Q: What do hemorrhoids feel like? I'm afraid to ask my friends.
A: Hemorrhoids are something you don't hear talked about much in polite conversation. But it's not because people don't experience the burning, pain and itching that goes along with the condition. In fact, hemorrhoids are extremely common with an estimated 75% of people experiencing hemorrhoid symptoms at some point in their lives. Yet only a small fraction of that number seek care for hemorrhoid symptoms from their doctor.
As you get closer to age 50, the likelihood that you'll develop the condition increases.
Hemorrhoids cause irritation, pain and/or extreme itching around the anus. There can be itchy or painful lumps or swelling, along with fecal leakage, painful bowel movements and blood after a bowel movement. If you're living with some or all of these irritations, you're not alone — a surprising number of people are suffering. Around 1 in 20 Americans have the condition, and your risk increases as you grow older.
There are two key types of hemorrhoids — internal and external. Internal hemorrhoids are inside the anal canal, and external hemorrhoids occur right at the anal opening. Internal hemorrhoids are far enough inside your body that you usually can't see or feel them, and bleeding might be the only sign you have them. They don't cause much pain because there are few pain-sensing nerves inside the rectum.
External hemorrhoids are covered in skin around the anus, and there are many more pain-sensing nerves in this area. That's why they hurt in addition to bleeding. Sometimes hemorrhoids can prolapse, or get bigger and come out of the anus. This type is more likely to hurt, especially when you have a bowel movement. Prolapsed hemorrhoids frequently go away on their own. If they don't, they can often be pushed back into place.
Inactivity and not getting enough fiber are two habits that make people more prone to developing hemorrhoids. If your parents had hemorrhoids, you're more likely to have them too. In general, hemorrhoids are triggered by swelling when the pressure in your lower rectum affects blood flow, making the veins swell.
Hemorrhoids aren't likely to cause you any direct harm. Only when you have excessive bleeding — which happens in rare cases — that leads to anemia, are hemorrhoids a cause of serious concern.
But that doesn't mean you shouldn't talk with your doctor. Because you can't see for sure if internal hemorrhoids are the cause of bleeding, people with blood in their stool or new bleeding should share this information with a health care professional in case it is something more serious. So skip the urge to grab an over-the-counter treatment and ignore the pain. One thing you can do to bring quick relief: soak in a warm bath to soothe irritation.
The best way to prevent symptomatic hemorrhoids over time are consistent fluid intake of at least 64 ounces of non-caffeinated fluid daily, increased dietary fiber or daily fiber supplementation and avoiding straining on the toilet or spending more than 5 minutes on the toilet at a time.
Dr. William "Buck" Lyman is a colorectal surgeon with University Surgical Associates and a member of the Chattanooga-Hamilton County Medical Society.