Recently I received an email from a DRUM reader in Italy asking for some medical advice for treating an embarrassing problem. He was not able to sit on the thrown of his kit because of a painful problem that he had developed called hemorrhoids. At first it seemed strange to me as a novas drummer at best, that drummers would ever be sidelined by such a problem. It was only after asking around the drum community I learned that this was a much more common problem than one would think. Since it seemed to be so common amongst the drummers I know I decided to write about it.
Hemorrhoids are a condition in which the veins around the anus and or lower rectum become swollen and inflamed.
Hemorrhoids can result from straining to move your bowels and can also be associated with aging, chronic constipation or diarrhea, pregnancy or anal intercourse.
Hemorrhoids develop either under the skin around the anus (external) or inside the anus (internal).
Other anorectal problems such as irritation and itching (pruritus ani), anal fissures and fistulae or abscesses, have similar symptoms and are incorrectly referred to as hemorrhoids.
Although many people have hemorrhoids, not all experience symptoms. Hemorrhoids usually are not dangerous or life threatening. In most cases, symptoms from hemorrhoids go away within a few days. The most common symptom of internal hemorrhoids is bright red blood on the stool, toilet paper, or in the toilet bowl. Internal hemorrhoids may protrude through the anus (protruding hemorrhoid), becoming irritated and painful.
Symptoms of external hemorrhoids include painful swelling or a hard lump around the anus that results when a blood clot forms known as a thrombosed external hemorrhoid.
Excessive straining, rubbing, or cleaning around the anus may lead to irritation with bleeding and/or itching, which may lead to further symptoms.
Hemorrhoids are very common in men and women with 50% of the population having hemorrhoids by age 50. Hemorrhoids are also very common during pregnancy.
An evaluation by a physician is important any time blood in the stool or bleeding from the rectum occurs.
Swollen blood vessels that indicate hemorrhoids can be detected by a simple digital rectal exam by a physician.
Closer evaluation of the rectum for hemorrhoids requires an internal exam with an anoscope, a proctoscope. Other causes of gastrointestinal bleeding can be determined with sigmoidoscopy or colonoscopy.
The goal of initial treatment of hemorrhoids is to relieve symptoms. These include warm water tub baths several times a day for about 10 minutes and the application of hemorroidal creams and or suppositorys to the affected area.
Preventing the recurrence of hemorrhoids requires relieving the pressure and straining of constipation. Increasing fiber content and fluids in the diet are beneficial. Eating a diet rich in fiber and drinking six to eight glasses of fluid per day results in softer, bulkier stools. Makes emptying the bowels easier, lessening the pressure on hemorrhoids caused by straining. Eliminating straining also helps prevent the hemorrhoids from protruding. A stool softener or a fiber supplement such as psyllium (Metamucil) or methylcellulose (Citrucel) may also be recommended by your physician.
In severe cases, hemorrhoids must be treated endoscopically or surgically to shrink and destroy the hemorrhoidal tissue. There are a number of techniques utilized including rubber band ligation, sclerotherapy, infrared coagulation and finally hemorrhoidectomy.
The best way to prevent hemorrhoids is to keep your stools soft, decreasing pressure and straining during bowel movements, and to empty bowels as soon as possible after the urge occurs. Exercise and increased fiber in the diet help reduce constipation and straining by producing stools that are softer and easier to pass.