Should You Use A Stool Softener For Hemorrhoids?

Content

• Overview
• What is the connection between hemorrhoids and constipation?
• What is the difference between a stimulating laxative and a stool softener?
• What is the best laxative for hemorrhoids?
• What are the side effects of stool softeners?
• Are there any foods that can help soften your stool?
• What else can help with hemorrhoid symptoms?
• The lowdown

Hemorrhoids are painful and itchy inflammation of the small veins around the anus and rectum. They are often, but not always, associated with constipation. Because of this, many people do wonder if stool softeners can be helpful and, if so, what is the best kind of stool softener to take.

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Two of the main causes or aggravations for hemorrhoids are straining to pass feces and spending an extended time on the toilet. This means that both constipation and diarrhea can contribute to hemorrhoids.

While constipation does not directly “cause” hemorrhoids, it can result in additional straining to pass hard feces, which can both cause them and make them worse. Other causes of hemorrhoids include:

• Not eating enough fiber

• Weakening of the tissues around the anus and rectum due to pregnancy or aging

• Frequently lifting heavy objects.

If your hemorrhoids are related to chronic constipation then your doctor may advise you on steps to relieve it. This often means increasing the amount of fiber in your diet.

A stool softener is a specific kind of laxative. 

There are two kinds of laxatives; stool softeners and stimulating laxatives. Stimulating laxatives work by increasing bowel “energy,” and if you are not careful, they can result in diarrhea. As diarrhea can also aggravate hemorrhoids, you should be very careful when taking any laxatives and be sure to never exceed the recommended doses.

On the other hand, stool softeners work by pulling water into the bowel. This results in larger and softer stools that are easier to pass. Again, taking too much can cause your stool to become too liquid and result in diarrhea.

First, you should talk to your doctor before attempting to treat hemorrhoids at home, as they may advise a different treatment plan. However, establishing a good self-care routine can be extremely helpful if you have recurrent hemorrhoids.

Docusate is one laxative that can be taken. You should use the oral version and take it with plenty of water. Do not use a laxative enema containing docusate if you have hemorrhoids, as it can irritate them and worsen your symptoms.

Another recommended medication is sennosides. Some products contain both of these medications.

You may have to try more than one medication to find the one that works best for you.

Note that docusate has been determined to be safe during pregnancy and while breastfeeding. Pregnancy is a risk factor for hemorrhoids due to hormonal changes.

Many pregnant women benefit from taking a stool softener to reduce the annoyance of constipation and the risk of hemorrhoids.

Like all medications, stool softeners can have side effects. Typically this means stomach or intestinal cramps, and nausea. Some people also find that oral liquid stool softeners irritate their throats.

If you experience the following, it is an indication of a likely allergy, and you should call your doctor immediately:

Again, never take more of any laxative than is recommended. If you are taking it for several days and miss a dose, do not double up the dose. This will almost certainly result in diarrhea.

If you prefer not to take medication until necessary, altering your diet may help. The first rule is to drink plenty of water. Increased fluid intake means more fluid is available for your gut to use to soften the stool.

Increasing fiber should be the focus when deciding what to eat. You want soluble fiber, which includes legumes, fruits, and vegetables. Eating these foods helps make your stool softer and easier to pass. 

More exercise can also help because movement is good for bowel health.

Hemorrhoid symptoms are irritating, and while they often go away relatively quickly, they can come back. Some actions which can help with hemorrhoid symptoms include:

Taking a sitz bath

A sitz or hip bath¹ is a bath to soak the perineal area between the urethra and anus. If you get hemorrhoids regularly, it’s probably worth purchasing a commercially available sitz bath. These fit over a toilet seat and hold warm water in a bag.

You can also jury rig a sitz bath by filling a regular bathtub or a hot tub with two to three inches of warm water. Leave the bubblers or jets off.

After taking a bath, dry your perineal area with a blow dryer on a low warm setting. Avoid using a towel, as this will aggravate external hemorrhoids.

