Hemorrhoids are inflamed veins around the anus and lower rectum. Hemorrhoids normally aid in the process of bowel movement. In fact everyone has hemorrhoids but many do not have symptoms or signs from them. They are cushion-like bundle of tissues composed of vasculature and smooth muscle (Burkitt HG, Quick CRG and Reed JB, 2007).
According to anatomy, the rectum normally extends from the terminal sigmoid colon and to the anus. This epithelia is normally lined by columnar epithelial mucosa. This is innervated by the sympathetic and parasympathetic system and is relatively insensate. The hypogastric system is responsible for the vascular and lymphatic systems.
The anal canal, which is approximately 4 cm in length, extends from the anal verge to its junction with the rectum close to the proximal aspect of the levator-sphincteric complex.
Unlike the rectum, the anus is lined by anoderm, which is a modified and sensitive squamous epithelium richly innervated with somatic sensory nerves, and supplied by the inferior hemorrhoidal system. The manor anatomic reference point when considering management of hemorrhoids is the dentate line.
There are a number of causes of this condition especially those that increase pressure within the hemorrhoidal veins. These include:
- Straining during defecation
- Chronic constipation
- Chronic liver disease
- Senile causes
Do Hemorrhoids go away on their own
- Do Hemorrhoids go away on their own
- How long do Hemorrhoids last? What Factors will determine the Duration?
- External & Internal Hemorrhoids
- How long they last During Pregnancy & After Birth
- How long does Bleeding, Itching & Pain last?
- Without treatment and with Treatments like Preparation h?
- How to make hemorrhoids go away fast in 2 Steps
One of the most frequently asked questions regarding this condition is if they go away on their own. Unfortunately, they don’t.
Hemorrhoids, more especially the external types, will only stat to vanish or fade away after treatment. This is mostly done by cutting open the hemorrhoid and thereafter applying some treatments that quicken the healing process.
How long do Hemorrhoids last? What Factors will determine the Duration?
The time it takes to get hemorrhoids to heal is not clearly elucidated. This means that it may take longer or shorter than the ideal duration of time depending on the factors that influence healing.
There are some who may feel better in 7 days while others may have one lasting to as long as 6 months. Many people have reported feeling much better in the nigh of 2 weeks.
There are a number of factors that determine how long hemorrhoids last. Obviously, the more complicated a type is, then the more complicated it becomes for your body or a mediation to treat it. The factors are detailed as follows.
Type of hemorrhoid
There are two types of hemorrhoids including the internal and external hemorrhoids. The internal hemorrhoids are basically cushions of fibrovascular tissue. This tissue is found to the proximal area of the dentate line while the external hemorrhoids lie distal to it.
Some of the external hemorrhoids reside inside the anal verge. The cushions spoken of hereof are composed of submucosa in the area of the anal canal hence forming a discontinuous layer of thickened tissue. The cushions are then supplied by the superior hemorrhoidal artery and the branches of the middle hemorrhoidal arteries.
The inferior hemorrhoidal artery is also involved in supplying the cushions. The venous drainage is charged on the superior, middle and the inferior hemorrhoidal vessels. This kind of drainage therefore creates a communication between the portal and systemic circulation.
The reason hemorrhoidal bleeding is arterial in nature rather than venous is due to the direct communication of the arteriovenous within the cushions.
It therefore will dawn on you that depending on the type, the time will vary.
Number of times you have had it
Is it the first time you are getting hemorrhoids? If not, then how many times have you had it? While this may be debatable, it has been discovered that people who have had hemorrhoids for the first time have a high chance of healing faster.
Those who have it in higher frequencies may have to suffer for weeks before they can recover. This means that damage occurring on the vasculature and the cushions through which the hemorrhoidal arteries pass. Summative damage results in slow healing making it take longer.
Size of the hemorrhoids
If your hemorrhoids are small, then it may require less time for it to go away. It will also mean that you will need relatively less aggressive treatment options. Probably and most preferably, non-pharmacological treatment options.
In other words, those that do not require drug regimen. You will therefore require to pursue interventions such as lifestyle and dietary changes. When they are large, they may protrude or protract out through the anus resulting in prolapsed hemorrhoids. This will take longer to treat and heal and may be even require hospitalization.
These are diseases or conditions that are existent alongside you having hemorrhoids. Without making it too complicated, consider pregnancy as a dis-ease state of the body and therefore a disease condition. There are many cases of hemorrhoids during pregnancy due to an increase in the pressure in the abdominal region. According to Abramowitz L and Batallan A (2003), the estimated prevalence in this crop of people is 25% to 35%
This mostly occurs in the last three months or third trimester. At this stage of pregnancy, the veins and the rectum and the anal region have grown larger and so are the arteries. As this material mentioned before, hemorrhoids are arterial in nature.
