Pain in the butt. How to deal with hemorrhoids?

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Pain in the butt. How to deal with hemorrhoids?

By: Aleksandr Kavokin MD/PhD

This is very sensitive area of your body. Too private. Nobody likes when something is wrong over there. However it happens.

Hemorrhoids occur practically in everyone. Though hemorrhoids cause problems in 1 out of 25 people. Mostly those are people between 45 and 65 years of age.

You find a blood on toilet tissue. Bright red blood. Ok, now what? You do not know why you bleed. It could be rectal cancer by the way. It could be hemorrhoids.

So? What are the hemorrhoids?

They look like cushions. They contain blood vessels, some muscle and elastic fibers. People often call them piles.

Not everything over there is a hemorrhoid. There could be other problems. Fissure, abscess, fistula, pruritus (itching), condylomata (sort of hanging skin caused by viral infection), viral and bacterial skin infections can happen in that, so sensitive area.

It is worth to talk to your doctor.

How would a scenario of hemorrhoids look?

A 46-year-old female presents with complaints on rectal discomfort, occasional bright red blood on toilet tissue and prolapsing tissue in of anal area. This is probably internal hemorrhoid.

Another scenario brings a patient who complains on severe rectal pain and prolapsed tissue.

The severe pain happens in external hemorrhoids. The pain follows thrombosis (thrombosis is the blood clot in your blood vessels).

There are four degrees of internal hemorrhoids.

It may be interesting for you to know because first, second and sometime third degree can be treated by banding only. Fourth degree and sometime third degree requires surgery.

Do not forget non-hemorrhoid causes of symptoms.

To check with your doctor is worthwhile because there could be other problems, including cancer or anal fissure. (By the way for anal fissure medical treatment alone may heal it in 90% of cases).

How are hemorrhoids treated?

Well first you need to understand how do hemorrhoids happen. Several reasons lead to hemorrhoids:

  • Constipation and extra straining

  • Chronic Diarrhea and loose stools

  • Long sitting or standing

  • Weight lifting

  • Obesity

  • Pregnancy and childbirth

  • Inherited tendency to hemorrhoids.

So, avoid all this and you are free.

Obviously this list of reasons is too wide.

The list of measures is wide too.

Increase the fiber in your diet.

Eat more cereals, fruits, vegetables, grains, etc

Psyllium and methylcellulose are supplemental types of fiber.

Exercise, avoid long standing or sitting, don't strain, keep the anal area clean.

Increase liquids in your diet.

Use stool softeners, stool-bulking agents (not a tasty ones, but what can you do).

Treat diarrhea with anti-motility drugs and fiber.

Not every of these methods are proved scientifically. Nonetheless they are included in the standard recommendations for hemorrhoids treatment.

To treat itching or discomfort you may use suppositories, ointments, creams, and gels. You may find that all in your local pharmacy.

These products contain protectant and anesthetics (pain relievers). Local anesthetics numb the area and decrease burning and itching.

Remember that local anesthetics may cause allergy.

Analgesics (menthol, camphor) relieve pain and itching as well

Vasoconstrictors reduce swelling in the perianal area. Though they may have side effects. Better discuss with your doctor.

Protectants (kaolin, cocoa butter, lanolin, mineral oil, starch, zinc oxide or calamine, glycerin, etc) create a physical barrier to prevent contact of stool and the skin. This reduces irritation, itching, and burning.

Similarly, some agents - astringents - dry the skin. That helps to relieve burning, itching, and pain as well.

To kill or at least suppress bacteria and other organisms use antiseptics. Boric acid, phenol, resorcinol and many others can be used. Again better to discuss with your doctor or at least pharmacist. Many of these drugs are sold over-the-counter.

Corticosteroids. Corticosteroids decrease inflammation and relieve itching, but may cause skin damage. They should be used for few days only.

Sitz bath may also help in relieving the symptoms.

When those methods fail your doctor may perform one of the following:

Sclerotherapy (causes scarring of the hemorrhoid).

Rubber band ligation. The rubber band cut off blood supply and hemorrhoid heals with scarring.

Side effects of any of the treatment may be infection of fat and other tissues surrounding the anal canal, especially if patient has diabetes cancer, AIDS.

Another option - electrotherapy and infrared photocoagulation. Works the same way, cause scarring of the tissue.

Cryotherapy uses cold to cause inflammation and scarring. Practically the same, though more time consuming.

Let say your medical treatment fails. What do you do then?

Well, you go to surgeon and treat it surgically.

Operations are done in less than 10% of patients. Though it depends.

