Hemorrhoids?!
Hemorrhoids. Ugh. They are not fun, uncomfortable… and can truly interfere with the joys of the holiday season. If you struggle with hemorrhoids it may be that the pelvic floor is working against you and not with you. Lets take a look at what hemorrhoids are, how addressing the pelvic floor can be part of the solution, and how to help if you do have a flare up!
What are hemorrhoids??
Hemorrhoids are small swollen veins around the area of the anus or rectum. Hemorrhoids can be internal or external. You may experience itching, pain, a sense of swelling or pressure and/or bleeding.
What causes hemorrhoids?
Straining during bowel movements
Constipation
Pregnancy
Surgeries
Overactive pelvic floor muscles
Labor & Delivery
What does the pelvic floor have to do with it?
The pelvic floor muscles have a role in our ability to poop (& pee but that is for another day). I often find during an evaluation, people are bearing down into a their pelvic floor instead of learning how to relax the pelvic floor and make space for the poop to release. If we are bearing down into the pelvic floor or trying to force the poop to get out, we are often putting a lot of stress on an overly stressed muscle group and the veins that are intwined within the muscle. Let’s not forget the pelvic floor is a group of muscles and does any muscle or vein like to be overworked? Nope!
What are some strategies to avoid a flare up?
Proper toilet set up.
Ever heard of the squatty potty?? Look they even have a travel version!
The general set up is your knees should be above your hips, forearms resting on legs, letting go of tension in the belly.
Remember it is a restroom for a reason. Give your body the space to rest and relax. Try giving yourself 5mins of just relaxing on the toilet. If it doesn’t happen in 5mins. Walk away and try again 15 or so minutes after your next meal, hot drink, or when you get an urge (play some music, dim the lights).
Bowels LOVE consistency. Try to set up a schedule that works for your day.
Relax your digestive system and nervous system. Try this video!
I am using a coregeous ball in this video.
Diet and water intake are important as well. Here are general considerations:
Consider your fiber intake (25-35grams per day). Trying to get it in a variety of ways (fruits, vegetables, supplements). I personally like psyllium husk.
Consider your hydration.
1/2 of your body weight in ounces is a good place to start.
Consider all your electrolytes (potassium, magnesium, calcium, sodium). I’ll dive into this on another blog.
What are some strategies to manage the discomfort if I have a flare up?
Avoid straining with pooping, or picking up anything heavy. (Exhale as you lift).
Instead of wiping after a poop, consider using a peri bottle to clean.
I often find that simple tweaks can help a tremendous amount. I always recommend conservative care first (aka working with a pelvic health therapist) but understand there are other options available as well such as rubber band ligation, injections, surgery, or coagulation using a laser. These are options you should discuss with your provider.
Sending you warm wishes of great and satisfying poops… hemorrhoid free!
In health,
Dr. Emma Lengerich PT, DPT, OCS, CMTPT, Birth Doula
