It’s been said that getting older isn’t for sissies. That’s true particularly for older adults who suffer from painful or uncomfortable hemorrhoids.
Hemorrhoids are swollen blood vessels in and around the anus and lower rectum. They are nothing to be embarrassed about, says Carrie Gwyer, a nurse practitioner with Tidelands Health Gastroenterology.
They are a common ailment and can strike anyone at any age. It’s estimated that 50 percent of the general population will experience a hemorrhoid at some point in their lives. And although hemorrhoids can affect anyone, people ages 45 and older are more likely to get them because constipation and straining during bowel movements is more common as people age.
Hemorrhoids aren’t life threatening, but they can cause pain or discomfort.
There are two types of hemorrhoids: external and internal. External hemorrhoids are found near the anus and are shielded by sensitive skin. Internal hemorrhoids form beneath the lining of the anus. Sometimes an internal hemorrhoid prolapses, which means it has come out of the anal opening and cannot be pushed backed inside.
There are many causes of hemorrhoids, but a primary cause is constipation that leads to straining during bowel movements and puts pressure on veins in the rectal area. Sitting for long periods of time, a low-fiber diet, heredity, overuse of enemas or laxatives, liver diseases and obesity also are factors.
Symptoms include bleeding during bowel movements, eruption of skin during bowel movements, itching or pain in the anal area and a purplish lump near the anus.
A visual inspection by your physician may be all that is needed to diagnose an external hemorrhoid. A digital inspection in which a doctor inserts a gloved, lubricated finger into the rectum to feel for anything out of the ordinary is used to diagnose an internal hemorrhoid.
Since internal hemorrhoids are often soft, a physician may use a flexible, lighted tool such as an anoscope, proctocope or sigmoidoscope to provide a view inside the rectum and anus. When other risk factors are present such as a family history of colorectal cancer, a physician may order a colonoscopy.
Importance of lifestyle
The good news is that hemorrhoids are not life threatening and recurrences may be avoided by changing your lifestyle.
“The main thing we push is lifestyle changes,” says Gwyer. “We recommend a high-fiber diet and drinking plenty of water. You also don’t want to sit too long. You want to get up and move around as much as possible.”
The uncomfortable symptoms of hemorrhoids can be eased with at-home treatments.
“Soak in warm bath water, wear loose clothing and don’t use harsh soaps or perfumed lotions to avoid scratching,” she says.
Over-the-counter treatments and prescription-strength suppositories and creams can also help relieve the discomfort of hemorrhoids that produce mild symptoms.
“They are good for taking away the pain and shrinking them,” Gwyer says.
A rubber band ligation is an in-office treatment for persistent, painful hemorrhoids. A rubber band cuts off the blood supply to the hemorrhoid until it shrivels and falls off.
Surgery is another option for more severe cases and involves stapling bulging veins to block the blood supply to them.
Although hemorrhoids are far from pleasant, there is sometimes a silver lining that accompanies them, Gwyer says.
“The lifestyle modifications people often make to minimize the risk of hemorrhoids can have other benefits to health, too,” she says. “So, in some ways, the short-term discomfort of a hemorrhoid can lead to positive changes over the long term.”
Nurse Practitioner, Tidelands Health Gastroenterology
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Carrie Gwyer is a family nurse practitioner at Tidelands Health Gastroenterology at The Market Common.Learn More
University of Virginia, Bachelor of Science in Nursing
University of Cincinnati, Master’s Degree in Nursing, Family Practitioner Program
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Carrie Gwyer is a family nurse practitioner at Tidelands Health Gastroenterology at The Market Common.