However, increase in pressure in the veins may build it too in the arteries and cause bleeding. Another factor that could lead to increased time of healing in pregnancy is the fact that there are anti-hemorrhoidal drugs that are contraindicated in pregnancy. Treatment is mainly symptomatic and increasing fibre content, water intake, administering laxatives and proper toilet habits would suffice though it may take longer.
There are other diseases that are linked to slow would healing and these could influence the rate at which hemorrhoids heal such as: diabetes mellitus, vascular disease, low human growth hormone, Cushing’s syndrome, liver failure, rheumatoid arthritis, zinc deficiency among others.
The type of treatment intervention matters. Hemorrhoids may take up to 4 weeks or even more when you institute infrared coagulation. If you opt for Hemorrhoidectomy, it may take more weeks to heal.
Ligation is the most popular type of non-invasive treatment as it provides a shorter healing time of about 7 to 10 days. In line with non-pharmacological interventions, it may take longer than 4 weeks and even longer if you decide not to initiate any treatment.
How you take care of it
While you are on treatment, there are ways in which you could handle your hemorrhoids so as to prevent expanding. Get some of these tips in the last section of this material, “How to make hemorrhoids go away fast”.
External & Internal Hemorrhoids
External hemorrhoids which usually thrombose are associated with hemorrhoid-associated pain. Hence, hemorrhoids associated with pain should trigger a differential diagnosis with options such as anal fissures, solitary rectal syndrome and pelvic floor dysfunctions such as pelvic dyssynergia, proctalgia fugax and internal sphincter spasm.
It may take thrombosed external hemorrhoids about 3 months or so to heal. Thrombosed vasculature has clots in the lumen and this presents a complication and thus more time.
While it may take about of slightly more than 7 weeks if it has not thrombosed, it lasts a bit longer before you can actually feel significantly better. There are factors such as seating too long on a hard surface of a concurrent constipation that would make it last longer and this is due to its expanding in such times.
People who have had external hemorrhoids mention focusing on non-pharmacological interventions and desisting from surgical ones. If a slightly moistened toilet paper is use and constipation prevented by fortifying your diet with fibre and lots of water, you may see it last a couple of weeks.
Majority of symptoms associated with hemorrhoids are linked to internal hemorrhoids with bleeding as the most common presenting symptoms. This is caused by a prolapse of the tissue through the canal, subsequent traumatizing and friability. Internal hemorrhoids have an origin in the proximal to the dentate line and are covered by insensate mucosa hence typically not painful. They also rarely thrombose.
Internal hemorrhoids may take about 7 days to heal but in case of enlargement and prolapsing of the hemorrhoid, longer time is required to heal. In such a case, it may take about 2 months.
How long they last During Pregnancy & After Birth
The hemorrhoids you get after child birth is known as post-partum hemorrhoids. There are a number of reasons that could make you get them including the type of child birth: there are various types inclusive of spontaneous vaginal delivery (SVD) and caesarian section (C-section).
SVD requires that you exert some amount of pressure on the pelvis which in turn leads to an appreciable amount of pressure on the pelvic veins and the inferior vena cava. This pressure eventually leads to occlusion of flow of blood increasing blood pressure on the veins below the uterus. Hemorrhoidal arteries are therefore affected and may rupture.
C-section involves non exertion of pressure but the drugs that are administered to you in the process may lead to hemorrhoids. A significant connection is that of morphine, a drug used to provide analgesia during the operation and its side effect of constipation.
Remember that constipation is a potential cause of hemorrhoids. Other reasons include the growing uterus exerting some pressure on the pelvic veins and lead to hemorrhoids and the ability of progesterone, a hormone that sustains the endometrium during pregnancy, to cause constipation. This is essentially due to the reduction of motility of the gastrointestinal tract.
Hemorrhoids therefore last differentially depending on the cause but it is important to note that institution of necessary interventions reduces the time significantly. There are cases of time lasting 2 weeks or as far as 6 months.
Pregnancy hemorrhoids- how long do they last?
Pregnancy hemorrhoids are due to the exertion of the fetal and uteral mass on the pelvis. When the pelvic veins are under this duress, it may lead to increased blood pressure in the hemorrhoidal arteries. This hemorrhoids start off in the last trimester and are likely to stop after you have given birth, perhaps 2 weeks with appropriate aftercare or as long as months if you don’t.
How long does Bleeding, Itching & Pain last?
Bleeding, itching and pain are symptoms that occur with both internal and external hemorrhoids. According to the National Institute of Diabetes and Digestive and Kidney Diseases, the symptoms are meant to clear up in a few days to a week or two.
This is depending of course on the treatment or care you offer them. However, the symptoms accompanying prolapse of the hemorrhoids may take longer to clear up. Sequentially, this could be demonstrated as:
Bleeding would expectedly be controlled first and hence, on treatment, will stop in the first 3 days. However, this may be transient as bowel movements, uncontrolled constipation or sitting too long could lead to re-rupture and a repeat of the cycle.
