6/15/2023

Hemorrhoids at different ages and stages of a person's life

Hemorrhoids are considered to be one of the most common anorectal diseases, so prevalent and oftentimes under-reported in fact that it has been estimated a rather worrying 50% of adults around the world, over the age of 50, will suffer from hemorrhoids at least once in their lifetime.[1]

It would, however, be a grave mistake to assume that the younger generations are somehow immune to this painful and possibly recurring condition. Since although hemorrhoids are more common during pregnancy and in the older population, they can also affect young adults.

Explore how hemorrhoids might affect different stages of our lifetime and their possible causes.

 

Hemorrhoids in young people

Hemorrhoids are a very common disease that can indeed happen at any stage of life, including as young adults and even teenagers. One of the culprits for hemorrhoids seems to be lifestyle and mental health which includes a lack of exercise, deficient diet, obesity, chronic constipation, a less than desirable water intake, chronic diarrhea, and stress and depression. However, there are also several new habits that seem to be negatively impacting the prevalence of hemorrhoids amongst the younger population such as using and being distracted by a smartphone while on the toilet which leads to extended periods of time sitting in the same position which can increase the pressure on the anal area.[2]

The most typical symptoms of hemorrhoids in young adults and teenagers are:

  • A burning sensation while defecating
  • Itching in and around the anus area
  • Pain in the anal area, and blood on the toilet paper or in the stools
  • Pain that lasts for more than 2 days[3]

Hemorrhoids in young adults and teenagers are therefore also common and can be easily prevented and treated with lifestyle changes, a healthy and balanced diet with an increased fiber intake, exercise, and with the help of venotonic medications that can efficiently and effectively manage hemorrhoid symptoms, treat their root cause, and even be used as a preventative to decrease the chances of hemorrhoids returning.

 

Hemorrhoids during pregnancy

Pregnancy and the time directly after birth are both very physically demanding stages in the lives of women.

It is widely known, due to added pressure exerted on the surrounding veins in the anal area by the growing uterus, that a high number of pregnant women will develop hemorrhoids. In fact, a recent study was carried out in Serbia and Montenegro, due to widespread concerns in relation to complications from untreated hemorrhoids, and they found that during the women’s second or third pregnancy the number of hemorrhoid cases rose to a staggering 85%.[4]

Two independent and major risk factors were identified and concluded as the likely causes for hemorrhoids developing during the late stages of pregnancy and childbirth. These include:

  • The direct combination of hormonal changes and elevated blood pressure – which can lead to the widening of the veins themselves.
  • Constipation – which is known to increase the likelihood of hemorrhoids occurring and, once present, can often make them worse and lead to flare-ups.[5]

 

Thankfully, more research and studies are being done, since the cases of dyschezia (difficulty with bowel movements) and general constipation during pregnancy, childbirth, and the weeks that follow are so high – reportedly affecting approximately half of pregnant women[6] – that this condition, together with a late or traumatic delivery (described as more than 20 minutes of severe straining during labor), have been highlighted as another 2 contributing aspects most responsible for the formation of hemorrhoids.[7]

As seen in the previously mentioned Serbian study, it has since been confidently noted that the likelihood of hemorrhoids forming “directly correlates with number of pregnancies and deliveries”,[8] with the same study stating that the demands of childbirth itself raises the risk of having hemorrhoids by nearly 8 times.

 

In this article we explore everything you need to know about hemorrhoids during pregnancy.

 

Hemorrhoids in older people

The elderly population is more susceptible to developing hemorrhoids, many suspect due to the overall weakening of the muscles, connected tissue, and even the rectal veins’ strength with the advancement of age, among other key issues. Indeed, while scientific studies have found that half of all those over the age of 50 will need hemorrhoid treatments, a further 10%-20% of those cases may even develop and worsen to the point of requiring surgery.1

Another main factor for the increased likelihood of hemorrhoids in old age is due to constipation which becomes a more recurrent problem as time goes by. Constipation causes people to strain with increased pressure on the veins that are located in the rectal area, causing those veins to enlarge and become swollen. [9]

It has been noted that diseases of the liver and kidneys are also connected, raising the likelihood of a person developing hemorrhoids, especially among the older generations.[10]

The common symptoms of hemorrhoids in older people include:

  • Bleeding during and after bowel movements
  • Itching and discomfort in the anal area
  • Pain and burning in the anus
  • Anal leakage
  • Swelling in the anal region

Treatment of hemorrhoids for those over the age of 50 differs little from the common treatment for hemorrhoids, except perhaps in some cases for an extra need of more gentle care. It includes the requirement:

