I have been diagnosed with hemorrhoids. I know what causes them, but my question is: how can I prevent them?--Itchy painful crack

Dear Itchy painful crack,

Hemorrhoids are enlarged veins in the lower rectum and anus. Sometimes hemorrhoids occur outside the anus and can be seen, while at other times they can occur inside the rectum and are invisible to the naked eye.

There are many lifestyle changes that you can make to prevent hemorrhoids. As constipation is a frequent cause of rectal problems, a diet high in fiber may help. Fiber adds bulk and moisture to the stool, and it speeds movement through the intestinal t ract. Foods that are rich in fiber include whole grain breads and cereals, beans, fresh or lightly cooked fruits and vegetables, brown rice and other grains, nuts and seeds. If you cannot fit these foods into your diet, you can add bran (available in most grocery stores) to your food. Try avoiding highly refined foods like cream of wheat, white rice, white bread, pastries, cakes, pies, and macaroni products. If you have not been eating a high fiber diet, be sure to increase your dietary fiber slowly. Sudd en increases in fiber may cause diarrhea, bloating, intestinal gas, or other discomfort. You also need to drink 2 quarts of fluid each day. Alcohol should also be avoided as it can contribute to small, dry stools.

In addition to diet, hemorrhoids can be prevented by not straining or sitting on the toilet for long periods of time. Straining, putting off the urge to go, and using laxatives or enemas may aggravate symptoms. Many people think that they must have a b owel movement every day. Daily bowel movements are not necessary. In fact, bowel movements may occur from once a week up to several times a day, and still be normal. It is best to go when you feel the urge. Holding the stool in the bowel causes it to beco me hard, dry, and difficult to eliminate.

Regular exercise may help. If you are obese, talk to your physician about developing strategies to lose weight, as this may also contribute to your hemorrhoids. And finally, avoid heavy lifting because it puts pressure on the anal opening and may contr ibute to hemorrhoid formation. Keep in touch with your doctor about the progression of your hemorrhoids, better and worse. You should be able to work out some lifestyle changes that will work for you and eliminate this problem.

Alice

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