectal cancer." (Watch for these 5 common signs of colorectal cancer.) Plus, lingering symptoms could actually be due to other causes, like fissures or warts, she says, which would warrant different treatment.
All that straining and pushing increases the pressure that can lead to inflamed hemorrhoids. Treating any constipation is the second step in standard hemorrhoid treatment, Grucela says, and the easiest way to do that is getting hydrated, fast. The more parched you are, the more parched your poop is. Eating enough fiber (or taking a fiber supplement, whether in old-school powder form or newfangled gummies) helps bind water to stool. "That way, it will be softer and pass through less traumatically," she says. The ideal: The kind of poop that glides out so effortlessly you almost don't even need to wipe. If you're still stopped up, constipation meds may help, Grucela says, "but most people will get better by increasing hydration and fiber."
You've cringed at the embarrassing ads, but you can probably save face at the pharmacy by avoiding over-the-counter hemorrhoid creams. "Most patients don't find them that helpful," Grucela says. If you're looking for quick symptom relief, draw yourself a warm bath, she says. Soaking the area can help soothe some irritation. Wiping with witch hazel may also help, she says.
In rare instances, serious hemorrhoids may need to be removed. Doctors use a number of different techniques to do so, including ligation (which uses rubber bands to essentially "choke" a hemorrhoid until it falls off), stapling, infrared light treatment, and, as a last resort, surgery. "The surgery is simple, but the recovery is miserable," Grucela says.
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