Using a cold/hot compress

Applying a cold or hot compress to the perineal area may relieve itching, pain, and other symptoms.

Medications

If your hemorrhoids are painful, you can take an over-the-counter pain reliever. Another over-the-counter medication you can take is hydrocortisone as a cream or ointment.

Your doctor may also prescribe a hydrocortisone cream (for external issues) or suppository (for internal issues). However, you should not use these creams if you are pregnant or breastfeeding, as they can potentially harm your baby. Talk to your doctor first.

Taking a stool softener can help ease the symptoms of hemorrhoids by making your stools easier to pass and reducing straining. They can also help prevent hemorrhoids by reducing chronic constipation. 

However, you should always take a stool softener as directed, as overdosing can cause diarrhea and make hemorrhoids worse. If you are not sure what kind of stool softener to take, you should talk to your doctor for further advice.

Best Laxatives for Hemorrhoids | Proctology Institute

April 23, 2017 by admin

Constipation is one of the leading symptoms of hemorrhoids. Laxatives help you deal with constipation because they help you achieve a more regular bowel movement, and prevent your hemorrhoids from worsening.

Unfortunately, laxatives are also habit-forming, and may create a dependency which can end up worsening your constipation instead of curing it.

A Word of Caution on Laxative Use

Laxatives force the stool to come out, and frequent consumption may cause the veins of the rectum and anus to bruise and swell, making them vulnerable to infection and inflammation. Regular use will make you a dependent, to a point that you may find it difficult to do your business without a laxative.

Therefore, you should only use laxative as a last resort, and only if you’ve already tried to make some lifestyle changes to relieve the constipation. Lifestyle changes such as loading up on fiber-rich food and drinking plenty of liquids usually clear up the problem. If these measures have failed, then that’s the time you can look at laxatives as your next recourse.

There are many types of laxatives, which is why you need to choose the right kind. Here are the most common laxatives used in the treatment of hemorrhoids:

Bulk-Forming laxatives

Bulk-forming laxatives absorb water into the stool. They form a softer and bulkier stool, which is easier to eliminate. They can either be natural (psyllium) or synthetic (methylcellulose).

Emollient laxatives

Also known as stool softeners, these laxatives work by increasing the moisture content of the stool in order to make it softer.

Stool softeners do not directly stimulate bowel movement, but they are used to prevent straining in the toilet, which is why they are highly recommended for hemorrhoids patients.

Stimulant laxatives

This type of laxatives makes the intestinal muscles contract in order to facilitate an easier bowel movement. However, frequent use of stimulant laxatives like senna can damage the lining of the intestines.

Rectal stimulants

Laxatives can be taken orally, or they can be inserted in the rectum. Suppositories and enemas are examples of rectal stimulants. They cause contractions within the colon lining to move the stool along.

Safest Laxatives

Bulk-forming laxatives and stool softeners are the safest to use and are the most effective in treating constipation. Avoid those that stimulate or simulate contractions, as this will only worsen your hemorrhoids.

If you’re taking laxatives and your hemorrhoids seem to have taken a turn for the worse, it is wise to consult a Los Angeles proctologist. Please visit us at the Institute to get the best treatment for your hemorrhoids today.

how to get rid of and causes of constipation in hemorrhoids

Hemorrhoids are a fairly common disease throughout the world. Out of 100 people,
every fourth can face it, and after 50 years – every second ¹ . In recent years, the prevalence of this disease has been growing. Its causes may be ² :

• physical inactivity;
• long sedentary work, including at the computer;
• prolonged driving;
• long standing work without movement;
• constipation, including during pregnancy;
• births.

What else do you need to know about hemorrhoids?

• This delicate problem can often be accompanied by constipation ³ .
• Together, these problems can increase pain, worsen symptoms, and increase the chance of bleeding ² .
• But even if there is no constipation, and the stool is hard, every trip to the toilet can cause discomfort. Therefore, the question “How to relieve pain with hemorrhoids?” may become more relevant than ever.

