Horror! It's Hemorrhoids!

By about age 50, more than half of adults have dealt with hemorrhoids. The November issue of “Mayo Clinic Health Letter” covers home treatments that can relieve symptoms of this common and embarrassing problem.

[ WELLNESS WEDNESDAY ]

Hemorrhoids are blood-engorged veins in the lower rectum (anal canal) that form tiny sacs (anal cushions) when too much pressure is exerted on the veins serving the pelvic and rectal areas. Increased pressure can result from straining during bowel movements, sitting on the toilet for an extended time, chronic diarrhea or constipation, obesity, lifting heavy objects, sitting or standing for long periods, and pregnancy.

Symptoms can include painless bleeding during bowel movements, leakage of feces and mucus, severe pain, swelling, or inflammation. Embarrassment aside, it's important to talk with a doctor about any rectal bleeding. While hemorrhoids generally don't cause serious problems, other, more serious concerns, such as polyps, cancer or inflammatory bowel disease, can cause bleeding too. A colonoscopy may be needed to determine the cause of bleeding.

Mild pain, swelling, and inflammation from hemorrhoids often can be managed with self-care measures. Options include

>topical over-the-counter remedies. Nonprescription hemorrhoid creams, suppositories containing hydrocortisone, or pads containing witch hazel or a topical numbing agent may provide relief. They shouldn't be used longer than a week unless directed by a doctor.

>leanliness in anal area. Taking a warm sitz bath several times a day can be helpful. A sitz bath, where only the hips and buttocks are immersed, can be done in a regular bathtub or using a plastic tub that fits over the toilet. The tubs are readily available from medical supply stores and pharmacies.

>swelling relief. Ice packs or cold compresses on the anus can relieve swelling.

>pain relievers. Nonprescription pain relievers such as acetaminophen (Tylenol, others), or ibuprofen (Advil, Motrin IB, others) may provide relief.

>hydration and fiber. Softening and bulking up stool for easier passage is helpful. Strategies include drinking six to eight glasses of water or other nonalcoholic beverages daily, eating high-fiber foods, and taking fiber supplements such as Metamucil and Citrucel.

In addition, it's best to head for the bathroom when the urge occurs and to avoid straining or breath-holding when passing stools, since this strains the veins in the lower rectum.

When self-care measures don't work, a doctor can discuss several minimally invasive surgical procedures for consideration.