Every week Edwin de Vaal (47), general practitioner in Nijmegen, answers a frequently asked or striking question from his practice. This week that is an embarrassing topic for many people: what are hemorrhoids and can you do something about it?
What is a hemorrhoid?
"A hemorrhoid is a bulge of a blood vessel on the inside of the anus. Just before the sphincter muscle, which stops the stool at the end of the intestine, there is a kind of spongy body that prevents moisture and mucus from seeping out. Through pressure on the anus, for example due to pregnancy, many presses, heavy lifting, overweight or constipation, blood vessels in that spongy body may swell and eventually become a varicose vein. "
How do you notice that you have a hemorrhoid?
"A hemorrhoid on the inside can cause clear red, fresh blood loss in the stool. You notice that when you wipe your buttocks. Sometimes a hemorrhoid can also be on the outside of your anus. You feel a bump or bump. This can also hurt or itch. Usually it is because the blood flow in the hemorrhoid has deteriorated. "
Do you have to go to the doctor?
"Not always. First take a mirror to see what the bump looks like. Sometimes it is a red bump. With a little Vaseline on your finger you can gently push it back past the circle muscle. Then the blood flow starts again and disappears the pain and the hemorrhoid. In some cases it comes out the next time you have to poop. Then you can push it back again. "
"If you find it nasty to do this with your bare finger, you can also put a sandwich bag on your finger. I think it would be wise anyway if people occasionally look at their 'bottom' with a mirror. I notice that people often have no idea what it looks like there, so they don't know if anything changes there either. "
When should you go to the doctor?
"Most people find it very embarrassing to go to the doctor with a hemorrhoid or other problems. GPs know that. But don't worry, doctors don't find it weird or dirty at all. It's our job. At ( too much pain and swelling and of course also if you have blood with the stool, I would certainly consult with the doctor's assistant. Especially blood with your stool is out of the question. "
See also: Why you should always look back after a toilet visit
"Sometimes the hemorrhoid has become a dark blue marble that hurts a lot. It usually contains a clot. If you cannot gently push it back because of the pain, consult your doctor. He can carefully try to get the hemorrhoid back for you. push or optionally remove the clot by cutting open the hemorrhoid under anesthesia. "
"Internal hemorrhoids are usually treated by a specialist surgeon who specializes in them: the proctologist. Nowadays, this is very simple with a small rubber band."
Does hemorrhoid ointment work?
"No. Ointment briefly relieves itching or pain, but does not solve the problem."
What can you do to prevent hemorrhoids?
"Provide gentle stools. Drink 1.5 liters of fluid per day. Water, juices, coffee and tea, everything counts. Also ensure adequate exercise and eat lots of fiber. They are in whole grain products, brown rice, beans, peas, lentils , fruits and vegetables."
"And please go to the toilet if you have to. Some people just dare to poop on their own toilet at home and stop it elsewhere. Step over your embarrassment. Postponing causes your poo to get harder again, so you have to squeeze more later . That increases the chance of hemorrhoids. "
Every week Edwin de Vaal (47), general practitioner in Nijmegen, answers a frequently asked or striking question from his practice at NU.nl.
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