Why does hemorrhoid pain occur?

On the one hand, hemorrhoids themselves cause pain and discomfort. During a trip to the toilet, hard stools can damage enlarged veins and cause bleeding. Pain comes from injury of the nerve endings located on the veins of the rectum ⁴ by the solid contents of the intestine. Fear of worsening symptoms can cause a person to restrain urges, avoid bowel movements. This can lead to even more compaction of the stool, disruption of the biorhythms of the intestines and the appearance or increase of constipation. And this, in turn, increases the likelihood of pain, damage, cracking ⁴ .

On the other hand, with constipation, prolonged straining increases the pressure in the veins of the rectum, contributes to their stretching. The dense contents of the rectum can cause pain and bleeding. Thus, to reduce the pain of hemorrhoids, it is necessary to make the contents of the intestine softer so that it does not injure the veins, and going to the toilet is easy and comfortable.

Treatment of hemorrhoids

In addition to the generally accepted measures and drugs used in the treatment of hemorrhoids (for example, anti-inflammatory and analgesic suppositories), you can add a laxative ⁵ . Let’s see why.

Often hemorrhoids are accompanied by constipation, and then the use of a laxative is understandable. However, if the hemorrhoids are not constipated but the person has hard stools that make going to the toilet painful, the use of a laxative can soften the stool and thereby reduce discomfort ⁵ . Not all laxatives are suitable for softening the stool, but only those that form a physiological, soft and natural stool ⁵ . The optimal choice is Duphalac ^® due to its specific properties: mild action, favorable safety profile and the possibility of long-term use of the drug ^6.8 .

Due to its mechanism of action, Duphalac ^® attracts water to the intestines, thereby helping to soften the stool and gently cleanse the intestines ⁶ . Thus, Duphalac ^® helps to reduce pain when going to the toilet in people with hemorrhoids.

If hemorrhoids are accompanied by constipation, then Duphalac ^® will help to treat it and restore the natural rhythm of the intestines. The drug has a double effect. Working throughout the large intestine, Dufalac ^® gently and comfortably cleanses it, providing a laxative effect. Due to its prebiotic action, the drug restores a healthy balance of intestinal microflora ⁶ . Duphalac ^® has a long lasting effect in the normalization of stools ^6.7 .

Since hemorrhoids are basically a chronic disease and their treatment is long, the following characteristics are especially important for laxatives:

• long-term use;
• soft and comfortable action.

Duphalac ^® fulfills the above requirements and can therefore be a good helper for hemorrhoids, especially in their chronic form ^4-8 .

More information about the treatment of hemorrhoids and its prevention can be found in the articles:
“Hemorrhoids during pregnancy” and “Prevention of hemorrhoids”.

top 12 rating according to KP

Constipation (which is what doctors officially call constipation) indicates problems in the gastrointestinal tract. If the process becomes chronic, then this is already a serious cause for concern. Obviously: it’s time to see a doctor, because the problem cannot be solved by auxiliary drugs alone.

Treatment of chronic constipation should be complex. It is necessary to change the lifestyle – increase physical activity, reconsider the nature of nutrition, accustom yourself to the optimal water regime, and, of course, choose medications together with the doctor.

To combat constipation, a number of drugs are used that help soften the intestinal contents and increase its volume, increase peristalsis and facilitate the process of defecation. Our top 12 best laxatives for colon cleansing combines remedies with different mechanisms of action. The rating includes syrups, tablets, capsules and powders for oral solution preparation. The drugs in the rating are divided into groups according to the active substance.

Top 12 rating according to KP

Important! Any drugs and dietary supplements have side effects and contraindications. Our list is an overview and does not serve as a guide to action. Before using any drug, consult your doctor.