Itching occurs when the wounds are healing. It is a normal part of a healing process when a plug/clot is being deposited on the wounds. This would last longer perhaps to the last day.
Pain after Banding
Hemorrhoids are painful and taking analgesics will helps suppress the pain mediators. However, pain is expected to have alleviated when the wounds are completely healed. This may take longer. As long as 2-4 weeks.
How long does pain last after hemorrhoid banding?
Rubber band ligation for hemorrhoids is one of the best methods of treating hemorrhoids. According to WebMD, pain is at its peak during the first 24 or 48 hours after the surgery. It may last 7 – 10 days but when pain is suppressed, it isn’t quite a bother.
Flare ups last?
There is not absolute period of how long flare-ups last. They may take a couple of weeks to recede.
Without treatment and with Treatments like Preparation h?
You need to use treatment options whether conservative or pharmacological. Hemorrhoids would stay longer or even not go away when not treated.
How long do hemorrhoids last with preparation h?
Preparation H is phenylephrine hemorrhoidal gel that may contain vitamin E. it is a good option for inflamed or bulging hemorrhoids. It constricts the blood vessels and offers temporary relief of symptoms in 5-7 days.
How to make hemorrhoids go away fast in 2 Steps
Step# 1: Non-Pharmacologic management
Some conservative interventions can be used in the management of hemorrhoids.
Diet: One of this is the intake of daily fiber intake. In such as condition, the dietary daily fiber content should to be increased to > 25 g/day with or without fiber supplements. Fiber supplements are a first-line of therapy of hemorrhoids. These include: Metamucil, Citrucel Fiber Con, and Benefiber. Fiber supplementation can help reduce the severity of hemorrhoids by about a mean of 50 % in patients with Grade Ι-ΙΙΙ hemorrhoids
Fluids should be taken in larger quantities to minimize the time taken in the toilet in terms of evacuation time. Care should also be taken so as to visit the toiled as soon as one feels the urge. Such interventions help in the reduction of constipation and straining that would otherwise worsen the hemorrhoids.
Bathing in warm water. This provides a soothing effect on the anal and alleviates the discomfort initially felt.
Hemorrhoidal banding: indicated despite adequate fiber supplementation and if the hemorrhoids are only internal. It involves placing the internal hemorrhoid within the barrel of an instrument, which then places a rubber band over the hemorrhoid. The rubber band strangulates the hemorrhoidal tissue that then sloughs in 48-72 hours, leaving a raw surface which gradually heals.
This method is only for internal hemorrhoids and these usually lack 3 pain fibers. The procedure is usually well tolerated. Banding however does not remove all the hemorrhoids as in surgery and the success rates vary between 65% and 85%.
Those who are candidates of surgery are those that fail to show positive response to bulking agents and banding. This is however followed by complications such as bleeding, blood clot, pain and rarely, an infection.
Hemorrhoidectomy – this is a conventional surgical procedure that involves the removal of external and internal hemorrhoids. This is normally done under a local anesthetic especially if you present with severe pain in the perianal area. This is usually a sign of thrombosed external hemorrhoid. Fortunately, it removes all the internal and external hemorrhoids.
Stapled hemorrhoidopexy – this involves reposition of the hemorrhoids by excision and stapling of the lining of the lower rectum. At this time, the blood supply to the hemorrhoids is cut short as the staples are fixed to the end of the rectum above the anal canal. This procedure however does not remove all the outside hemorrhoids and has been lined to anorectal ‘facelift’.
Step #2: Pharmacologic treatment options
There are various drugs that are indicated to relieve and manage the hemorrhoids including:
- Venotonic agents such as diosmin. Diosmin is a flavonoid that is administered as an injection at the hemorrhoidal site. It has shown to provide improvement to the outcome of conservative treatment.
- Local anesthetics – includes Lidocaine 5%, cinchocaine/dibucaine hydrochloride 0.5%, pramocaine hydrochloride
- Steroids – these includes hydrocortisone acetate 0.5%, 0.25% or 1% depending on the preparation, fluocortolone caproate 0.095%, fluocortolone pivalate 0.092%. The steroid reduces the inflammation that is present in hemorrhoidal disease.
- Astringents – these are able to shrink or constrict body tissues such as calamine lotion and witch hazel. Zinc oxide is one astringent used in most preparations.
- Antiseptics – there are ointments with benzyl benzoate
- Bulking agents – these agents include kaolin and Ispaghula husk.
- Stool softening and milk of magnesia
 Burkitt HG, Quick CRG, Reed JB. Anal and perianal disorders. In: Essential Surgery-Problems, Diagnosis and Management. 4th edition, Hunter L, Hewat C, Swan R (Eds.), Churchill Livingstone Elsevier: China, 2007
 Epidemiology of anal lesions (fissure and thrombosed external hemorrhoid) during pregnancy and post-partum]. Abramowitz L, Batallan A; Gynecol Obstet Fertil. 2003 Jun; 31(6):546-9.