By about age 50, more than half of adults have dealt with hemorrhoids -- blood-engorged veins in the lower rectum (anal canal) that form tiny sacs (anal cushions) when pressure builds up within the veins serving the pelvic and rectal areas. Increased venous pressure can result from straining during bowel movements, sitting on the toilet for an extended time, chronic diarrhea or constipation, obesity, lifting heavy objects, sitting or standing for long periods, and pregnancy.

Symptoms can include painless bleeding during bowel movements, leakage of feces and mucus, severe pain, swelling or inflammation. Embarrassment aside, it's important to talk with your doctor about any rectal bleeding. While hemorrhoids generally don't cause serious problems, other, more serious concerns, such as polyps, cancer or inflammatory bowel disease, can cause bleeding, too. Colonoscopy may be needed to determine the cause of bleeding.

Mild pain, swelling and inflammation from hemorrhoids often can be managed with self-care measures. Options include:

Topical over-the-counter remedies:

Nonprescription hemorrhoid creams, suppositories containing hydrocortisone or pads containing witch hazel or a topical numbing agent may provide relief. They shouldn't be used longer than a week unless directed by a doctor.

Cleanliness in anal area:

Taking a warm sitz bath several times a day can be helpful. A sitz bath, where only the hips and buttocks are immersed, can be done in a regular bathtub or using a plastic tub that fits over the toilet. The tubs are readily available from medical supply stores and pharmacies.

Swelling relief:

Ice packs or cold compresses on the anus can relieve swelling.

Pain relievers:

Non-prescription pain relievers such as acetaminophen (Tylenol, others), or ibuprofen (Advil, Motrin IB, others) may provide some relief.

Hydration and fiber:

Softening and bulking up stool for easier passage are helpful. Strategies include drinking six to eight glasses of water or other nonalcoholic beverages daily, eating high-fiber foods, and taking fiber supplements, such as Metamucil and Citrucel.

In addition, it's best to head for the bathroom when the urge to defecate occurs and to avoid straining or breath-holding when passing stools, as this strains the veins in the lower rectum.

When self-care measures don't work, talk to your doctor about the minimally invasive surgical procedures available.

-- Adapted from Mayo Clinic Health Letter

Medical Edge from Mayo Clinic is an educational resource and doesn't replace regular medical care.

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