Battling the hemorrhoids stigma

They can be painful to endure and embarrassing to talk about, but hemorrhoids might be more common than you think.

“It’s estimated that 10 million people suffer from hemorrhoids in the U.S.,” says Dr. Jan Kaminski, a colon and rectal surgeon at Advocate Illinois Masonic Medical Center in Chicago. “And more than half of people older than 50 years old will have a hemorrhoid symptom.”

To combat the stigma that can come along with hemorrhoids, Dr. Kaminski answers pressing questions about this bothersome condition.

What are they?

Hemorrhoids, also known as vascular cushions or piles, are part of every human’s normal anatomy and are composed of blood vessels, connective tissue, smooth muscle and elastic tissue in the anal canal’s submucosa just underneath the surface tissues. They have a physiologic function when they work properly — roughly 15-20% of fecal continence, a person’s ability to contain feces, gas and other waste in the rectum until the person is ready to expel the waste, is supplied by hemorrhoids — but can be a major pain in the rear when they become dysfunctional.

How do you know if you have hemorrhoids?

The most efficient and certain way to determine whether you have hemorrhoids is to see a colon and rectal doctor. External hemorrhoids mainly cause pain and form on the outside of the anal canal. Internal hemorrhoids often cause bleeding and form on the inside of the anal canal. Patients can have a combination of both at the same time. Other symptoms include prolapse of internal hemorrhoids where they actually protrude through the anal canal after bowel movements. Afterwards, they can spontaneously return into the anal canal or might have to be physically pushed back into the anus by the patient. Itching, burning, swelling, mucus discharge and difficulty with hygiene after bowel movements can be symptoms, as well; however, hemorrhoids don’t necessarily have to cause symptoms.

Are they dangerous?

Hemorrhoids themselves are not dangerous, but they can cause enough bleeding to lead to anemia. However, this rarely occurs. What’s more dangerous is when people assume their issue is hemorrhoids and don’t get it checked out. If you have symptoms, you should see a colon and rectal surgeon to make sure they are not being caused by something more dangerous, such as colon cancer, rectal cancer or anal cancer.

What are the risk factors for hemorrhoids?

Hemorrhoids can become symptomatic for a variety of reasons, including dietary patterns, behavioral factors and excessive straining to have a bowel movement during constipation or diarrhea. Other factors include:

• Obesity
• Pregnancy
• Chronic coughing
• Bad toilet habits — like sitting on the toilet for a long period of time
• Aging
• Lifting heavy objects repeatedly
• Anal intercourse
• Family history

Want to learn more about your risk for colorectal cancer? Take a free online quiz here.