Lactulose products

Lactulose is a synthetic disaccharide that is not absorbed in the intestines but serves as food for the beneficial bacteria living there. These bacteria break down lactulose into lactic, formic and acetic acids, as a result, the contents of the intestine “acidify” and begin to attract water. This increases the osmotic pressure, the stool becomes softer, and the peristalsis of the colon increases ¹ . All this contributes to the gentle cleansing of the intestines.

But it is important to know that lactulose has a very low level of evidence.

Duphalac

Lactulose syrup at a dosage of 667 mg/ml is packaged in individual sachets. Each sachet contains 15 ml of the drug, in total there are 10 sachets in the package. But the manufacturer also offers other forms of release: bottles containing 200, 500 and 1000 ml of syrup. These packages come with a measuring cup.

The preparation is a viscous liquid which may be colorless, yellowish or yellow-brown. It has no smell, and the taste is slightly sweet due to the presence of sugars in the composition. “Duphalac” is indicated for use in constipation, hepatic encephalopathy and for softening stools for medical purposes. It is allowed to use during pregnancy and lactation, as well as in childhood.

Contraindications : galactosemia, galactose and fructose intolerance, individual hypersensitivity to the components, obstruction of the gastrointestinal tract, perforation of the digestive tract or the threat of its occurrence. A complete list of contraindications is in the instructions.

Pros and cons

suitable for children, pregnant and lactating women.

high price in the segment.

Portalac

Lactulose clear viscous syrup is supplied in 500 ml vials. The syrup has a neutral smell and a sweetish taste. The active ingredient lactulose is an osmotic laxative that increases the volume of fluid in the intestines, helps soften the stool and improve peristalsis. The drug is used in the treatment of chronic constipation, for the treatment and prevention of hepatic encephalopathy, and for diseases that require relief from defecation.

Contraindications : intestinal obstruction, hypersensitivity to lactulose, suspected appendicitis, acute inflammation in the abdominal cavity, rectal bleeding not associated with hemorrhoids, glucose-galactose malabsorption and others. Use during pregnancy and lactation is possible only with the permission of a doctor.

Pros and cons

reasonable price; large bottle.

extensive list of contraindications; in the reviews there are complaints about too sweet taste.

Lactulose

Lactulose syrup appears as a viscous, clear liquid that varies in color from colorless to yellowish brown. Sometimes crystals are visible in the liquid, which dissolve when heated. Release form – individual sachets, which contain 15 ml of syrup. The drug can be used for the prevention and treatment of hepatic encephalopathy, chronic constipation and other diseases and conditions in which defecation is difficult.

Among contraindications indicated intestinal obstruction, individual intolerance to lactulose, suspicion of appendicitis, acute inflammatory diseases of the abdominal cavity, intolerance to galactose and fructose, lactase deficiency and others. Use in pregnant and lactating women is allowed only after consulting a doctor.

Pros and cons

convenient packaging; you can take with you, reasonable price.

many contraindications; may not be available for sale.

Macrogol laxatives

Macrogol 4000 is an osmotic laxative that increases the water content of the intestinal lumen and thereby increases the volume and softens its contents. Macrogol is not absorbed into the blood and is excreted from the body unchanged. Due to this, macrogol preparations practically do not have side effects ² .

Like lactulose, macrogol has a very low level of evidence.

Forlax

Macrogol laxative is intended for adults and children over 8 years of age and appears as a white powder with a slight citrus scent. The characteristic aroma of the preparation is given by orange and grapefruit oil and concentrated orange juice. A solution for oral administration is prepared from the powder. “Forlax” is used for the symptomatic treatment of constipation, and it is allowed for pregnant and lactating women.

The list of contraindications for includes: individual intolerance to the components, total or partial intestinal obstruction or suspected obstruction, abdominal pain of unknown origin, toxic megacolon, Crohn’s disease and other serious inflammatory bowel diseases, perforation or risk of perforation of the gastrointestinal tract.

