Help for hemorrhoids

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https://www.health.harvard.edu/diseases-and-conditions/help-for-hemorrhoids

Help for hemorrhoids

One of the most embarrassing conditions also can be one of the easiest to treat and manage.

Hemorrhoids are without doubt among the most unpleasant of health topics. But if you have suffered from them, you may find comfort in knowing that you are not alone.

More than 75% of people ages 45 and older have had hemorrhoids, with symptoms like rectal pain, itching, and bleeding after a bowel movement.

Put an end to your hemorrhoid flare-ups, with these tips from the experts at Harvard Medical School

"Hemorrhoids can be painful and embarrassing, but they often shrink on their own with simple self-help and over-the-counter remedies," says Dr. Howard LeWine, assistant professor of medicine at Harvard Medical School.

A look inside

Hemorrhoids are swollen veins near the anus. There are two types: internal and external. You can have either type by itself, or both at the same time.

Internal hemorrhoids form inside the anal canal and are often painless. However, they may cause intermittent bleeding, usually with bowel movements, and sometimes discharge mucus. Internal hemorrhoids may also protrude outside the anus, where they appear as small, grape-like masses.

External hemorrhoids form just outside the anal opening, where they primarily cause swelling, bothersome protrusions, and discomfort.

Cause and self-care

Sometimes hemorrhoids develop for no apparent reason, but often they are associated with chronic constipation or diarrhea, straining during bowel movements, and prolonged sitting on the toilet. This can interfere with blood flow to and from the rectum (the last six inches of the large intestine) and the anus, causing blood to pool in the veins around the anus, enlarging them.

The good news is that neither kind of hemorrhoid is dangerous, and severe complications are rare. Still, it's important to see your doctor if you experience rectal bleeding, feel a lump in the anus, or have ongoing rectal pain, as these might be signs of an unrelated and more serious condition, such as colorectal or rectal cancer.

Symptoms for either kind of hemorrhoid often can be relieved with self-care treatments. For example:

Sitz baths. A regular sitz bath can relieve itching and irritation. Fill a tub with three to four inches of warm (not hot) water and sit in it with your knees bent for about 10 to 15 minutes. Gently pat yourself dry with a towel.

Fiber supplements. These reduce hemorrhoid bleeding, inflammation, and enlargement by drawing water into your stool to make it easier to pass. A psyllium husk fiber supplement, such as Metamucil or a generic equivalent, is a good choice, although psyllium may cause gas or bloating. In that case, try a supplement containing wheat dextrin (Benefiber) or methylcellulose (Citrucel).

Topical therapies. Over-the-counter products are available for hemorrhoids, such as pads infused with witch hazel (Tucks), as well as soothing creams that contain lidocaine, hydrocortisone, or other ingredients like phenylephrine (Preparation H). These substances help shrink the inflamed tissue and provide relief from itching. External hemorrhoids rarely need more than self-care.

"The exception is a thrombosed hemorrhoid, the sudden formation of a hard, inflamed clot inside the hemorrhoid," says Dr. LeWine. "If this occurs, contact your doctor, since you may need a surgical procedure."

Nonsurgical options

When internal hemorrhoids continue to cause symptoms despite home treatment, your doctor may recommend an office-based nonsurgical procedure. Here are the most common options.

Rubber band ligation. This is the most widely used procedure for treating internal hemorrhoids. The doctor inserts a small elastic band into the anal canal and places it around the base of a hemorrhoid. The band cuts off the hemorrhoid's circulation, which causes the hemorrhoid to wither and die. The rubber band eventually falls off unnoticed. The procedure requires no anesthesia, although a numbing agent is sometimes used if you feel discomfort.

Sclerotherapy. The doctor inserts a proctoscope (a special metal or plastic scope used to view the hemorrhoids) into the anus. He or she then injects a chemical solution directly into the hemorrhoid or the area around it. This solution causes a local reaction that interferes with blood flow inside the hemorrhoid, causing it to shrink. Afterward, some people experience mild bleeding, pain, and pressure.

Coagulation therapy. This uses heat, laser, or electric current to cut off the hemorrhoid's blood supply. Once the hemorrhoid shrinks and dies, scar tissue forms on the anal canal wall to hold nearby veins in place so they don't bulge into the anal canal. One hemorrhoid is treated at a time, with a 10- to 14-day period between treatments.

6 Reasons to See a Gastroenterologist

https://www.healthgrades.com/right-care/digestive-health/6-reasons-to-see-a-gastroenterologist?cid=63emHLN111517C

By Mary Elizabeth Dallas

Many conditions can cause problems during digestion. Chronic pain in the belly is one warning sign that something is wrong. Nagging symptoms, such as bloating, gas and diarrhea are others. They're all reasons to see a gastroenterologist. These doctors are trained to treat conditions that affect the organs of the digestive tract, including the esophagus, stomach, colon, pancreas and liver. If you notice any of the telltale symptoms, it may be time to check in with a gastroenterologist.

