Relief From Hemorrhoids

Recognizing Symptoms
Relieving Discomfort

Napoleon had them at Waterloo. George Brett had them during the 1985 World Series. They are hemorrhoids, a painful and embarrassing condition that makes sitting uncomfortable. All types of people can have hemorrhoids: athletes and generals, secretaries, pregnant women, and workers who do a lot of heavy lifting. It is estimated that 80% of all Americans will develop them at sometime in their lives.

Actually, everyone has hemorrhoids. That's because, strictly speaking, hemorrhoids are clusters of venous tissue inside the rectum and under the skin around the anus that swell gently to aid in elimination. The condition we call hemorrhoids (or piles) actually refers to an abnormal swelling of the tissue in the anal canal. As painful, discomforting, and embarrassing as hemorrhoids can be, they are generally not a sign of anything more serious. You can often treat their symptoms at home without resorting to expensive medical procedures. And preventing their return often means making changes that are good for you.

Symptoms of Hemorrhoids
There are two types of hemorrhoids: internal and external. Internal hemorrhoids usually remain along the anal wall. Most people who have internal hemorrhoids aren't aware of them unless checked by a physician. Internal hemorrhoids may protrude (or prolapse), bleed, or discharge mucus. External hemorrhoids are small soft pads around the outside anal opening, the same color as your skin. When an external hemorrhoid forms a blood clot (or thromboses), it can appear blue in color and generate considerable pain and itching. An obvious sign of hemorrhoids is their external appearance. But if you see blood on your toilet tissue or notice changes in your bowel patterns, it may be a sign of hemorrhoids -- or something more serious. If this is the case, you should consult your physician. Your doctor will do a visual examination and if necessary, a digital rectal exam to check for internal hemorrhoids.

Causes of Hemorrhoids
To understand why you suffer from hemorrhoids, let's take a quick tour of your digestive system.

• The digestive process begins in your mouth. Your teeth break up the food into small pieces and your saliva mixes with the food, allowing it to pass through the esophagus into the stomach.
• Using muscular contractions, the esophagus sends food from the mouth to the stomach.
• Like a giant processing center, the stomach churns the food into smaller pieces, preparing it to travel on to the lower part of the digestive tract.
• After leaving the stomach, the food passes into the small intestine, where the food's nutrients are further broken down and absorbed into the bloodstream. By the time food passes through all 21 feet of the small intestine and reaches the colon, only water and waste products remain.
• The colon absorbs up to 90 percent of the water from the stool, making it more solid. Your lower, or sigmoid, colon stores the stool until it's time to pass it.
• The rectum is the last portion of the colon, where the body's wastes are expelled. During normal elimination, wastes collect in the rectum as soft stool. The sphincter muscles, which expand and contract like rubber bands, relax and your internal hemorrhoids swell slightly to cushion the stool as it leaves the body.

Hemorrhoidal swelling occurs during difficult elimination, when the stool is hard and you strain to pass it. The straining causes the hemorrhoids to swell repeatedly and if the hard stool passes, it scrapes against the tissue, irritating it. A variety of conditions and activities can increase your chances of getting hemorrhoids. Pregnant women can suffer from hemorrhoids because of the extra weight they carry. Straining to lift too much weight can also contribute to abnormal swelling.

One of the most common causes of hemorrhoids is hard stool, when your waste doesn't contain enough bulk. Constipation can also aggravate hemorrhoids. Simple solutions to constipation associated with hemorrhoids can be a high-fiber diet or a bulk-fiber laxative, which soften the stool and encourage normal elimination.

Treatment of Hemorrhoids
If you think you have hemorrhoids, see your doctor before trying any medical treatments. For instant relief of pain and swelling, try sitting in a bathtub of three or so inches of warm water. This is known as a "sitz bath." Cotton pads soaked in an astringent such as witch hazel, also bring relief for some sufferers. To encourage better bowel movements, your doctor may suggest some initial lifestyle changes, such as improving your diet and increasing exercise. If these changes do not help relieve your constipation, your doctor may suggest one of the following types of laxatives:

• A bulk fiber laxative
• A stool softener

Laxatives should be used only as directed. Different laxatives work in various ways; let your doctor choose the best one for you.

