Alternatives to Laxatives for Hemorrhoids
Q: I suffer from painful hemorrhoids and I've been using laxatives for
about six months to prevent straining during bowel movements. Trouble is, now
I think I might be addicted to them. Whenever I stop taking the laxatives I
get extremely constipated. Is there any way to break free of these pills and
stay regular?
Dr. Donnica: If constipation is the only symptom you have when you stop
taking laxatives, chances are that you are not addicted to them. Laxative addiction
and laxative abuse are terms we use to refer to situations in which people are
misusing them as an inappropriate tool for weight loss. Usually those individuals
have difficulty discontinuing laxative use and may have serious symptoms of withdrawal
(such as palpitations, leg swelling, or weakness) when they do. In your case,
it sounds like you have two different but related problems: how to treat
your hemorrhoids and how to prevent constipation.
As you've recognized, an important step in hemorrhoid management is preventing
constipation. Occasional laxative use is fine to treat constipation. To prevent
it, first look at your diet. Drink 8 to 10 full glasses of water per day. Eat
at least 5 servings of fruits and vegetables. Add fiber to your diet, either
in your food choices or as a dietary supplement. Eliminate foods known to be
constipating (such as bananas) and add foods known to be lubricating (such as
raisins or prune juice). Certain medications can be constipating, such as iron
and calcium supplements. Following a very-low carbohydrate diet may also exacerbate
constipation. There's a reason that a regular morning walk is known as
the "morning constitutional:" Aerobic exercise helps get everything
in your body going, including your bowels. Good bowel habits are also important
in the prevention of constipation. When you feel the urge to have a bowel movement,
attend to that need as soon as possible, rather than "holding it"
for a more convenient time or location.
You didn't mention how you were treating your hemorrhoids. Hemorrhoids
are abnormally swollen veins in the rectum and anus, similar to varicose veins
a person's legs. When these veins are irritated, they cause surrounding membranes
to swell, burn, itch, become painful, and even bleed. Hemorrhoids are caused
by too much pressure in the rectum. Risk factors and causes in addition to constipation
and straining with bowel movements include constant sitting (especially sitting
on the toilet for too long), diarrhea, severe or chronic coughing, pregnancy
and childbirth, or heavy lifting. In addition to avoiding or reducing these
risks, you can treat your hemorrhoids with sitz baths (soaking the rectal area
in hot water, in a shallow bath) for 15-20 minutes, 3-4 times/day. Pain medicine
may be used for the irritation, but the burning and itching respond best to
surface-acting creams and suppositories such as Anusol or Preparation H. These
may also help shrink the hemorrhoids. If using these techniques and treatments
for up to 4 weeks does not provide relief, consult your physician. If you have
severe hemorrhoid pain, see your physician immediately.
Created: 11/24/2004 - Donnica Moore, M.D.