  • To be active and to avoid sitting for long periods of time
  • Soaking in a sitz bath for 10 to 15 minutes in order to help with the pain and swelling of hemorrhoids
  • Maintaining a healthy diet and drinking plenty of water to stay hydrated
  • Visiting the doctor to ask the best course of treatments to avoid developing chronic hemorrhoidal disease

 

Three tips to prevent hemorrhoids

  1. Avoiding foods that are low in fiber which might increase dehydration, in order to prevent hemorrhoids at any age, maintaining a healthy and balanced diet and staying hydrated by drinking plenty of water are 2 of the best treatments. When it comes to avoiding constipation, fiber is a key element that can help us ensure efficient and easier bowel movements. [11]
  2. Acquiring good toilet habits. It is important to avoid sitting for too long on the toilet since it increases the pressure on the veins of the rectum area. Spending extended lengths of time browsing on our smartphones while on the toilet is a habit that should be avoided.
  3. Being active. A sedentary lifestyle is also one of the major risk factors for hemorrhoids.[12]

In conclusion, whether you are young or old, if you develop any of these uncomfortable and often painful symptoms it is of vital importance to act quickly and seek the advice of your doctor. This is due to the fact that, if left untreated, hemorrhoids can quickly worsen and lead to more serious conditions. Added to this, there is no need to suffer in silence, as there are plenty of treatments, such as oral venotonic medications, which alleviate painful symptoms, and can even be used as a preventative measure.

References

  1. Song SG, Kim SH. Optimal treatment of symptomatic hemorrhoids. J Korean Soc Coloproctol. 2011 Dec;27(6):277-81.
  2. The Relationship Between Hemorrhoids and Smartphone Use in the Lavatory; Clinical Trials; US National Library of Medicine
  3. Karavelioglu, A., Senayli, A. et al., Haemorrhoids in Children: A Retrospective Study; Journal of Contemporary Medicine
  4. Gojnic M, Dugalic V, Papic M, Vidaković S, Milićević S, Pervulov M. The significance of detailed examination of hemorrhoids during pregnancy. Clin Exp Obstet Gynecol. 2005;32(3):183-4.
  5. De Marco, S., Tiso, D. (2021) Lifestyle and Risk Factors in Hemorrhoidal Disease. Front. Surg., 18 August 2021. Sec. Visceral Surgery. https://www.frontiersin.org/articles/10.3389/fsurg.2021.729166/full
  6. Poskus T, Buzinskienė D, Drasutiene G, Samalavicius NE, Barkus A, Barisauskiene A, Tutkuviene J, Sakalauskaite I, Drasutis J, Jasulaitis A, Jakaitiene A. Haemorrhoids and anal fissures during pregnancy and after childbirth: a prospective cohort study. BJOG. 2014 Dec;121(13):1666-71.
  7. Abramowitz L, Sobhani I, Benifla JL, Vuagnat A, Daraï E, Mignon M, Madelenat P. Anal fissure and thrombosed external hemorrhoids before and after delivery. Dis Colon Rectum. 2002 May;45(5):650-5.
  8. Bužinskienė D, Sabonytė-Balšaitienė Ž, Poškus T. Perianal Diseases in Pregnancy and After Childbirth: Frequency, Risk Factors, Impact on Women's Quality of Life and Treatment Methods. Front Surg. 2022 Feb 18;9:788823.
  9. Johanson JF, Sonnenberg A. The prevalence of hemorrhoids and chronic constipation. An epidemiologic study. Gastroenterology. 1990 Feb;98(2):380-6.
  10. Yamamoto M, Ikeda M, Matsumoto T, Takemoto M, Sumimoto R, Kobayashi T, Ohdan H. Hemorrhoidectomy for elderly patients aged 75 years or more, before and after studies. Ann Med Surg (Lond). 2020 May 16;55:88-92.
  11. Alonso-Coello P, Mills E, Heels-Ansdell D, López-Yarto M, Zhou Q, Johanson JF, Guyatt G. Fiber for the treatment of hemorrhoids complications: a systematic review and meta-analysis. Am J Gastroenterol. 2006 Jan;101(1):181-8.
  12. Peery AF, Sandler RS, Galanko JA, Bresalier RS, Figueiredo JC, Ahnen DJ, Barry EL, Baron JA. Risk Factors for Hemorrhoids on Screening Colonoscopy. PLoS One. 2015 Sep 25;10(9):e0139100.

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