The Ins and Outs of Hemorrhoids

What are hemorrhoids?

• Hemorrhoids are swollen veins just inside or outside the anus or rectum.
• Hemorrhoids are more common as you get older. They might come from:
  • Constipation or diarrhea.
  • Sitting for a long time (even on the toilet).
  • Pregnancy.
  • Straining or pushing when you have a bowel movement.

How do I know if I have hemorrhoids?

If you have hemorrhoids, you may notice:

• Bright red blood in the toilet or on the tissue when you wipe after a bowel movement.
• Rectal itching or pain.
• A lump near the anus.

What can I do for my hemorrhoids?

Here are a few things you can try:

• Eat foods high in fiber or take fiber supplements (e.g., Benefiber [Benefibre in Canada], Metamucil). Try to get about 30 grams of fiber each day.
  • Examples of foods high in fiber: beans, fresh fruits and vegetables, and whole grains.
• Try to drink about two liters (~8 cups) of fluid each day.
• Sit in warm water for about 10 to 15 minutes a few times a day.
• Use ice packs to help with swelling. Avoid putting ice directly to the skin.
• Get regular exercise.
• Ask your pharmacist which over-the-counter (OTC) meds may help with pain, itching, or swelling (e.g., Preparation H, Tucks, acetaminophen, ibuprofen).
• Ask your pharmacist about a laxative (e.g., Dulcolax, MiraLAX) to treat constipation, if fiber, fluids, and exercise are not enough.

What should I avoid?

• Ask your pharmacist if any of your meds may be causing constipation.
• Some things make hemorrhoids worse. If possible, avoid:
  • Foods that give you constipation (e.g., cheese, milk, yogurt).
  • Sitting for a long time (even on the toilet).
  • Straining or pushing when you have a bowel movement.
  • Holding it. If you feel like you need to have a bowel movement, you should go.

When should I call my prescriber?

• Call your prescriber if:
  • You see bright red blood in the toilet or on the tissue when you wipe.
  • Home treatments and OTC meds don’t help after about one week.