According to my experience, the probability that patients with constipation have hemorrhoids appears to be high. Constipation is a major cause of hemorrhoids. However, this does not mean that hemorrhoids develop in all patients who are suffering from constipation over the long term. Hemorrhoid swelling may occur suddenly due to straining during defecation; therefore, it cannot be generalized that there is a causal relationship between the duration of constipation and the development of hemorrhoids.
It is recommended to consult a physician if perianal swelling or pain is noted. People who have anal bleeding or who have tested positive for occult blood in a mass stool screening must consult a physician. On the other hand, some people do not decide to undergo a detailed examination at their own discretion, assuming that the stool test showed positive because they have hemorrhoids. However, this is a mistake. People who tested positive must visit a medical institution.
Procedures for constipation in patients with hemorrhoids are basically the same as routine treatment for constipation. However, if difficult defecation causes rectal blockage, resulting in anorectal swelling, enema or disimpaction will be performed. As pain cannot be relieved without the removal of stools in the anal canal, it is recommended to visit a proctology clinic.
The incidence rate of hemorrhoids resulting from constipation is not clearly known. There is no clear understanding about the relationship between the duration of constipation and the development of hemorrhoids; however, from my experience, many patients with hemorrhoids appear to have been suffering from constipation for a long time. If any such symptoms as anal bleeding, prolapse, or pain occur during defecation, consult a proctologist. Especially, patients with anal bleeding must consult a proctologist because bowel diseases may be present. Recently, patients receiving fecal occult blood tests regularly have been increasing. It is also recommended that people above 50 years of age undergo a colonoscopy examination. Even if there are no symptoms of anal disorders, a colonoscopy examination is recommended.
The treatment of constipation in patients with hemorrhoids is the same as routine treatment for constipation. However, for patients with anal pain, stool softeners will be first used and then a painkiller will be used. Especially, patients with anal fissure may be trapped in a vicious circle in which it takes time for them to pass stools due to firm stool consistency and painful defecation, leading to less frequent bowel movements and blocked evacuation. For such patients, it is important to eliminate the fear of bowel movements first by use of stool softeners, laxatives, painkillers and such.
Hemorrhoids may develop suddenly even in patients who have been asymptomatic, and emergency surgery may be required in some cases. Therefore, it is difficult to judge whether the patient’s condition requires medical treatment based only on the duration of constipation. It is recommended to consult a physician when any hemorrhoids symptoms occur, not based on the duration of constipation. If there is any anal discomfort, pain, bleeding or such, a physician must be consulted. Anorectal examinations can be performed in outpatient settings. In order not to overlook the possibility of rectal cancer, consult a physician promptly if any such symptoms occur.
As a simple measure against hemorrhoids, it is recommended for patients to immerse themselves in a bathtub to relax and warm the perianal region. Hemorrhoids cause throbbing pain and patients tend to think that they should not take a bath. However, for patients with hemorrhoids, immersing themselves in a bathtub to warm the affected area is recommended rather than just taking a shower. Excessive straining on the toilet must also be avoided. Go to the toilet promptly when you feel a sensation of urgency to defecate, and pass stools. Even if you have a sensation of inadequate defecation, leave the toilet soon after defecation. Do not go to the toilet with a smartphone or newspaper in hand.
I understand that people suffering from hemorrhoids, especially women, may feel embarrassed to visit a proctology clinic/hospital. Recently, the number of female proctologists has been increasing. We proctologists also think that we can support or encourage patients suffering from hemorrhoids. If you have any concerns, visit a proctology clinic/hospital.
