Prevention
You often can prevent hemorrhoids by preventing episodes of constipation. Some of the following diet and lifestyle changes may help you to soften your stool, establish a regular schedule for bowel movements and avoid the straining that can lead to hemorrhoids:
* Add more fiber to your diet � Set a goal of 25 to 30 grams of fiber daily, from such high fiber foods as beans, broccoli, carrots, bran, whole grains and fresh fruits. To avoid bloating and gas, add these foods gradually over a period of several days.
* Drink adequate amounts of fluid � For most healthy adults, this is the equivalent of 6 to 8 glasses of water daily.
* Begin a program of regular exercise � As little as 20 minutes of brisk walking daily can stimulate your bowel to move regularly.
* Train your digestive tract to have regular bowel movements � Schedule a time to sit on the toilet at approximately the same time each day. The best time to do this is usually right after a meal. Do not sit on the toilet for long periods (it tends to make hemorrhoids push out and swell up).
* Respond immediately to the urge to have a bowel movement � Do not postpone until the time is more convenient.
If dietary changes are not enough to prevent hard, dry stools, your doctor may suggest that you take a fiber powder supplement containing psyllium (Metamucil) or methylcellulose (Citrucel).
Treatment
If you have been diagnosed with hemorrhoids in the past, and you are experiencing a flare-up of pain or itching, try the following strategy:
* Because persistent constipation can aggravate your hemorrhoids and prevent them from improving, take preventive measures to avoid constipation.
* Take warm sitz baths, especially when the hemorrhoids are uncomfortable. Sit in a tub or pan of plain warm water, 3 or 4 times a day, for 15-20 minutes each time. (Large pharmacies and medical supply stores also sell convenient plastic sitz bath devices that fit into a toilet). The water will keep the area clean, and the warmth will reduce inflammation and discomfort. Be certain to dry the rectal area thoroughly after each sitz bath. If you work, you can still take a sitz bath in the morning, upon returning from work, and again at bedtime.
* Apply a cold compress or icepack to the anal area, or try a cool cotton pad soaked in witch hazel.
* Apply petroleum jelly or aloe vera gel to the anal area, or use an over-the-counter hemorrhoid preparation containing lidocaine or hydrocortisone.
* After every bowel movement, clean the anal area with a witch hazel pad, a soothing baby wipe or a cotton cloth soaked in warm water. Be thorough but gentle. Aggressive rubbing and scrubbing, especially with soaps or other skin cleansers, can irritate the skin and make your hemorrhoids worse.
If you have more severe hemorrhoid symptoms, or if your hemorrhoids are prolapsed or filled with a blood clot, your doctor may recommend one of the following treatment options:
* Rubber band ligation � A rubber band is slipped around the base of the hemorrhoid to cut off its circulation. Once it has been deprived of its vital blood supply, the banded hemorrhoid withers and falls off.
* Sclerotherapy � An irritating chemical solution is injected directly into the hemorrhoid or the area around it. This solution causes a local reaction that interferes with blood flow inside the hemorrhoid, making the hemorrhoid shrink.
* Coagulation therapies � These treatments use electricity, a laser or infrared light to destroy hemorrhoids by burning.
* Hemorrhoidectomy � Although this surgical removal of hemorrhoids is painful, it is effective.
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