Prevalence rates for hemorrhoids, also known as piles, is 4.4 percent globally. In the US around 10 million are known to be afflicted with the condition, with an additional 1 million cases added annually. The condition refers to swollen and inflamed veins in the rectum and anus. The two different types of hemorrhoids are internal – located inside the rectum and external – located outside the anus. Various reasons are attributed to the condition, with different treatment options presently in use to offer relief from the condition across various stages of development. A common question among patients seeking treatment is – can hemorrhoids cause urinary problems? Following subsections have in-depth information about the condition including answers to the question.
Who is at risk of hemorrhoids?
The condition is generally linked to one of many condition including straining during bowel movements, chronic constipation or diarrhea, pregnancy, obesity, and a sedentary lifestyle. This helps identify individuals at higher risk of developing the condition, including the following:
- Hemorrhoids become more common as people age.
- Hemorrhoids may be genetically inherited from parents.
- Chronic constipation or diarrhea, and straining during bowel movements can put pressure on the veins in the rectum and anus, leading to hemorrhoids.
- The pressure of the growing uterus on the veins in the lower rectum and anus can cause hemorrhoids.
- Overweight or obese individuals are risk as this can increase pressure on the veins in the rectum and anus.
- A sedentary lifestyle can increase the risk of developing hemorrhoids.
- Prolonged sitting or standing for long periods of time can put pressure on the veins in the rectum and anus.
Symptoms of hemorrhoids
While the symptoms of hemorrhoids may vary depending on the location and severity of the condition, there are certain common indicators of the condition, including the following:
- Pain or discomfort around the anus
- Itching or irritation around the anus
- Swelling or a lump near the anus
- Bleeding during bowel movements
- Mucus discharge after bowel movements
- A feeling of incomplete bowel movements
- Leakage of feces
- Painful bowel movements
There are distinctions in symptoms of internal hemorrhoids and external hemorrhoids. For instance, internal hemorrhoids may cause bleeding during bowel movements, while external hemorrhoids may cause pain and swelling around the anus. In certain instances, hemorrhoids may not cause any symptoms at all, and this could actually aggravate and develop to a more advanced stage.
Treatment options for hemorrhoids
Treatment for hemorrhoids depends on the severity, stage and type of the condition. Treatment for mild cases, detected at the early stages are simple, including:
- Increased fiber intake – A diet high in fiber can help prevent constipation and reduce the pressure on the veins in the rectum and anus.
- Increased fluid intake – Staying hydrated can help prevent constipation and reduce the risk of developing hemorrhoids.
- Regular exercise – This will help promote bowel regularity and reduce the risk of developing hemorrhoids.
- Over-the-counter medications – Pain relievers, creams, and suppositories can help relieve the symptoms of hemorrhoids.
Medications used for treating the condition
Medications for treating the condition include OTC and prescription medications, and depends on the severity of the symptoms and the stage of development.
- Topical creams and ointments: Containing ingredients such as hydrocortisone, lidocaine, or witch hazel, these topical applications can reduce inflammation, pain, and itching associated with hemorrhoids.
- Suppositories: Small, cone-shaped medicated pellets inserted into the anus to help reduce inflammation and swelling. Suppositories are often used for internal hemorrhoids.
- Oral pain relievers: Formulations such as acetaminophen or ibuprofen may reduce pain and discomfort associated with hemorrhoids.
- Fiber supplements: Containing psyllium, methylcellulose, or other types of fiber, supplements can help soften the stool and reduce constipation, that is known to worsen hemorrhoid symptoms.
- Stool softeners: Medications such as docusate sodium help prevent constipation and reduce straining during bowel movements, preventing hemorrhoids from turning severe.
- Prescription-strength creams and ointments: Used for treating severe cases of hemorrhoids, stronger topical creams or ointments contain hydrocortisone or other anti-inflammatory medications.
Surgical treatment for hemorrhoids
Surgical treatment is necessary for more severe cases that do not respond to other treatments, including office-based procedures. Various surgical treatment options for hemorrhoids, are presently in use, and may be performed either under local anesthesia, general anesthesia, or spinal anesthesia, depending on the extent and location of the hemorrhoids.
- Hemorrhoidectomy: This refers to removal of the hemorrhoids through an incision in the anus. Performed under general anesthesia, this may require a hospital stay, and is considered the most effective treatment for severe or recurring hemorrhoids. However, the procedure is linked to more pain and a longer recovery period.
- Stapled hemorrhoidopexy: A minimally invasive surgical procedure, this refers to the repositioning of the prolapsed hemorrhoids which are stapled back into their normal position. Performed under general anesthesia, stapled hemorrhoidopexy is known to be less painful with a faster recovery time. However, it may be less effective for large or external hemorrhoids.
- Hemorrhoidal artery ligation: A procedure in which the blood vessels that supply the hemorrhoids are tied off and cut, causing the hemorrhoids to shrink and eventually disappear. Performed under local anesthesia, hemorrhoidal artery ligation is less painful with a faster recovery period, though less effective for large or external hemorrhoids.
- Laser surgery: This refers to the use of a laser beam to remove the hemorrhoids. Laser surgery is associated with less pain and a faster recovery period, though this may be less effective for large or external hemorrhoids.
Can hemorrhoids cause urinary problems?
As explained above, hemorrhoids are swollen veins in the rectum or anus, and while the condition is not typically linked with urinary problems, there are certain situations that may cause urinary problems. In certain cases, large hemorrhoids may put pressure on the bladder or urethra, resulting in difficulty urinating, urinary retention, or frequent urination. This is more likely to occur in individuals with existing bladder or urinary tract problems, including enlarged prostate or urinary incontinence.
Additionally, patients with hemorrhoids may experience irritation or inflammation of the perineal area, accompanies by pain or discomfort during urination. Urinary symptoms associated with hemorrhoids are relatively rare and not commonly experienced by all patients.
What happens when hemorrhoids are left untreated?
Hemorrhoids, when left untreated, can result in several complications, including:
- Thrombosis: When a blood clot forms in a hemorrhoid, causing severe pain and swelling.
- Prolapse: When internal hemorrhoids protrude outside the anus and cannot be pushed back in, causing pain, discomfort, and bleeding.
- Strangulation: When a hemorrhoid becomes trapped outside the anus and the blood supply is cut off, resulting in tissue damage and infection.
- Anemia: When hemorrhoids bleed frequently and excessively, leading to a decrease in the number of red blood cells and oxygen in the body.
- Infection: Improperly cleaned or treated hemorrhoids can become infected, causing pain, swelling, and fever.
- Cancer: Extremely rare in occurrence, this refers to the risk of developing anal cancer as a result of long-standing hemorrhoids.
Education: Master’s in Clinical Nutrition from Tufts University. Experience: 6 years of experience as a registered dietitian and freelance writer, creating content on nutritional science and weight management for various health websites.
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