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A variety of problems may be mistaken for hemorrhoids. These include benign tumors called polyps, cancerous tumors, slit-like breaks in the skin (fissures), venereal warts, infection of an anal valve (sphincter), or other infection that leads to abscess.

These problems can produce the same symptoms as hemorrhoids. Therefore, a physician should be contacted when there is any question as to the cause of symptoms.

A physician also should be contacted if hemorrhoidal symptoms are relieved in seven or fewer days with self-care and self-medication, if pain is severe, or if bleeding is noticed. Also consider contacting a physician if any of the following is apparent:

• Abscess: painful swelling caused by infection (often produces pus).
• Seepage: passing of mucus or fecal material due to inability of the anal sphincter to close completely.
• Prolapse with strangulation: an internal hemorrhoid (in rectum) descending through the anal sphincter with blood supply cut off.
• Painful defecation: severe or persistent pain occurring with defecation.

Hemorrhoids are composed of masses of blood vessels and other tissues in the area of the anus and rectum. Itching, burning, discomfort, swelling, inflammation, and pain can occur with “piles” the common name for hemorrhoids.

Although these symptoms often can be relieved with self-care and nonprescription medicines, a physician’s advice is needed for some hemorrhoid symptoms and for problems resembling hemorrhoids.

Hemorrhoids are most likely to occur between the ages of 20 to 50, but can appear at other times. Some authorities believe that heredity plays a role in hemorrhoid development. Most experts agree that occupations involving either prolonged sitting or standing can contribute to hemorrhoids, as can a lowfiber diet or a diet with insufficient fluids.

Any activity that increases pressure on the blood vessels in the anorectal area can lead to hemorrhoids (e.g. exertion, constipation, diarrhea, coughing, or sneezing). Pregnancy is a common cause of hemorrhoids and they can be aggravated by labor.

Avoiding circumstances that increase pressure in the blood vessels of the anorectal area could prevent hemorrhoids or reduce the intensity of symptoms. Constipation should be avoided. Consuming a high-fiber diet (vegetables, fruits, and whole grains) and drinking plenty of fluids (several glasses daily) is helpful.

Daily use of a bulk-forming laxative product can add needed fiber to the diet. Try to avoid prolonged sitting or standing and activities that involve excessive exertion and straining.

Keeping the anal area clean can relieve itching and other symptoms. Soap and water are excellent. Commercial wipes (available at pharmacies) are a convenient away from home alternative. Sitz baths (sitting in warm water) can relieve many symptoms.

Several non-prescription products are available for relieving the many symptoms of hemorrhoids. Some authorities recommend ointment-type products (including creams and gels) over suppositories. Pile-pipes are useful to place ointments inside the anorectal opening. A product should be selected based on one’s specific symptoms. Knowledge of various ingredients is a must. Ask your pharmacist to recommend a product that is just right for you.

Itching, burning, and pain: Anesthetics such as benzocaine and pramoxine help relieve these frequently experienced hemorrhoids symptoms. The local anesthetics in some hemorrhoid preparations have not been proven to be effective.

Inflammation: Hydrocortisone cream and ointment in 1% and lesser strength is now available for reducing rectal itching. Such preparations also may relieve some of the inflammation (redness and burning) that often occurs with hemorrhoids.

Swelling: Several hemorrhoid preparations contain vasoconstrictors such as ephedrine, epinephrine, and phenlyephrine. There is some controversy as to whether or not these agents reduce swollen hemorrhoids or provide any special benefit. Although vasoconstrictors may reduce or check bleeding, this symptom requires evaluation by a physician and generally should be treated with non-prescriptive products.

Wound healing: Some hemorrhoid preparations contain a variety of ingredients, which may be promoted as useful in wound healing. These include skin respiratory factor or SRF, a yeast extract, cod liver oil, Peruvian balsam, shark liver oil, vitamin A, and vitamin D. According to an American Pharmaceutical Association publication, there is no evidence that these agents are effective as wound healers.

Miscellaneous ingredients: Most hemorrhoid preparations contain oily materials to protect tissues from fecal materials as well as astringents such as zinc oxide to coagulate protein, reducing irritation and itching. Antiseptics may be included but are of questionable value because of the large number if microorganisms present in the anorectal area.

Mission Statement
The Pat Walker Health Center, University Health Services provides professional and comprehensive medical care, mental health care, health education, and health promotion for a diverse community of students, faculty, and staff.

We, the University Health Services Staff of the Pat Walker Health Center, have a commitment to physical, mental, spiritual, social, and emotional health, the highest standards of quality, and appreciation of the value of each individual.

Through these endeavors we support the educational mission of the University of Arkansas and the growth of each individual.

Pat Walker Health Center – University Health Services
525 N. Garland Avenue, Fayetteville, AR 72701 – (479) 575-4451 – TTY (479) 575-4124
Website: health.uark.edu

Accredited by Accreditation Association for Ambulatory Health Care – A Member of the Division of Student Affairs.

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