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Hemorrhoids
Hemorrhoids are enlarged and inflamed veins that may develop either inside or outside the anal canal. These veins can become enlarged and inflamed when we strain to pass hard, compacted stools.

Prolonged sitting or standing, or being overweight or pregnant, can also cause hemorrhoids.

The symptoms of hemorrhoids include:

• Bright red streaks of blood on stools or spurting from the anus.

• Leakage of mucus from the anus.

• Irritation or itching around the anus.

Sometimes an internal hemorrhoid will actually stick out of the anus, and it may have to be pushed back into place with a finger. Although they can cause discomfort, hemorrhoids do not usually cause severe pain unless a blood clot forms in a hemorrhoid.

A clotted hemorrhoid can be extremely painful, but is not dangerous. While itching around the anus can be a symptom of hemorrhoids, anal itching is usually caused by other conditions.

If the anus is not kept clean, itching may result. Any fecal seepage that comes with diarrhea can irritate the skin around the anus. Trying to keep the area too clean by rubbing with dry toilet paper or using excess soap can also injure the skin.

While it is important to keep the skin in the anal area clean, it is also important to be gentle when doing so. Although uncomfortable at times, hemorrhoids rarely pose a serious health problem. They generally last several days and often come back (recur).

Nearly everyone, in fact, has hemorrhoids at some time. There are, however, steps you can take to reduce your discomfort from hemorrhoids and help prevent their recurring.

How to prevent hemorrhoids

• Try to keep your stools soft
  Be sure to include plenty of water, fresh fruits, vegetables, and whole grains in your diet. Add two tablespoons of bran or a commercial fiber product such as Citrucel or Metamucil to your diet each day.

• Avoid using laxatives, because they may cause diarrhea which can irritate hemorrhoids
  For information about constipation, check your Kaiser Permanente Healthwise Handbook or search online at kp.org.

• Try to exercise every day to promote smooth bowel movements.

• Avoid sitting or standing too much
  This restricts blood flow around the anus. Take short walks to increase blood flow in your pelvic region.

• Go to the bathroom as soon as you have the urge
  Try not to strain during bowel movements. Remember to take your time and never hold your breath.

• If you are pregnant, try sleeping on your side to relieve the pressure on your pelvic area.

• Keep your anal area clean
  More importantly, be gentle when cleaning yourself.

Home treatment

• Taking warm baths can be soothing and cleansing, especially after a bowel movement.

• Try using pre-moistened tissues (baby wipes) or moistened toilet paper instead of dry toilet paper.

• Wear cotton underwear and loose clothing.

• Relieve itching by using cold compresses on the anus four times a day, ten minutes at a time.

• Sitz baths (hot baths with just enough water to cover the anal area) can be soothing, but may worsen itching.

• Use medicated suppositories to relieve pain and lubricate the anal canal during a bowel movement.

• Ease itching and irritation with zinc oxide, petroleum jelly, or hydrocortisone (1 percent) cream.
  Ask your physician before using any product that contains a local anesthetic. These products have the suffix “-caine” in the name of the product or in the name of one of the ingredients. Such products can cause allergic reactions in some people.

Call Kaiser Permanente if:

• Any bleeding continues for longer than one week despite home treatment.

• Pain is severe or lasts longer than one week after home treatment.

• Bleeding occurs for no apparent reason and is not associated with straining to pass stools.

• A lump on the anus is increasing in size or becoming more painful and you develop a fever.

• Fever accompanies bloody stools.

• Stools become more narrow than usual (maybe no wider than a pencil).

• Any unusual material or tissue seeps or sticks out of the anus.

Other resources:

• Connect to our Web site at kp.org. to access health and drug encyclopedias, interactive programs, health classes, and much more.

• Check your Kaiser Permanente Healthwise Handbook.

• Contact your Kaiser Permanente Health Education Center or Department for health information  programs, and other resources.

This information is not intended to diagnose health problems or to take the place of medical advice or care you receive from your physician or other health care professional.

If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse any brand names; any similar products may be used.

© 2002, The Permanente Medical Group, Inc. All rights reserved. Regional Health Education.
Adapted from copyrighted material of Healthwise, Incorporated. 915800009 (Revised 8-08) RL 8.0

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