hemorrhoids procedure preparation

Overview

Hemorrhoids are swollen veins in the lower rectum or anus (the opening where stool leaves your body). They can cause itching, pain, and bleeding. Sometimes, when home care doesn't help enough, a doctor may recommend a procedure to shrink or remove them. This article explains how to get ready for such a procedure.

Yes, hemorrhoids are extremely common, especially in adults over 50. Many people get them at least once in their life.

Hemorrhoids affect people of all ages, but they are most common in adults aged 45 to 65. Pregnant women also often get them due to pressure on the veins during pregnancy.

Symptoms

Common symptoms

• Bright red blood on toilet paper or in the toilet bowl after a bowel movement
• Itching or irritation around the anus
• Pain or discomfort, especially when sitting
• A lump or swelling near the anus that may be tender

Symptoms in children

• Hemorrhoids are rare in children, but if they occur, symptoms are similar: discomfort, itching, or a small lump.
• Children may also have bleeding from a different cause, so a doctor check is important.

Symptoms in older adults

• Older adults may have more fragile tissue, making hemorrhoids more likely to bleed or cause pain.
• They may also have other health issues that affect healing, so preparation for any procedure needs extra care.

Causes

Main causes

• Straining during bowel movements, often due to constipation
• Sitting on the toilet for a long time
• Pregnancy (especially the third trimester) and childbirth
• A low-fiber diet that leads to hard stool

Risk factors

• Being overweight or obese
• A family history of hemorrhoids
• Chronic constipation or diarrhea
• Lifting heavy objects on a regular basis

When to see a doctor

See a doctor urgently if:

• If you have heavy bleeding or a clot (hard lump) that causes severe pain
• If you feel weak or dizzy from blood loss

Book a routine appointment if:

• If you have blood in your stool that lasts more than a week
• If you have itching, pain, or discomfort that home care does not relieve
• If you notice a new lump near the anus that does not go away

Diagnosis

A doctor will ask about your symptoms and then perform a quick physical exam. They may check the anal area and use a gloved finger to feel for swollen veins inside the rectum.

Tests that may be done

• Digital rectal exam — the doctor inserts a lubricated, gloved finger into the rectum
• Anoscopy — a short, lighted tube is used to look inside the anal canal
• Sometimes a sigmoidoscopy or colonoscopy if there are concerns about other bowel problems

What to expect at your appointment

The exam is usually brief and takes place in the doctor's office. It may be a little uncomfortable but rarely painful. You can ask for a numbing spray or gel if needed.

Treatment

Treatment for hemorrhoids depends on how bad they are. For mild cases, home care is often enough. For more severe or lasting hemorrhoids, a doctor may recommend a procedure done in the office or a surgery.

Self-care at home

• Eat high-fiber foods like fruits, vegetables, and whole grains
• Drink plenty of water (at least 8 glasses a day)
• Soak in a warm bath (sitz bath) for 10 to 15 minutes a few times a day
• Use over-the-counter creams or pads that contain witch hazel or a numbing ingredient (ask your pharmacist)

Medical treatments

If home care isn't enough, doctors can offer treatments such as rubber band ligation (placing a small band on the base of the hemorrhoid to cut off blood flow), injection therapy (injecting a chemical to shrink it), or heat/coagulation treatments. These are done in the office, usually without needing to go to a hospital.

When is surgery considered?

Surgery (hemorrhoidectomy) is reserved for very large hemorrhoids or when other treatments have failed. It involves removing the swollen tissue. Recovery usually takes a few weeks. Another option is stapled hemorrhoidopexy, which uses staples to hold the hemorrhoids in place.

Living with this condition

After a procedure, follow your doctor's instructions for cleaning and caring for the area. You may need to avoid heavy lifting and sitting for long periods. Use a cushion or pillow when sitting to reduce pressure.

Lifestyle tips

• Avoid straining during bowel movements — go when you feel the urge, not later
• Keep the anal area clean and dry by gently washing with water
• Stay active with walking or other low-impact exercise to improve circulation

Diet and exercise

Eat a high-fiber diet with at least 25 to 30 grams of fiber per day. Good sources are oats, beans, broccoli, and apples. Drink plenty of water. Exercise like walking helps prevent constipation.

Mental health and emotional wellbeing

Hemorrhoids can be embarrassing or stressful, especially if you have pain or bleeding. It is normal to feel worried. Talk to your doctor or a trusted friend. Remember that treatment is effective and most people feel much better afterward.

Prevention

You can lower your chances of getting hemorrhoids or having them come back by eating a high-fiber diet, drinking enough water, staying active, and not straining on the toilet. But they are very common and may still happen.

Complications

If left untreated

• Chronic bleeding that can lead to anemia (low red blood cells, causing tiredness and weakness)
• A thrombosed hemorrhoid (a painful clot inside the hemorrhoid that may need emergency care)
• Strangulation (when a hemorrhoid gets stuck and its blood supply is cut off, causing severe pain)

Long-term outlook

With proper treatment, the outlook for hemorrhoids is very good. Most people get complete relief from symptoms. Procedures are safe and effective. Even when hemorrhoids come back, they can usually be managed with simple changes.

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