HEMORRHOIDS
PROBLEM
A hemorrhoid is a varicose vein of the rectum. You may not know you have a hemorrhoid until bleeding occurs. Hemorrhoids are often found after painless rectal bleeding with a bowel movement (BM). They may cause rectal pain, itching, or a sensation that you have not emptied completely after a BM.
CAUSE
Repeated pressure in the anal or rectal veins causes hemorrhoids. Hemorrhoids are commonly seen with obesity, pregnancy, constipation, lack of exercise, and liver disease.
PREVENTION
A.Avoid heavy lifting.
B.Try to prevent constipation or straining.
C.Eat a high-fiber diet.
D.Drink eight to 10 glasses of water a day.
E.Lose weight if you are overweight.
F.Exercise regularly.
TREATMENT PLAN
A.Spend less time sitting on the toilet to reduce pressure in the veins around the anus.
B.Pat with toilet paper instead of rubbing.
C.Take sitz baths or soak in a warm bathtub three or four times a day for comfort.
D.Apply cold packs or witch hazel (Tucks) compresses for symptom relief.
E.Take a stool softener two to three times a day to prevent straining, then take one a day.
F.A hemorrhoid treatment may need to be done for severe cases.
Activity: No restrictions are required. Bowel function improves with good physical activity.
Diet: A high fiber diet helps to prevent constipation.
TIPS FOR INCREASING FIBER IN YOUR DIET
A.Read the Nutrition Facts food labels for fiber content per food serving:
1.Cereals that provide 5 g of fiber per serving give you 20% of your daily fiber.
2.Look for whole grain
on the label. Just because bread is brown does not mean it is whole grain.
B.Increase fiber in your diet gradually to prevent gas. Adding too much fiber too quickly may give you abdominal pain, bloating, and constipation. Increase your fiber over several weeks so that it gives time for you to adjust.
C.As you increase fiber, it is also important to increase the amount of fluids you drink up to six to eight glasses a day, including tea, milk, fruit juices, coffee, and even soft drinks. The extra fluids that you drink along with the extra fiber makes you feel fuller, which can help control snacking.
D.Keep a food diary and review it periodically to decide on other diet adjustments that need to be made.
E.Several fiber supplements are available over the counter to help you get your daily recommendation of fiber.
GOOD FOOD SOURCES OF FIBER
A.Bran: Add one teaspoon of whole-grain bran to food three times a day, or take an over-the-counter fiber supplement such as psyllium (Metamucil), as directed.
B.Whole-grain cereals and breads: Eat oat, bran, multigrain, light, wheat, or rye breads rather than pure white bread or breads that list eggs as a major ingredient. Grains are not only a good source of fiber but also contain vitamins and minerals. Folic acid has been added to breads and cereals to help reduce neural tube defects.
C.Fresh or frozen fruits and vegetables: Citrus fruits are especially good sources of fiber. Eat raw or minimally cooked vegetables, especially squash, cabbage, lettuce, other greens, and beans. Leave the skins on fruits and vegetables; eating the whole fruit is better than drinking the juice. Whole tomatoes offer more fiber than peeling the skin off. The more colorful the fruit and vegetable (dark green, reds, blue, yellow) the better; they are a good source of antioxidants that are good for the heart and the prevention of some cancers. Apples are a good source of both fiber and water.
D.Legumes (pods): Peas and beans are a good source of fiber. Add chickpeas and kidney beans to salads for extra fiber and flavor. Add baked beans as a delicious side item to your meal.
E.Coffee is another source of fiber.
F.Nuts are an excellent source of fiber. They are considered nutrient-dense and are a good source of vitamins and folic acid. Sprinkle sunflower seeds on a salad to add flavor and fiber. The amount of nuts eaten should be limited to 1 to 2 ounces because they are also high in calories.
G.If you have diverticulosis: Avoid foods with seeds or indigestible material that may block the neck of a diverticulum, such as nuts, corn, popcorn, cucumbers, tomatoes, figs, strawberries, and caraway seeds.
Medications:
You Have Been Prescribed the Following Stool Softener: ___________________________________________________________
You Need to Take: ___________________________________________________________
You Have Been Prescribed the Following Local Cream: ___________________________________________________________
You Need to Apply: ___________________________________________________________
Emergent Instructions:
A.Had a procedure to remove a hemorrhoid and a hard lump develops where the hemorrhoid has been.
B.Excessive rectal bleeding needs to be evaluated.
You Need to Notify the Office If You Have:
A.Hemorrhoids that cause severe pain that is not relieved by the previous treatment.
B.Excessive rectal bleeding: More than a trace or streak on the toilet paper or BM.
C.Rectal bleeding may be an early sign of cancer.
D.Other: ___________________________________________________________
Phone: ____________________________
PATIENT TEACHING GUIDE