Dr. Marie's Hemorrhoid Advice

By Marie Savard MD

One of our favorite experts, Marie (Dr. Marie) Savard, M.D., confides that back when she gave birth for the first time, she ended up with a huge hemorrhoid that made having a bowel movement exquisitely painful. “I was so preoccupied with my sore bottom that I could barely enjoy my new baby,” says Dr. Marie. She adds, though, that this incident inspired her to teach her patients how to prevent and treat hemorrhoids, also called “piles.” Here is what you need to know about this nuisance ailment that strikes an estimated 90 percent of us at least once.

What Are Hemorrhoids?

Hemorrhoids are varicose veins of the rectum. “For a variety of reasons, the veins become swollen and inflamed,” Dr. Marie says. “Those that are below the ‘dentate line’ in your anal opening can cause itching, burning, and pain. The ones above that line are called ‘internal hemorrhoids.’ They don’t hurt because they don’t have nerve fibers. However, they may pop out from the anal opening after a bowel movement. You may also see bright red blood in the stool or the toilet bowl.” The blood is probably not worrisome but if bleeding is persistent in spite of following Dr. Marie’s tips for hemorrhoid treatments, she urges you to see a doctor to rule out colon cancer.

What Are the Causes of Hemorrhoids?

Not enough fiber in you diet. A low-fiber diet creates hard stools that make you strain when you need to pass them.

Sitting too long on the toilet. This puts pressure on your buttocks and makes your anal tissues bulge.

Sitting too long, period. This is popularly called “truck driver’s syndrome.” It can happen during long rides in a car, train, or plane, and also when you sit at a desk for many hours.

Standing too long. Dr. Marie says she gets hemorrhoids at holiday parties unless she remembers to sit down every now and then during the festivities!

A pear-shaped body with hips that are larger than the breasts. This body type is also prone to varicose veins in the legs.

Lifting heavy objects. This can makes the rectal veins protrude.

How Can I Prevent Hemorrhoids?

Eat a high-fiber diet with whole grains, fruits, and vegetables.

Drink plenty of liquids.

Lead an active lifestyle.

Break the habit of reading on the toilet!

What Are the Treatment for Hemorrhoids?

With a soapy finger during your shower, gently push a hemorrhoid back in so that it can heal. You could also coat your finger with petroleum jelly after your shower and push again.

Apply ice packs for symptomatic relief and to help shrink the tissues. Put crushed ice cubes in a zippered plastic bag, wrap in a soft cloth, and lie on your side with the pack in place for about fifteen minutes at a time. Don’t sit on the pack and don’t leave it on too long.

Apply witch hazel. This is the liquid astringent that has been used for generations. It really works. Towelettes moistened with witch hazel are now available. Dr. Marie says that when she was a nurse in the 1960s on the postpartum floors, she used iced witch hazel compresses for the new mothers.

Apply petroleum jelly, cocoa butter, lanolin, mineral oil, glycerin, or the healing ointment called Aquaphor after each bowel movement. Cleanse first with nonallergenic baby wipes.

Apply or insert topical OTC anesthetics such as Lanacane and Fleet Pain Relief.

Use Proctofoam-HC. You need a prescription for this pain relieving foam. It comes in a spray canister. “I love this product!” says Dr. Marie.

Use fiber supplements and stool softeners.

What If Home Remedies Don’t Work For Me?

In some cases, you may need to see a proctologist or rectal specialist who can treat you with one or more of the following procedures:

A rubber band ligation to cut off the blood supply to the hemorrhoid

Sclerotherapy, an injection of a chemical solution that will shrink the swollen tissues

Coagulation therapy using lasers, infrared light, or radio waves that restrict circulation to the veins

Cryotherapy in which a liquid nitrogen probe is inserted to freeze the tissues

Surgical hemorrhoidectomy, a procedure reserved for severe cases and performed far less often today than it once was

Are The Any Remedies I Should Avoid?

Don’t take a warm “sitz bath.” This old wives’ tale does more harm than good. You would be sitting on a hard plastic basin that fits over the toilet. This position can cause blood vessels to become congested. That only aggravates the problem.

Don’t use “Preparation H.” “This product has been around since 1935 but it doesn’t cure or prevent hemorrhoids,” says Dr. Marie. “The active ingredient is phenylephrine and although it constricts blood vessels, the effect is temporary. You’re better off with lifestyle changes and the pain-relieving products and tactics I’ve recommended.”

Marie Savard, M.D. is a nationally known internist, women’s health expert, advocate for patient empowerment, and Medical Contributor to ABC’s “Good Morning America.” She is the author most recently of “Ask Dr. Marie.” Please visit www.drsavard.com.