Increasing dietary fiber can make a big difference
David Dunaif, MD
We all have hemorrhoids. They are vascular structures that help control stool. If it becomes inflamed and inflamed, we often say, “I have hemorrhoids.” What we really want to say is that hemorrhoids are causing us pain.
Many of us have suffered from hemorrhoid pain at some point. They affect men and women equally, but women tend to be higher during pregnancy and childbirth.
When hemorrhoids become inflamed, symptoms such as itching and pain may occur, making it difficult to concentrate and making sitting uncomfortable. This is because the veins inside your rectum are swollen. Bleeding often occurs, especially during defecation, which can be frightening. Fortunately, hemorrhoids are not a sign of a more serious disease.
There are two types of hemorrhoids. One type is external hemorrhoids, which occur outside the anus. Internal things that occur within the rectum.
Treatment of external hemorrhoids
Fortunately, external hemorrhoids tend to be mild. Most cases can be treated with pain-relieving creams or suppositories containing hydrocortisone (such as Preparation H).
Another treatment option is a sitz bath. All of these can help relieve pain. External hemorrhoids can be treated with over-the-counter medications and usually do not require medical attention.
For a more comprehensive solution, the most effective way to reduce this bleeding and pain is to increase your fiber intake with dietary changes and supplements (1).
However, in some cases, thrombosis (clotting) of external hemorrhoids may occur. In these cases, the pain may worsen and require medical treatment.
If you have rectal bleeding and are at high risk for colorectal cancer or are over 50 years old, you should consult your doctor to make sure it is not due to other causes, such as a malignancy or inflammatory bowel disease. there is.
Treatment of internal hemorrhoids
Internal hemorrhoids can be a little more complicated. Because hemorrhoids are usually located above a sensory point in the colon called the dentate line, the main symptom is bleeding during bowel movements rather than pain. If you experience pain or discomfort, it is usually because the muscles and ligaments in your colon have weakened and internal hemorrhoids have prolapsed or fallen out. This allows it to be located below the dentate line.
The first step in treating internal hemorrhoids is the same as for external hemorrhoids: adding fiber to your diet or supplements. Study after study has shown that there are significant benefits. For example, in a meta-analysis by the Cochrane Systems Data Review 2005, fibers reduced the incidence of bleeding by 53 percent (2). In another study, the incidence of daily bleeding was dramatically reduced after 2 weeks of fiber intake and an additional 2 weeks of follow-up (3).
What treatments are available for hemorrhoid pain that is difficult to heal?
There are several minimally invasive options to address persistently painful hemorrhoids, including banding, sclerotherapy, and coagulation therapy. The most effective of these is banding, with a success rate of approximately 80% (4). This is a procedure that is usually done in a doctor’s office and involves placing a rubber band around the neck of each hemorrhoid to cut off blood flow. Patients should also take fiber supplements to avoid complications from constipation. Side effects of this procedure are usually mild and the risk of infection is very low. However, incorrectly applying the band below the dentate line can cause severe pain. If this procedure fails, the next option is hemorrhoidectomy (surgery).
What can I do to prevent hemorrhoid problems?
First, sitting on the toilet for long periods of time can put a lot of pressure on the veins in your rectum, increasing the risk of inflammation. You may want to read in your private time, but the bathroom is not a library. It is important to leave the toilet immediately after defecating.
Please stay well hydrated. This softens the stool and prevents constipation. Exercise can also help prevent constipation. Do not hold back your bowel movements. If you don’t go to the toilet when you feel like it, your stools may become hard, straining, constipation, or take longer to go to the toilet.
How can I eat more fiber?
Eating more fiber can increase the volume of your bowel movements and help you avoid constipation, diarrhea, and excessive straining.
Americans consume an average of 16g of fiber per day (5). The Institute of Medicine (IOM) recommends a daily fiber intake of 25 to 38 grams for people under 50, depending on gender and age (6). We usually recommend at least 40 grams. My wife and I try to only eat foods that have a lot of fiber, about 65 grams per day.
It is best to gradually increase the fiber levels. If done too quickly, you may experience side effects such as gas and bloating for the first week or two, so be forewarned.
It is usually a good idea to adjust your diet before returning to supplements. Fruits, vegetables, whole grains, nuts, beans, and legumes all contain significant amounts of fiber. Grains, beans, and nuts are the highest sources of fiber. For example, 1 cup of black beans contains 12g of dietary fiber.
References:
(1) Colorectal. July-August 1982;25(5):454-6. (2) Cochrane.org. (3) Hepatogastroenterology 1996;43(12):1504-7. (4) Dis Colon Rectum 2004 Aug;47(8):1364-70. (5) United States Government. (6) Am J Lifestyle Medicine. January-February 2017; 11(1): 80-85.
Dr. David Dunaif is a speaker, author, and local lifestyle medicine physician focused on integrating medicine, nutrition, fitness, and stress management. For more information, please visit www.medicalcompassmd.com or speak to your doctor.