Heartburn

Heartburn is pain or burning in the chest or throat. It occurs when acid from the stomach backs up into the esophagus. That's the tube that connects the mouth to the stomach. Many people get heartburn now and then. It goes away on its own or with over-the-counter medicines. But, symptoms that occur more than twice a week could be a sign of a more serious problem: gastroesophageal reflux disease (GERD).

GERD develops when acid from the stomach irritates the lining of the esophagus. GERD is more common among people who smoke or are overweight. Pregnant women also are apt to develop the condition. Medication is available to treat GERD. Severe cases may need surgery. Untreated GERD can cause more serious problems, including chronic inflammation in the esophagus and breathing problems.

Gallstones

Gallstones are small, hard nuggets that form in the gallbladder, a small organ in the belly. A gallstone can be as tiny as a grain of sand or as big as a golf ball. Some people have one large stone. Others develop multiple stones of different sizes. Sudden pain on the right side of your abdomen could be a gallstone. Pain from gallstones passes once they move. Gallstones develop because of imbalances in the substances that form bile. That's the digestive liquid made by the liver. Doctors don't know why these imbalances occur.

Obese people and pregnant women are more likely than others to have gallstones. Having gallstones also becomes more common with age. Anyone who has had one gallstone is at risk for another. Many people who develop gallstones have surgery to remove their gallbladder. In some cases, medications can dissolve the stones.

Lactose Intolerance

People who develop uncomfortable symptoms after drinking milk or eating dairy products may be lactose intolerant. Lactose is a sugar found in milk. The body produces the protein lactase to help break down milk products, including cheese and yogurt.

But, people with lactose intolerance don't make enough lactase to fully digest even small portions of these foods. This can lead to bloating, belly pain, diarrhea, gas, and upset stomach. Symptoms usually appear up to two hours after eating dairy. They can range from mild to severe. Gastroenterologists can test for lactose intolerance. Treatment may involve dietary supplements and changes to your diet.

Celiac Disease

Celiac disease is a genetic condition that involves the immune system. People with the disorder must avoid eating gluten. Gluten is a protein in wheat, rye and barley. It may also be found in certain medicines, vitamins and supplements. When people with celiac disease eat gluten, their immune system responds by damaging their small intestine. This can cause pain and diarrhea. A blood test can help diagnose celiac disease. A gastroenterologist may also need to examine a sample of the small intestine to look for damage.

Celiac disease is not the same as gluten sensitivity. The conditions share common symptoms. The main difference is that people with gluten sensitivity don't develop damage in their small intestine. Completely avoiding gluten can ease symptoms of celiac disease and gluten sensitivity. You may need additional treatment for intestinal damage.

Inflammatory Bowel Disease

Sometimes, a person's immune system mistakes food and other substances in the digestive tract for dangerous germs. It acts against healthy tissue by mistake. This causes inflammatory bowel disease (IBD). IBD includes several disorders that trigger chronic inflammation in the digestive tract. The small and large intestines become irritated and swollen, causing severe belly pain, diarrhea, and rectal bleeding, as well as symptoms that seem unrelated, such as fatigue, joint pain, and fever. Symptoms may ease up and then return during a flare.

The most common IBDs are ulcerative colitis and Crohn's disease. Ulcerative colitis affects the large intestine. Crohn's disease affects anywhere along the digestive tract. Blood tests, tissue or stool samples, X-rays, and CT scans help doctors diagnose IBD. So does endoscopy. That involves checking the inside of the intestines with a scope that has a specialized camera.

Treatment may include medication, surgery, and lifestyle changes, including taking steps to avoid stress. IBD is not the same as IBS, or irritable bowel syndrome. Some symptoms are similar, but IBS does not cause damage in the digestive tract from inflammation.

Colon Cancer Screening

A gastroenterologist can look for signs of certain diseases, such as colon cancer, even if you don't have symptoms. For a colonoscopy, for instance, the doctor will insert a thin tube with a tiny camera into the rectum to see the inside of the colon. Also, imaging scans and stool samples can help diagnose cancer.

Colon cancer usually develops from abnormal growths on the colon or rectum. Finding these growths early lets doctors remove them before they have a chance to become cancerous. Early detection and diagnosis of cancer saves lives. By the age of 50, all people should start getting regular screenings for colon cancer.

