Hemorrhoids are among the most common afflictions of the gastrointestinal system. Among American adults, approximately half will have experienced symptoms of hemorrhoids by age 50.
Despite this surprising statistic, hemorrhoids are rarely discussed in the mainstream media or even in the medical literature. This may be because hemorrhoids are usually a benign condition that rarely has a serious or long-lasting effect on overall health.
However, it is equally true that many people are embarrassed to admit they have hemorrhoids and this often translates into a reluctance to discuss their symptoms or seek help from medical professionals.
This article can help you to better understand what hemorrhoids are, why you might be experiencing them, and the duration and nature of symptoms you can expect if you develop hemorrhoids.
What Hemorrhoids Are
Hemorrhoids are a condition affecting the veins that move deoxygenated blood away from the tissues of the anus and rectum. If excessive pressure is applied to these veins, they become swollen. This creates the condition we call hemorrhoids. Interestingly, the word ‘hemorrhoids’ is also used to describe clusters of blood vessels found normally in the anal canal. These are often present from birth and serve to maintain numerous venous connections.
Hemorrhoids can cause bleeding of the rectum or anus. Beyond this, they can be quite uncomfortable if not downright painful.
Hemorrhoids that are inside the rectum are called internal hemorrhoids are unlikely to be painful, as there are few nerve endings in this area. In fact, unless they are actively bleeding, you may be unaware you have them at all.
Painful hemorrhoids are usually those on the anus, where more nerve endings can sense pain. These are referred to as external hemorrhoids. They will be most painful when you have a bowel movement.
Because of their rich blood supply, sensitive location, and tendency to become engorged or prolapsed (which means extension outside the anal orifice), hemorrhoids are a very common cause of anal symptoms like bleeding, pain, and itching.
Why Hemorrhoids Happen
Normally, the veins of the lower gastrointestinal tract are not dilated, as they are with hemorrhoids. However, when there is force or pressure applied to the outer walls of these veins, they will swell and expand, causing the vein to bulge outwards and cause hemorrhoids to occur.
There are many reasons that this happens, including all of the following:
- Pregnancy. The extra weight that pregnant women carry puts extra pressure on these veins, making hemorrhoids more likely to occur.
- Obesity. Much like pregnancy, carrying a great deal of extra weight on your body creates excessive pressure on the veins and mucosa of the lower gastrointestinal tract.
- Too much sitting or standing. If you stand or sit for large periods of time at work or home, this applies pressure to the sensitive tissues of the anus and bowel as well.
- Constipation or straining with bowel movements. If you have to apply lots of effort to have a bowel movement, this causes excessive pressure to the delicate veins of the anus and rectum, which causes hemorrhoids.
- Coughing or sneezing. The brief increase in intra-abdominal pressure associated with coughing or sneezing can cause vein walls to weaken, allowing hemorrhoids to develop.
- Heavy physical labor. Much like straining with bowel movements, straining to lift or push heavy objects can result in hemorrhoids as well.
- Genetics. There is some evidence to suggest that predisposition to developing hemorrhoids has a genetic component. If your parents commonly experienced hemorrhoids, you may be at increased risk of developing the same.
Beyond this list, age plays a role in hemorrhoid development as well. As the thickness of blood vessel walls decreases with age, older adults become more susceptible to the development of hemorrhoids.
How long do hemorrhoids last?
How long your hemorrhoids last will depend on their severity. Most mild hemorrhoids resolve on their own within a few days. Sometimes, they may take up to a week. Larger hemorrhoids might last longer, and since they’re more prone to complications, sometimes they’ll not resolve on their own and you’ll need to visit a doctor.
If you’re wondering what makes a hemorrhoid mild or severe, here’s how the American Society of Colon and Rectal Surgeons classifies hemorrhoids.
Hemorrhoids that don’t stick out of the anal canal are called grade 1. Those that protrude out but go inside on their own are termed as grade 2. Another one that needs to be manually pushed inside the anus are called grade 3, and those that cannot be pushed inside at all are called grade 4.
External hemorrhoids can be considered mild and can disappear within a week. If they last longer – or if your symptoms begin to increase in severity – you must see a doctor.
Since grade 3 and 4 hemorrhoids stick out of the anal canal, they’re prone to complications like strangulation and clot formation. These complications can lengthen the duration of your hemorrhoids up to several weeks. It’s best to seek medical care for them immediately.
Can hemorrhoids return?
Yes, hemorrhoids can return. Although there’s not a lot of research on how often it recurs, current estimates suggest that the rate of recurrence depends on the type of treatment you get.
With non-surgical treatment techniques (usually used for mild, grade 1), hemorrhoids can return at a rate of 10-50% in a 5-year period. For surgical treatments, which is usually performed for more severe disease, this rate drops to less than 5%.
How long do thrombosed hemorrhoids last?
