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More than half of people over 50 have experienced hemorrhoids, according to the National Institutes of Health and other medical sources.
To help patients and providers navigate this common issue, the American Gastroenterological Association (AGA) recently released updated clinical practice guidelines in the journal Clinical Gastroenterology and Hepatology.
The update focuses on a simple approach, emphasizing lifestyle modifications over quick-fix products.
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Hemorrhoids are swollen, enlarged veins that develop both internally and externally. According to the Cleveland Clinic, they can range from a minor annoyance to a source of significant pain and rectal bleeding.
Experts estimate that one in 20 Americans have hemorrhoids that irritate them. They become more common with age.
They are also particularly common during pregnancy due to increased pelvic pressure, though these cases can usually be managed with conservative symptom care.
One takeaway from the AGA update is that a promising treatment for hemorrhoids is often found in the pantry rather than the pharmacy. The experts labeled increased fiber intake as a “reasonable first-line therapy.”
By softening the stool and increasing its bulk, fiber reduces the need for straining, a culprit behind hemorrhoid flare-ups.
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Most Americans are nowhere near the recommended daily fiber intake.
The USDA Dietary Guidelines recommend 22 to 28 grams for women and 28 to 45 grams for men, but data suggest that 90% of women and 97% of men fall short.
The AGA highlighted that restroom habits are also a contributing factor.
In an era where many people take their smartphones into the bathroom, prolonged sitting and straining can lead to increased pressure. The updated guidelines recommend avoiding long sessions that exacerbate symptoms.
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People may reach for sitz baths or topical creams at the first sign of discomfort, but the AGA says there is limited data to support their long-term effectiveness.
The guidelines also warn against the overuse of topical steroids. While they can reduce inflammation, using them for more than two weeks can cause the skin to thin and become more irritated.
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While lifestyle changes are important, the AGA emphasizes that a proper diagnosis is vital. Because rectal bleeding can sometimes be a symptom of more serious conditions, a physical exam is recommended before beginning any treatment plan.
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For persistent or severe cases, patients may need office-based procedures or surgical intervention.
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