Vitamin D May Help Ease Irritable Bowel Syndrome

Source: https://www.healthline.com/health-news/vitamin-d-may-ease-ibs

Vitamin D May Help Ease Irritable Bowel Syndrome

Researchers say they’ve noticed a vitamin D deficiency in many people with IBS. Increasing the level of the vitamin could reduce symptoms.

It’s the most common disease diagnosed by gastroenterologists and it affects approximately 10 to 15 percent of the adult population in the United States.

But there is no known cause and no cure for those suffering from irritable bowel syndrome (IBS).

Treatment for the condition is focused on alleviating symptoms such as abdominal pain, constipation, bloating, and diarrhea.

Now, researchers from the University of Sheffield in England have found a new way to possibly manage IBS — vitamin D supplements.

The inspiration for the study came simply from speaking with a patient with IBS.

“The vitamin D/IBS link wasn’t spotted by medics or scientists. It came from patients,” Bernard Corfe, PhD, lead author of the study and principal investigator in molecular gastroenterology at the University of Sheffield, told Healthline.

“Vitamin D is an important factor in multiple diseases and areas of health, including musculoskeletal, immune, mental health, and other gut health conditions, including colorectal cancer and IBD (irritable bowel disease),” he added. “The latter two suggested to us that there might be a plausible role for vitamin D in other colon conditions.”

What the study uncovered

Corfe and his team reviewed and integrated all research available on vitamin D and IBS, and also assessed the potential benefits of vitamin D supplements for those with IBS symptoms.

They found a high prevalence of vitamin D deficiency in IBS patients around the world.

“This study looked at all research reported throughout the world and found the deficiency was consistent irrespective of latitude or geography,” Corfe said.

It is unclear why those with IBS seem to have vitamin D deficiency. One theory is that diet plays a role. Another is that the impact of IBS on a person’s daily habits may prevent them from getting enough vitamin D.

“It’s unclear which is the chicken and which is the egg,” Dr. Jeffrey Baumgardner, an assistant professor of medicine in gastroenterology at the University of California, San Francisco (UCSF), told Healthline.

“Certain behaviors in IBS… that you’re not feeling well so you don’t go outside as much, would lead to people having vitamin D deficiency based on the consequences of the disease,” he said.

A disease that affects many

Although only 5 to 7 percent of the estimated 10 to 15 percent of adults living with IBS have been formally diagnosed, it is estimated in the United States there are between 2.4 and 3.5 million physician visits for IBS annually.

About 40 percent of patients who report having IBS are male, while about 60 percent are female.

For those living with the condition, the impact goes far beyond physical discomfort.

“It can lead to people being fearful of leaving the home, unable to go to work, and a significant use of the medical system. The difficult part of IBS is there is no good test to officially diagnose IBS… so often people are stuck being told it’s all in their head and there’s nothing wrong,” Baumgardner said.

Checking patients for vitamin D deficiency is becoming a common practice for gastroenterologists. It only requires a simple blood test.

Dr. Arnold Wald, a professor of gastroenterology at the University of Wisconsin, is one of many who regularly request tests of patients’ vitamin D levels.

“I do check vitamin D deficiency in many of my GI patients and I’m often rewarded by finding it,” he told Healthline. “It’s very inexpensive to order and very inexpensive to treat.”

Vitamin D solution

Wald argues that the link between IBS and vitamin D calls for further exploration and may become a regular test requested by physicians.

“It’s so easy to detect, it’s so easy to treat that you might be remiss in not thinking about vitamin D deficiency in almost any patient you see, particularly those with GI symptoms,” he said.

“It makes a lot of sense from a public health standpoint, as long as we don’t overdo the treatment and call people vitamin D deficient who may simply have marginally low levels. If we do that, we’re just making expensive urine,” Wald added.

Corfe and his colleagues concluded that the large majority of patients with IBS were likely to benefit from vitamin D supplements.

“Even if the vitamin D doesn’t benefit the IBS, there are multiple health reasons to maintain good levels of vitamin D,” he said.

Vitamin D also promotes bone health, immune function, general well-being, mental health, and gut health.

Baumgardner says patients with IBS should be cautiously optimistic about vitamin D supplements.

“If I were someone with IBS, I would want this to be the easy, simple silver bullet because vitamin D is cheap and has a low side-effect protocol. So, it could be useful,” he said.

However, he says, it is important people understand that as everyone’s symptoms of IBS vary, so too will their response to possible treatments.

“There is nothing that is 100 percent effective because everyone’s symptoms are somewhat different, so not everyone is going to respond to the same thing,” he noted.

“It will help people, but it won’t help everybody. If you are someone with IBS, I think you should talk to your doctor about vitamin D, but don’t be discouraged if it won’t work,” Baumgardner said.