Thrombosed hemorrhoids last for around 7-9 days but can be prolonged up to a few weeks. A thrombosed hemorrhoid is one that has developed a clot inside it.
External hemorrhoids (or those that stick out of the anal canal) are more likely to get thrombosed, which can potentially lengthen their duration.
If it develops a clot, pain and anal discomfort are the major symptoms for the first few days. As time passes, the clot is resorbed but occasionally the skin overlying the clot may ulcerate and the contents of the hemorrhoid will drain. This might cause significant bleeding while passing stool.
If significant pain associated with the hemorrhoid swelling, see your doctor right away. This is to make sure not an infection or abscess. Also, if appropriate, a thrombosed hemorrhoid can be removed in the office by your doctor which can decrease the pain and time to healing.
The symptoms of a thrombosed hemorrhoid generally improve significantly over a few days. This entire process takes around 7-9 days but it might stretch up to a few weeks.
Frequently, the clot does not cause splitting of the skin and drainage. In these cases, the body will slowly break down the clot over a few days and the symptoms of pain and discomfort will improve.
You should be aware that if a clot doesn’t get fully reabsorbed (or drained) within a few weeks, it might cause perianal tags to form.
How long do thrombosed hemorrhoids bleed?
When a thrombosed hemorrhoid ruptures, it may bleed anywhere from a few seconds to a few minutes. Importantly, it shouldn’t last more than 10 minutes. If it lasts more than 10 minutes, you should seek medical attention. It can mean an underlying clotting abnormality or some other problem.
Once the major bleeding episode is over, you may find intermittent traces of blood in your stool.
And while a ruptured hemorrhoid doesn’t require any treatment, you may want to take a Sitz bath to keep the area clean and help it heal well.
How to reduce the duration of hemorrhoids?
Hemorrhoids are associated with certain risk factors, and if you can avoid them, not only will your current hemorrhoid episode end quicker, but you’ll also be at a decreased risk for future hemorrhoid development.
One important risk factor is decreased venous drainage of the anal cushions. One major cause of reduced venous drainage is a low-fiber diet, which leads to constipation. Constipation makes people strain and this impairs proper venous drainage.
To avoid constipation, a diet rich in fiber is essential. If your constipation persists, you might want to consider laxatives but only after a chat with your doctor.
There are many other, less intuitive risk factors for hemorrhoids. These include obesity, inflammatory bowel disease, prolonged sitting on the toilet, liver disease, a family history of hemorrhoids, spinal cord injury, and long-term diarrhea. Some of these can be treated to reduce the risk of future hemorrhoid development. It’s a good idea to talk to your doctor about these.
For mild hemorrhoids, you can try home remedies such as topical creams (which often contain steroids that reduce inflammation and pain), bathing your anal area in a warm water bath (Sitz bath), and oral pain-killers like ibuprofen.
You can also try using soothing wipes to reduce the damage toilet paper can cause to your hemorrhoids. Some soothing wipes come with anti-hemorrhoid substances like aloe vera. If you can get your hands on these, you can reduce the discomfort your hemorrhoids are causing you as well as their duration.
Other simple remedies include wearing loose, cotton clothing, using ice packs, and applying a pure aloe vera gel on your hemorrhoids.
However, if symptoms persist longer than a week — or if they increase in severity — you must see your doctor. You should also be aware that using a topical steroid cream for more than a week can lead to thinning of your skin. Make sure you seek advice from a doctor before doing this.
Treatment of Normal Hemorrhoids
If it appears your hemorrhoids are not going to go away on their own within a few days, there are a number of remedies you can try at home. These include the following:
- Sitz baths. These are a type of soak for the anus and buttocks where these parts of the body are immersed in warm water for 10-30 minutes at a time. This can provide relief to the tissues and help the veins to heal.
- Over-the-counter topical products. There are many hemorrhoid creams and lotions available that can provide pain relief to the affected area as well as aiding in healing.
- Eating more fiber and drinking enough fluids. Not only does eating more fiber and staying hydrated help you avoid constipation and have bowel movements more quickly and avoid straining, but it also helps avoid irritation to current hemorrhoids as well.
- Cold therapy. If the pain or discomfort from hemorrhoids is persistent, try sitting on an ice pack for 15 to 30 minutes. Avoid exposing the affected tissues directly to the ice, however.
If the use of these techniques does not resolve your hemorrhoids after two weeks, speak with your family physician or another healthcare practitioner. They may be able to suggest more invasive treatment options, such as ligation, or banding. Other possible options include stapling and surgical removal.
You can help shorten how long hemorrhoids last! Discuss Treatment Options with Your Doctor today.
Though rarely a serious condition, unresolved hemorrhoids and the pain associated with them can have a severe impact on your overall health and well-being.
If you are concerned you might have hemorrhoids, or if the pain associated with hemorrhoids is affecting your daily life, contact your doctor for information about treatment options.