Surgical procedures include

Dilation. It is when surgeon stretches your anal sphincter.

Ligation. Often a Doppler probe helps to measures blood flow and finds the individual artery.

The doctor ties off the artery.

Sphincterotomy. It is when sphincter is partially cut. Whole idea is to reduce the pressure.

Hemorrhoidectomy. Hemorrhoidectomy makes sense for patients with third- or fourth-degree hemorrhoids. The hemorrhoids are cut out.

Stapled hemorrhoidectomy. Stapler cuts off the ring of expanded hemorrhoidal tissue.

There are different considerations why to do this and not that type of treatment. And vice versa.

There are complications (pain, difficulty urinating, bleeding several days after surgery, scarring, infection, stool incontinence). Complications happen relatively rare, but they are still there.

Better talk to you surgeon.

I hope you be OK.

You were not alone.

It looks like Napoleon Bonaparte, Carter, Hemingway, Tennyson, Lewis Carroll also were suffering from hemorrhoids.

About The Author

Aleksandr Kavokin MD/PhD,

Aleksandr Kavokin, MD 1994 Russia, PhD 1997 Russia - Immunology and Allergy, postdoc at Cancer Center at Med U of South Carolina, postdoc at Yale - Cardiology, Molecular Medicine.


skajunky_22 01.05.2006. 01:33

Best position to be in when you have hemorrhoids? I am 22 years old, and i am dealing with hemmorrhoids which have been bothering me for the past year. I have read about a floor kneeling position that is supposed to take the pressure off of the veins and bring some relief. I also know that you need to exercise more when you have this condition. My question is, when your not exercising and am just in general "sitting around" is it better to lay on your side and not sit directly on your butt? Is more bed rest better? What position will bring the most relief?


Admin 01.05.2006. 01:33

Invalid rings are great for that. Horrible name, but great results...that way you can sit without the pain of sitting directly an our butt.


Ivy 20.12.2008. 18:58

What is the scientific name anal extra tissue? You know, it is like an extra anal skin that grow under the butt that cause discomfort and pain. What is the scientific or the right word do people call this disease?

Approximately know how much does it cost to get it cut?
Does anyone know where I can find more information about this?
Yes, yes, I believe so. I think it is hemorrhoids, do you know about it?


Admin 20.12.2008. 18:58

You are talking about hemorrhoids. Try using Preparation H first. They even make one w/ a pain med in it. If that does not help, then you need to see a doctor. If you do not have health insurance, try a local health department.
Here is the gross part. Take a mirror and look at your anus. If it looks like you have a purple grape stuck there, you may have a hemorroidal thrombosis, which is a permanently swollen roid. The blood can't get back out so the only way to treat it is by lancing (cutting it), which sounds painful but it really isn't. Especially if you have been dealing w/ the pain from the roid in the first place. You need to have this taken care of because it can rupture and you run the risk of infection.


Utomars 25.12.2010. 19:30

My anus hurt a lot when I sneeze or clench? After I had anal sex i've been having anus pain. This has never happened before. I am not bleeding nor anything drastic. But it hurts a lot when I sneeze, sit, or clench my butt. It feels awkward to be asking this but I am worried that something wrong might have happened. Is there something wrong? Do I need a doctor?


Admin 25.12.2010. 19:30

Hemorrhoids, or "piles," are the most common rectal problem. There is a network of veins around the anus, and they tend to enlarge with age, particularly in individuals who sit a great deal during the day. Staining to have a bowel movement and passing hard, compacted stools tend to irritate these veins, and they may become inflamed, tender, or clogged. The veins themselves are "the Hemorrhoids." They may be outside the anal opening and visible, or they may be inside and invisible. Pain and inflammation usually disappear within a few days or a few weeks but this interval can be extremely uncomfortable. After healing, a small flap, or "tag," of vein and scar tissue often remains.

Soften the stool by including more fresh fruits and fiber (bran, celery, whole-grain bread) in the diet, or by using fiber bulk laxatives. Keep the area clean. Use the shower as an alternative to rubbing with toilet paper.
After gently drying the painful area, apply zinc oxide paste or powder. This will protect against further irritation. Also see your pharmacist for more info.
I hope this helps you. And good luck.


Dominic 22.02.2013. 02:43

Is it okay to "push" when going to the bathroom? I've heard people say that you're not supposed to do that, but is that true? I find that I always have to push when I'm having a bowel movement.


Admin 22.02.2013. 02:43

Excessive "pushing" has been known to cause hemorrhoids to some people later on in life, from the trauma it causes the blood vessels down there (and a lot of them that allow their poop to naturally go down with minimal effort reported an improvement with their butt-issues).

