Hemorrhoids

 What are hemorrhoids?

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Hemorrhoids are a normal collection of veins around the anal canal. If they don't cause symptoms then they don't need treatment. If aggravated, they cause symptoms including painless bleeding during bowel movements, feeling a bump at the anus, itching, and fecal soilage. 

What causes hemorrhoids?

Hemorrhoids can develop from increased pressure around the anus due to:

·       Straining during bowel movements

·       Sitting on the toilet for too long 

·       Constipation or diarrhea

·       Obesity

·       Pregnancy

·       Anal intercourse

·       Low-fiber diet

·       Aging (With age, the tissues that support the veins weaken and stretch)

 

Hemorrhoid Treatment

1.     Dietary & lifestyle recommendation

·       High fiber diet and fiber supplement (25g fiber/day, especially insoluble)

o  Consider a fiber supplement (Benefiber): Start with 1 teaspoon a day and increase to 1 tablespoon after 2 weeks, mixed with a large cup of water or black coffee

o  It may take 6 weeks to see results

·       Drink 2 liters of water a day

·       Do not strain or linger (reading, iPhone) on the toilet

·       Exercise regularly

·       Discuss any constipation or diarrhea symptoms with your doctor

·       Limit fatty food and alcohol

 

2.    Medications

·       Sitz baths

o  Sit and soak the area in a small bowl with warm water for 15 minutes, 2-3 times per day

o  Consider using Epsom salts

·       Calmol4 Suppositories 

o  Cocoa Butter (Protectant), Zinc Oxide (Astringent)

o  Use one suppository after each bowel movement

·       Witch hazel

o  Tucks, Preparation H pads

o  Use after each bowel movement

·       Steroid cream  

o  Anusol-HC, Preparation H, Proctosol

o   Apply sparingly up to 2 times daily (Do NOT use longer than 1 week)

·       Colace (docusate sodium)

o  Stool softener

o  Start with 200mg at night

 

 High fiber hemorrhoid diet

General rules:

Eat a lot of fruits, vegetables, whole grains

Drink at least 2 liters of water a day (avoid juice- there is no fiber!)

 

Example menu

Breakfast

Apple or banana with almond butter and whole grain toast

Fruits including prunes, raisins and smoothies

Overnight oats or any rolled oat (not instant oats) 

 

Lunch

Salad with lean protein (chicken, tofu)

Whole wheat pasta with sautéed vegetables (zucchini, squash)

Veggie burger with air-baked sweet potato fries

Lentil soup

 

Dinner

Chili with beans

Quinoa with sautéed vegetables

Baked cod with roasted brussel sprouts and baked potato

Buckwheat noodles with tofu and broccoli 

Salmon with string beans and almonds

 

Snack

Carrots with almond butter

Brown rice cake

Sprouted crackers