Diet and hemorrhoids

 

Diet can have a big role to play in managing hemorrhoids. One of the most common aggravators of hemorrhoids is constipation, and a diet high in fiber can prevent constipation from occurring.

Fiber is present in grains such as wheat or oat bran, bread with seeds, whole corn, barley and buckwheat, as well as in many vegetables. Fruits such as oranges, grapefruits, peaches, nectarines, prunes, pears, apples, papayas, and pineapples are also recommended. Legumes such as peas, beans and lentils are rich in fiber too.

Care must be taken in patients with irritable bowel syndrome as too much fiber may lead to additional symptoms. If you have difficulty balancing your fiber intake, speak to your doctor.

In addition to fiber intake, you must also drink more water. Fiber will help to keep the water in the stools, causing them to be softer and therefore easier to pass.

Medical treatment

The first goal of medical treatment is to treat the acute symptoms. It must be customized in each individual case. Several tools are available.

In case of pain, it is possible to take pain relief such as paracetamol/acetaminophen. Aspirin is not a good choice as it could facilitate bleeding.

If a clot exists resulting in a painful bluish swelling, nonsteroidal inflammatory treatment is widely prescribed; it is effective against the inflammation and pain. Their contraindications including digestive ulcers, allergy, pregnancy, or breastfeeding and must be strictly followed.

Oral treatment that target the veins (venoactive drugs) are efficient in relieving symptoms. They can relieve discomfort, bleeding and soiling associated with prolapse. They can be used alone or in combination (creams, suppositories).

Other treatments such as stool softeners act to facilitate bowel movements, which is important in preventing trauma to the hemorrhoids. This alone can be enough to stop symptoms.

Your doctor will be able to advise you on the most suitable treatment based on your condition.

One disease: three treatments available

There are three types of treatments used in the management of hemorrhoidal disease: medical, instrumental, and surgical.

The most common is medical treatment, which can be used for all stages of the disease. Oral treatments target the symptoms directly (eg. in the case of analgesics)  whereas local treatments (creams, suppositories) aim to decrease local inflammation and facilitate bowel movements.

Instrumental techniques to treat hemorrhoids include: sclerosis, infrared coagulation, cryotherapy, and rubber band ligation. The goal of these procedures is to retract the hemorrohidal tissue and stop the symptoms. They can be performed in the doctor’s office and are painless for the patient (although they may be uncomfortable over a very short period of time). These techniques can only be used to treat internal hemorrhoids that are not too large.

In severe cases, surgical removal of the hemorrhoid may be the only option. This is relatively rare (5-10% of cases1), but is best avoided as surgery is painful and can result in complications such as anal incontinence.

Your doctor will be able to advise you of the most suitable treatment based on your condition.

References

1. Cerato M, Cerato N, Passos P, Treigue A, Damin D, Surgical treatment of hemorrhoids: a critical appraisal of the current options, Arq Bras Cir Dig. 2014; 27(1): 66–70.