With good fiber in your diet, you don't really need to push... at least not that hard, you know?

Sometimes I do it when I'm in a hurry (LoL), and it may be fine to do once in a while, but I would be careful, since the moment you get hemorrhoids later on in life, they could be "a big pain in the ars" to deal with once it happens....

If you really feel the need to, just "push" very little, not like you wanna turn into a Super Saiyan.


chris 13.09.2010. 02:29

im 19 and i recently had a bout of constipation and my butt is bleeding but im trying to figure what it is..? As it said im 19 and i had a bout with constipation but the pain is non existent the blood isn't a very deep red and its not itchy what could it be and should i worry?and do anything besides eat more fiber.


Admin 13.09.2010. 02:29

Unless there is a lot of blood, or it is in your stool, then you probably have no need to worry.

It's probably just hemorrhoids.

When you have a bout of constipation, you have to strain really hard to pass the stools, and that will sometimes cause hemorrhoids. Yes, usually they can be itchy and/or painful, but not always. I've had constipations issues my entire life, and have had to deal with hemorrhoids a lot, unfortunately. It could also be a tear near your anus, but that tends to hurt a bit more than some hemorrhoids do.

You are totally right about the fiber. Also, add more liquids and roughage to your diet, so your stools can be looser when they come out, as not to disturb the tear or hemorrhoid. It's really just a waiting game at this point.

If it persists for more than a week, then contact a doctor for an exam.

Good luck to you.


foreverdream23 31.01.2011. 07:46

okay this is a question about my butt and it's gross but i really need help? i took an antibiotic about 2 weeks ago that literally gave me non stop diarrhea..the Diarrhea has stopped but ever since then my butt has been extremely itchy. Especially after i poop it itches like CRAZY. my parents told me i might have a hemmoroids (sp?) because i must have strained from all the diarrhea i have. Do hemmoroids itch? why do hemmoroids itch like this?


Admin 31.01.2011. 07:46

It could be a few things. It's likely that it's hemorrhoids - but it may also be other likes like parasites or other forms of intestinal distress.

Keep tabs on your bowel movements, and make sure that you're actualy having honest to god hard poops. If you're having what feels like diarreah, but is only one little squirt of gross crap (that smells really horrible to everyone!), that's an really bad infection caused by your antibiotic. This can cause itching and pain as the toxin irritates the heck out of your bowels.

Parasites (like worms) are unfortunately pretty easy to catch and cause itching all the time, even when you're not pooping. If this is the case you'll need to go to the doctor.

Since the itching is worse right after a bowel movement, and you say that the diarreah is gone, I would ask your parents to pick you up some hemmeroid medication to help you deal with the itching. If they don't want to get you something too expensive, regular white petroleum jelly will also do the trick very nicely (and is usually very inexpensive!)


Saleisha 31.05.2013. 22:03

bright red blood when defecating and pain? there's a bit (not a lot) of bright red blood when I defecate. There's also pain around the anal area :/

I'm 18 years old and female.

I suspect it's hemroids as I've had itching around the anal area before.


Admin 31.05.2013. 22:03

Yep, that's hemorrhoids. If they're bleeding you may wanna go to the doctor. If you don't feel like you need to, take a nice hot bath once a day and use Tucks Pads. All those are is pads you use to rub your butt hole after you poop or feel pain or irritation. Mine shrunk pretty quick when I did this. Just keep yourself clean and don't stress. Its not too big of a deal. Just don't push too hard when you go number 2. It might hurt or make them worse. Don't do too much heavy lifting, either. Oh, and if you can't find any Tucks pads, anything with Witch Hazel will do.


problemchild 23.03.2006. 03:20

Side effects of hemorrhoidectomies? I hope I spelled it right.
I ask this question because I'm gay and I wanna know if after having hemorrhoids surgically removed, I'd still be able to have anal sex, if it would be painful or not, if I would bleed, if there's a chance of becoming impotent (as I read once), etc.
And another thing, while having the problem (not having yet the operation), what could happen if you have sex, and if you use lubricant?
Oh, and is "Anusol" anything like Prep H? Cuz we don't have Prep H here but we do have Anusol.
Thanks a lot!


