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Dealing with hemorrhoids and anal itching or pain

Most problems in the anal and rectal area are due to poor health practices: lack of exercise, an unbalanced diet of highly refined foods, and constant tension. When hemorrhoids, a "fissure" (a tear in the anal canal), or anal itching become annoying or painful, correcting underlying problem habits is as important as treating symptoms. For many people, occasional use of one or more medications and changes in personal habits may be all you need.

The problem with hemorrhoids, itching, and/or anal fissures is that most people would prefer to remain in blissful ignorance of what's going on in that area. So they'd like a quick fix so that once again, they can continue to ignore the consequences of poor health practices. But medication alone doesn't work, and relatively simple modifications in your routine often suffice. If you master the recommendations that follow, you should be able not only to clear up your current symptoms but to prevent them from recurring.

Here is what you can do:
  1. The single most important treatment is to change your diet so that your stools are soft and easily passed without tearing or irritating. The easiest and least expensive way to do this is by adding a heaping table-spoon of raw, uncooked, unprocessed wheat or oat bran to your food each day. (Bran cereal, raisin bran, bran pills, bran muffins, etc., do not work. You need the raw ingredient-- tiny brown flakes that look like coarse flour and are just plain bran).

    Some people simply don't like bran. So, as a more expensive alternative, you may prefer Metamucil, FiberAll, UniFiber, or any of the dozens of fiber products you can find in the drugstore. They are equally effective and may be more convenient.

    Too much of any fiber product causes gas and cramps in the lower abdomen.
  2. Sitz baths are the second most important thing to do. Soak your bottom in three inches of warm water 23 times per day to relieve itching, swelling, bleeding, and pain. (Stop once you are feeling better).
  3. Drink lots of liquids. This is vital.
  4. Be sure to allow enough time for a bowel movement, Do not delay when you have the urge. Generally, plan for a bowel movement twenty minutes or so after your first real meal of the day ( usually breakfast). Don't prolong the bowel movement unduly to read or doodle this increases pressure on hemorrhoidal veins and may worsen swelling.
  5. Exercise daily, e.g., brisk walking or bicycle riding.
  6. Use witch hazel cleansing pads (e.g., Tucks), baby diaper wipes, etc., to cleanse your anus and prevent chafing. Above all, be gentle. You may find that toilet paper is simply too abrasive. This advice is particularly important if your main problem is anal itching: usually the culprit is the Brillo Syndrome (too much scouring of the anus).
  7. Medications:
    • Balneol is an over-the-counter anal lotion you may find soothing.
    • Preparation H and other over-the-counter suppositories are usually a waste of money.
    • Proctofoam HC (available only by prescription) contains cortisone and is often very helpful in the first two or three weeks of treatment.
    • Nupercainal Ointment contains topical anesthetic that may help burning and itching. Use after each bowel movement or sitz bath, plus every four hours.

Last updated Sun, Nov 1, 2009

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©2011, James Gagné, MD