There are hemorrhoids, and then there are prolapsed hemorrhoids. The latter are no laughing matter, and if left untreated can lead to serious health problems.
Although they’re embarrassing to talk about, hemorrhoids are simply swollen veins. Many occur inside the rectum and are called internal hemorrhoids. When they exist externally, they’re called prolapsed hemorrhoids. Most hemorrhoids will go away on their own in one or two weeks, according to the College of Family Physicians of Canada.
Prolapsed hemorrhoids can often be pushed back inside the anus. But sometimes they can’t, and that’s where the real fun begins.
Like “regular” hemorrhoids, prolapsed hemorrhoids can result from “straining at stool”: pushing too hard, especially when you’re constipated, puts pressure on the anal veins and fills them with blood.
As if prolapsed hemorrhoids weren’t bothersome enough—they can be extremely uncomfortable, making you feel like you have a golf ball between your cheeks—these growths can also develop blood clots. If that happens, the pain is usually off the charts.
Known as prolapsed thrombosed hemorrhoids, these can and should be treated immediately by a doctor. To relieve the agony, the physician will make a small incision and remove the blood clot. In effect, the hemorrhoid gets lanced. The procedure usually involves local anesthesia but is quick.
Other signs of prolapsed thrombosed hemorrhoids are blue, purple, or red lumps around the anus; anal itching and burning; and difficulty cleaning the anal area.
Left untreated, a hemorrhoid with a blood clot can lead to such serious complications as gangrene or sepsis.
Sometimes, very large prolapsed hemorrhoids must be surgically removed. Internal hemorrhoids that don’t go away on their own can be treated with a chemical injection or through a procedure called rubber-band ligation. With the latter, a small rubber band is placed around the base of the hemorrhoid, which then shrinks away.
To relieve the pain or discomfort of hemorrhoids, the College of Family Physicians of Canada has these suggestions:
- Take baths or “sitz baths” (in which just your bum goes for a dip) three or four times a day; you can use plain warm water or add Epsom salts. Do not use hot or cold water.
- After a bowel movement, pat the area dry with moist toilet paper or baby wipes.
- Stay off your feet and avoid heavy lifting
- Apply witch hazel to the affected area. A prescription hydrocortisone cream can also be used.
- Take acetaminophen or ibuprofen if necessary.
To avoid hemorrhoids in the first place, follow these tips:
- Never strain or push too hard while having a bowel movement
- Drink lots of water throughout the day
- Get regular cardiovascular exercise
- Eat a high-fibre diet, with plenty of fruit, leafy vegetables, and whole-grain breads and cereals.