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Call them hemorrhoids, piles or just a (literal) pain in the behind. If you’re stressing every time you need to park it on the porcelain throne, you’re not alone.
By the time you turn 50, more than half of your peers will have had hemorrhoids at least once in their lives, proving that misery does indeed love company.
If you have hemorrhoids, don’t fret — there are ways to prevent them from interfering with your life before and after the fact.
What are hemorrhoids?
You know that hemorrhoids can cause irritation, pain and even bleeding during bowel movements, but what exactly are these number-two nightmares? Think of them like varicose veins, but for your behind.
“Hemorrhoids are essentially blood vessels in and around the anus and rectum that become enlarged when there's increased pressure,” says Allison Fairbanks, ARNP, MPH, a nurse practitioner at UW Medical Center and Eastside Specialty Center. “They can occur with straining at the time of a bowel movement or after prolonged squatting or sitting in a position where there's increased blood flow to those vessels.”
Internal hemorrhoids can form in the lining of your rectum or anal cavity and, in the most severe cases, may even protrude out. External ones, on the other hand, may feel like bumps underneath the skin around your anus.
Just because you see blood in your stool, it doesn’t automatically mean you have hemorrhoids, either. Bleeding during a bowel movement can be due to a variety of things, from something as common as an anal fissure or tear to more serious conditions like intestinal bleeding or colon cancer.
If that isn’t ugh-worthy enough for you, here’s the clincher: You may not even know you have hemorrhoids. While some cases of the piles are painful and itchy, others may not cause any symptoms.
“It's difficult to predict who's going to have an issue with them,” says Fairbanks. “Commonly hemorrhoids are identified incidentally, for example on a colonoscopy.”
Why do I get hemorrhoids?
Have you heard that hemorrhoids are caused by sitting on a cold, wet surface? Or that you got them because you ate too much spicy food? Or that it’s a condition only older populations have to worry about? False, false and false again.
“Some aspects of the pathophysiology of hemorrhoid development remain poorly understood,” says Fairbanks.
All that said, the experts do have some pretty good hunches about what may be triggering your latest flare-up. The most likely causes are increased pressure in your abdomen and pelvis, as well as a natural weakening of the tissue surrounding your veins, which allows them to bulge.
That’s why hemorrhoids often occur in pregnant women, people who lift heavy objects like weightlifters and those who repeatedly push or strain to do their business, often due to constipation or diarrhea.
It also explains why many people think that piles are only a concern as you age. While it’s most common between the ages of 45 and 65, unfortunately, the reality is that you can get hemorrhoids at any age. (Oh, joy.)
Even though what you eat — or don’t eat — doesn’t directly cause hemorrhoids, your diet can also play a huge role. For example, if you don’t consume enough water or fiber, you’re more likely to become constipated. With all that increased straining, well, you see how this all flushes out.
“Many people don't get enough fiber in their diet. Fiber helps both constipation and diarrhea as it softens firm stools and forms loose stools,” says Fairbanks. “The recommended amount is 25 to 30 grams per day.”
In other cases, digestive disorders that commonly feature symptoms of diarrhea and constipation, such as irritable bowel syndrome, can also indirectly trigger a case of the piles.
Do hemorrhoids go away on their own?
If you already have hemorrhoids, you’re probably wondering what you can do to get rid of them ASAP. Luckily, you may not have to do much of anything.
“They may not completely go away but they often subside in terms of symptoms,” says Fairbanks. “They could potentially flare up again if there's an episode of constipation, diarrhea, straining or prolonged sitting. But by using at-home therapies, symptoms often improve and people can go on and not be bothered by hemorrhoids.”
Smaller hemorrhoids may clear up on their own in just a few days. But larger, more severe ones can take longer to soothe and may cause discomfort. If that’s the case, don’t be afraid to pay a visit to your doctor.
How can I treat hemorrhoids at home?
While a case of the piles can disappear as quickly and randomly as it popped up, there are a few home remedies you can try to prevent future occurrences or help move things along if you’re currently dealing with a flare-up.
Put away your phone
Your habit of scrolling through your social media feed while on the can may prolong your pushing and straining when you go number two. It’s better to do your business and then be on your way.
“Sometimes we use the bathroom as a space to get away from whatever chaos is going on in our lives,” says Fairbanks. If this is you, she has a strategy: Once you’ve done your business, flush, wash your hands and then sit back down on the toilet with the cover closed and continue scrolling away — this puts much less pressure on the rectum.
Up your water and fiber intake
Staying hydrated is good idea anyway, but it will also help prevent constipation. Also, increase your fiber to keep your plumbing working properly. If you’re really constipated, you can consider an over-the-counter laxative or stool softener as well.
Use a cream or another at-home remedy
For uncomfortable hemorrhoids, Fairbanks suggests short courses of hydrocortisone cream (less than 1 week), warm sitz baths (but not too hot) or moist towelettes to help soothe the affected area.
Try a toilet stool
Finally, Fairbanks recommends a toilet stool, or even a stack of books, to elevate the knees at the time of a bowel movement, which straightens the colon and helps your BMs go more smoothly and quickly.
When should I worry about hemorrhoids?
Let’s say you’ve waited it out and tried home remedies to no avail. If your hemorrhoids are still bothering you after several days, it may be time to seek out a medical professional.
“Go see your provider anytime there’s a persistent change in bowel habits, rectal bleeding, pain with bowel movements or pain around the anus,” says Fairbanks.
Your doctor will check to make sure you’re actually experiencing hemorrhoids and not something else like a digestive disorder, inflammation of the colon, intestinal bleeding or colon cancer.
If it’s really just pesky piles that refuse to go away, you can ask about minimally invasive options to help them resolve more quickly. The most common of these procedures is a rubber band ligation, where a rubber band is placed around an internal hemorrhoid to cut off its circulation, but other choices range from an injection to use of an infrared light.
With the right amount of care, you’ll be back to your regularly scheduled programming in no time.
This article was originally published October 7, 2019. It has been reviewed and updated with new info. Angela Cabotaje and Luke Whelan contributed to this article.