Prevention
Start by practicing good bowel habits.

• Don't think you have to have a good bowel movement every day or at the same time; you'll strain too hard to stay on schedule.
• If you feel the urge to have a bowel movement, respond immediately. Delaying now may mean straining later.
• Confine your bathroom reading to the tub; sitting and straining too long on the toilet will only encourage swelling.
• Wipe yourself gently with soft, white, unperfumed tissue, not only to keep the area clean but also to avoid any unnecessary irritation.

Exercise can aid digestion. Swimming, biking, or just walking is a good idea for your health in general. The biggest change you may have to make in your life is your diet. Most of us don't get enough fiber, which promotes regular elimination of soft stool.

The High-Fiber Diet
Fiber is probably the most misunderstood part of our diet. It furnishes no nutrients, vitamins, or minerals. It isn't even absorbed into our bodies. So why do we need it? Fiber adds bulk to keep other foods moving along the digestive tract, and it holds water, which in turn, softens the stool for easy elimination. Right now, most people could double or even triple their fiber intake just to reach suggested levels. The average American takes in 10-15 grams of fiber a day, but experts recommend taking in 20-35 grams.

Fiber comes in two different forms: soluble and insoluble. While they work differently, both are needed for proper bowel function. All fiber sources contain both kinds of fiber in varying amounts. Don't think you have to totally rearrange your diet to accommodate more fiber. One way to start is to substitute high-fiber foods for low-fiber ones. Switch your bakery habits from white bread and rolls to whole-grain breads. Try brown instead of white rice. Eat "whole grain" cereal. And most easily of all, add fruits and vegetables to your diet.

Your general rule of thumb should be at least one serving of whole grain in every meal. Try this sample menu:

Breakfast -- Cereal and/or toast. Make sure the first name on your cereals and breads is Whole Grain. Add banana slices to cereal.

Lunch -- Sandwich on whole-grain bread. Carrot sticks. Snack -- Apple or raisins. Skip the candy bar, or at least cut back.

Dinner -- Broiled chicken and steamed broccoli. Wheat rolls. Salad.

Try to increase your intake of vegetables and fruit. You should be getting three servings of each every day. Try a sliced banana on your cereal, substitute carrot sticks for chips as a lunch side, and crunch on a salad for dinner. Wherever possible, eat the peels (you're off the hook with bananas and oranges).

There are possible downsides to increasing fiber. Some high-fiber foods, like beans, can produce excessive gas or bloating. Take in too much fiber too soon and you could suffer from bloating or abdominal cramps.

Remember, whenever you change your diet, for whatever reason, do it gradually. Let your body adjust. And check in with your doctor if you experience any discomfort.

A Fiber Solution: METAMUCIL®
If your physician has recommended increasing your fiber intake in order to treat constipation, he or she may suggest the convenience and effectiveness of Metamucil.

What does METAMUCIL add?
METAMUCIL contains psyllium, a 100%-natural fiber that helps you restore regularity, increase your fiber intake, and maintain regularity when recommended by your physician.

How much fiber can METAMUCIL add?
At 3.4 grams per dose, taken up to three times per day, you can add as much as 10.2 grams of psyllium fiber. That's about half of the minimum amount of fiber recommended for your daily consumption. And it's one of the most concentrated sources of soluble fiber. In fact, METAMUCIL's fiber contains more than eight times the amount of soluble fiber found in oat bran, gram for gram.

When can I take METAMUCIL?
You can take METAMUCIL in the morning, at noon or in the evening, with or without food with at least 8 ounces of liquid (one to three times a day). Laxatives, including bulk fibers, may affect how well other medicines work. If you are taking a prescription medicine by mouth, take this product at least 2 hours before or 2 hours after the prescribed medicine.

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