Living with IBS can be a challenge; cramping with constipation, gas bloat and diarrhea can hinder your life and there are times when you don’t know what foods will trigger another attack and land you in the bathroom for hours.
Among the uncomfortable bloating and gas symptoms, you may also experience another condition alongside IBS: hemorrhoids. Hemorrhoids are a part of our anatomy just like our eyes, nose, ears, toes, etc. They are venous cushions which have a blood supply – an artery which pumps blood into the hemorrhoid and a venous return – veins which return the blood to the body.
Hemorrhoids are a part of our anatomy just like our eyes, nose, ears, toes, etc. They are venous cushions which have a blood supply – an artery which pumps blood into the hemorrhoid and a venous return – veins which return the blood to the body. We are born with at least 6 hemorrhoids, three within the anus (internal hemorrhoids) and three outside the anal opening (external hemorrhoids). External hemorrhoid veins are abundant in nerve endings. The internal hemorrhoid veins lack pain fibers.
Having IBS directly leads to hemorrhoid symptoms from straining too hard during bowel movements from chronic constipation or multiple bowel movements with irritation and increased anal pressure from gas and chronic diarrhea. Understanding the link between hemorrhoids and IBS can help you understand how to treat hemorrhoids and IBS to help prevent them from developing.
What is IBS?
IBS, or irritable bowel syndrome, is a common condition that affects 10% to 15% of people in the United States. The condition is a combination of symptoms including belly pain and problems with bowel movements that is a lifelong problem which can be hard to manage.
The exact cause of IBS is still unknown, but medical professionals have tied it to a few factors including:
- The nervous system and poor signal between the brain and intestines
- A severe infection called gastroenteritis, or a bacterial surplus
- Changes in the gut microbes
- The speed and strength of muscle contraction in the intestine. Weak contractions can lead to constipation while strong and faster can cause diarrhea.
IBS does not lead to colon cancer, but can have adverse conditions in connection to IBS, such as hemorrhoids or anal fissures. You may also have other health conditions that overlap with irritable bowel syndrome like migraine headaches, fibromyalgia, anxiety, and more.
Symptoms of IBS
If you have IBS you may not experience these symptoms all the time, but they can be worse when something triggers them. Triggers for IBS include food, such as a good allergy or intolerance, and stress.
- Recurring stomach pain with bowel movements
- Changes in bowel movements, such as increased diarrhea and constipation
- Gas and/or bloating
Types of IBS
IBS can be defined into three different types in order to give a patient the best course of treatment.
The three types of IBS are:
- IBS-C or constipation predominant IBS
- IBS-D, or diarrhea predominant IBS
- IBS-M, or mixed IBS in which a patient experiences both diarrhea and constipation
What are Hemorrhoids?
Hemorrhoids are a part of our anatomy just like our eyes, nose, ears, toes, etc. They are venous cushions which have a blood supply – an artery which pumps blood into the hemorrhoid and a venous return – veins which return the blood to the body. We are born with at least 6 hemorrhoids, three within the anus (internal hemorrhoids) and three outside the anal opening (external hemorrhoids). External hemorrhoid veins are abundant in nerve endings. The internal hemorrhoid veins lack pain fibers.
Internal and external hemorrhoid veins are like apples and oranges. Although they are both venous cushions, their symptoms and treatment are completely different. Though we have theories as to the function of hemorrhoids, there is no real scientific evidence of their purpose. It is proposed that the function of hemorrhoids is to aid in keeping stool from leaking out of the anus.
Symptoms of hemorrhoids depend on the type they are. External hemorrhoids can lead to anal itching, painful lumps outside the anus and swelling. Internal hemorrhoids, lead to increased anal pressure with urgency to have a bowel movement, bleeding from your rectum, prolapse (hemorrhoids coming out of the anus)
If you suspect you have hemorrhoids, it’s important to speak to a proctologist who can examine them and confirm the diagnosis. Hemorrhoids can often be a sign of something else occurring with your digestive systems, including IBS.
The Connection Between Hemorrhoids and IBS
Having irritable bowel syndrome can lead to having hemorrhoid symptoms, both internally and externally. IBS is not only known for stomach cramping, but for causing changes in bowel habits. Patients, especially those with IBS-C or IBS-M, often find themselves straining more than normal during a bowel movement or spending more time on the toilet than usual.
The added pressure in your abdomen and around your anus can cause hemorrhoid swelling and symptoms. If you are already a person who suffers from chronic hemorrhoids, developing IBS can make the condition worse.
Unfortunately, even medications intended to help symptoms of IBS, such as laxatives, can lead to more time spent on the toilet, which can lead to hemorrhoid symptoms.
If you do think you have hemorrhoid symptoms that are from IBS, your doctor should be able to help recommend treatments and tips to manage your conditions to help prevent them from reoccurring.
How to Treat Hemorrhoids Caused By IBS
While there is no direct cure for IBS, managing the symptoms through medications and lifestyle changes is possible. There are several treatments for hemorrhoid symptoms that can be effective at relieving the pain they can cause.
Home treatments for hemorrhoids
Mildly symptomatic external or internal hemorrhoids and may go away on their own. During this time, observe the hemorrhoids to ensure they aren’t growing or bleeding, in which case seek out a colorectal surgeon who can get you treatment.
Sitz baths can help soothe the pain at home, along with over the counter pain medications, including targeted hemorrhoid creams. Topical ointments like Vaseline or Preparation H can help soothe the area. Speak to your doctor before adding any new medicines into your routine. –
When there is pain, over the counter Recticare (Lidocaine 5%) is very effective for cutting the edge off of the pain. It shouldn’t be used for more than 4 days as the Lidocaine will begin to irritate and burn the skin after 4 days of use.
Lifestyle changes can also help ease hemorrhoids and prevent them from happening. This includes drinking plenty of water and eating raw psyllium fiber. If you can, try not to sit more than 5 minutes on the toilet to ease the pressure on your anus.
Surgical treatments for hemorrhoids
While your hemorrhoids may go away on their own, there is a good chance with IBS that they will return or cause more pain. A proctologist will be able to help find the right solution for you. Internal hemorrhoids can be treated painlessly in the office with sclerotherapy and/or rubber band ligation, although you may experience some discomfort. External hemorrhoids will require surgery which can be done in the office with a 3-7 day recovery.
If the internal and external hemorrhoids need to be removed, this is done in an outpatient setting. Although surgery can be daunting, your proctologist will be able to walk you through it and help you get the relief you need so you can focus on managing your IBS symptoms and returning to your normal life. Overall, Dr. Rosenfeld operates on about 15% to 20% of patients with hemorrhoid symptoms as the majority can be managed with painless therapy along with lifestyle and diet changes.