Admin 23.03.2006. 03:20

There is not a lot of info out there regarding what can happen after surgery. You might search out a doctor who is comfortable talking about these issues. Here is some info I found:

Anal sex shouldn't hurt. Having hemorrhoids can make anal sex painful. People who find anal sex painful often do not use enough water-based lube; others are not relaxed or aroused enough. Using lots of lube ? which makes anal (and vaginal) sex more slippery and wet ? can increase pleasure for both you and your partner. Relaxation will also minimize or prevent the possibility of tearing the thin lining of the rectum, and make insertion easier and more comfortable. Some people relax by taking a warm bath; others begin with a massage, starting with the butt and inner thighs, then gently playing in and around the anal sphincter with a finger. As the sensations become more comfortable and pleasurable, some people experiment by placing more fingers inside the anus. Others might progress to a small sex toy, or be ready to be penetrated by a larger toy, or even a penis. Communication with your partner about what feels good and how you want to be touched is essential for enjoyable anal play.

Although you can have anal sex when you have hemorrhoids, it's better to wait until they've healed. Friction and pressure from penetration can cause further irritation, discomfort, and pain. In addition, hemorrhoids that bleed may place you at increased risk for HIV infection, since the HIV virus can be transmitted more easily through an open "cut" or "wound." Whenever you have anal sex ? if you have hemorrhoids or not ? it's safer to use condoms and lube if you don't know your partner's HIV status.
I am a woman who recently experienced my first hemorrhoids. They were painful, revolting and extremely embarrassing. Sitting in the stirrups while my doctor treated them was humiliating enough -- I couldn't bear to ask her this question: how long should I wait before I have anal sex? PAIN IN THE...

Again with the ass and me calling doctors! The Hassle Free Clinic says you can proceed with anal sex "when you feel comfortable," but use plenty of lube and take it slow.

Some invasive surgery in the genital/anal area takes about six weeks to heal completely, but a hemorrhoidectomy, according to Heidi at Dr. Stubbs' office, may take only a week, depending on the severity of your condition and whether the procedure is done at a hospital or clinic. Looks like you'll be riding that red-eye flight again in no time.
Pick up a copy of the book Anal Pleasure and Health, by Jack Morin. Morin offers a seven-step program on hemorrhoid self-healing -- in case you have to deal with this again.


Jamie P 17.05.2010. 01:54

will my hemorrhoid eventually go away on its own? I'm embarrassed to go to my doctor about it .. and i know creams just get rid of the itch and burn. Will it eventually just go away?
thanks everyone .. i was pretty worried about it because i've never experienced this before .. now i'm not as worried! :)

Jamie P

Admin 17.05.2010. 01:54

Oh yes - hemorrhoids will dry up after a while. Usually people only go to the doctor with those when they're pretty horrible. Get some Witch Hazel - it's cheap - use lots. You'll find that it's an ingredient in Preparation H. But Preparation H doesn't work very well. Witch Hazel is great - wash the area as often as you like with it - it's very soothing. It's also an astringent - it shrinks things - it's an herb called Hammamalis, I think. Nice stuff.

Also, put some Witch Hazel on a piece of toilet paper and cram it up next to that hemorrhoid and hold it there. You can walk around with it. It really takes the sting out of those things.

And to prevent them later - really limit the time you spend on the john - no reading. And no holding your breath and pushing (Valsalva Maneuver) - it builds up the blood pressure a LOT and dumps it right onto the hemorrhoidal veins - they break - and you have a sore butt. And try to limit real heavy lifting too.

However - if you're really in horrible pain, you can screw up your courage and go to the doctor - they deal with these all the time. And mostly, they just make a little cut in these and the blood clot comes out - and you feel so much better. But you will reabsorb that blood clot on your own in a week or so.


thechikencliks_91 12.06.2009. 04:11

my mom has a thing on her butt, possibly HEMROIDS? she says she doesnt bleed when she poops , but it hurts, and theres like this part of the the buthole taht has inflamed outwards, but it just looks like a little extra sphere of flesh attached to the but hole. its not pink, or runny, or anyhting. its just same color as her butt.

im sorry if you think im joking but im not and im a girl so its okay, and is it hemroids? not sure.



Admin 12.06.2009. 04:11

Well, it could be hemorrhoids, there are usually a few spots of inflammation (note the plural name, not singular) They don't always cause bleeding, but can. But they are painful and itchy and can get inflamed. Here's info about them and how to treat. they would cause pain, where the cysts might not. Hemorrhoids can come from straining, constipation or pressure.

It could be a cyst, or it could be a pilonidal cyst and, which would have to be drained through a medical procedure. Here's a link with a picture and information. Personally, I'd wait a week and see if it doesn't just go away, but if it gets larger or more painful, then off to the doctor. Don't let it go too long because that would make it really awful to deal with.

Agreed, this topic is tough to talk about, but check and see if this description fits and if it does


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