Pros and cons

pleasant smell; convenient packaging; availability in pharmacies.

tastes too sweet according to some users.

Lavacol

This drug is a white or off-white powder for oral solution. The composition includes macrogol and electrolytes, including sodium and potassium. Macrogol increases the volume of fluid in the intestines and facilitates defecation, while electrolytes maintain the composition of the blood plasma. The drug can be used for the symptomatic treatment of constipation and bowel cleansing before surgery and endoscopy.

Contraindications : general serious condition of the patient, individual sensitivity to the components, obstruction and obstruction of the gastrointestinal tract, malignant tumors of the colon, perforation of the gastrointestinal tract or the risk of its occurrence, toxic colitis or toxic megacolon and others. Pregnant and lactating women can use the drug after consulting a doctor.

Pros and cons

reasonable price; retail availability.

many contraindications.

Macrogol Lekas ​​

Macrogol laxative is a white powder that is used as an oral solution. The finished solution has a neutral smell and a sweetish taste. Indications for the use of the drug: symptomatic treatment of constipation and bowel cleansing before surgical and diagnostic interventions on the colon.

The contraindication list for includes idiosyncrasy, gastrointestinal obstruction, severe heart failure, dehydration, gastric ulcers, tumors or other conditions involving the colonic mucosa, inflammatory bowel disease, and toxic megacolon associated with spastic stenosis. The entire list of contraindications is indicated in the instructions. Use during pregnancy and lactation – only with the permission of a doctor.

Pros and cons

inexpensive drug; convenient packaging.

many contraindications.

Laxatives with hay and sodium picosulfate

These drugs have a stimulating effect on the colonic mucosa, increase the amount of water and electrolytes in the intestinal lumen. Due to this, peristalsis is activated and the discharge of feces from the lower gastrointestinal tract is accelerated ³ . Please note that these drugs are not suitable for long-term use.

Picosulfate has moderate evidence and senna has low evidence.

Guttalax

Sodium picosulfate is available as oral drops. A 30 ml vial contains a clear, colorless or slightly yellowish viscous liquid. The drug is dosed in drops that can be mixed with water or taken in pure form.

“Guttalax” is intended for the treatment of constipation of various origins, including against the background of intestinal atony and hypotension, dysbacteriosis, after taking medications. It can be used for diseases of the gallbladder and irritable bowel syndrome, which are accompanied by constipation.

Contraindications : obstructive bowel disease, intestinal obstruction, intolerance to drug components, severe dehydration, abdominal pain with nausea and vomiting, acute inflammatory bowel disease and others.

Pros and cons

handy dispenser; economical consumption.

a large list of contraindications and possible side effects.

Senade

Herbal laxative contains dry extract of senna leaves. The active substance is able to irritate the receptors of the large intestine and thereby enhance its peristalsis. Tablets are recommended for constipation associated with atony and weak intestinal motility, as well as for regulating stool in certain diseases: hemorrhoids, proctitis, anal fissures.

Suitable for adults and children over 6 years of age, use with caution during pregnancy and lactation.

Contraindications : spastic constipation, abdominal pain of unknown origin, intestinal obstruction, peritonitis, strangulated hernia, cystitis, gastrointestinal and uterine bleeding, hypersensitivity to components, water and electrolyte imbalance.

Pros and cons

inexpensive drug; herbal ingredients.

long-term use may cause flatulence and abdominal pain.

Regulax Picosulfate

As the name implies, the drops contain sodium picosulfate, a laxative that has a stimulating effect on the colonic mucosa and causes the accumulation of water and electrolytes in it.

The drug facilitates defecation and is used to treat constipation associated with medication, intestinal atony and hypotension, and some diseases: diseases of the gallbladder and biliary tract, irritable bowel syndrome.

Contraindications : acute inflammatory bowel disease, severe dehydration, acute abdominal disease or severe abdominal pain, intestinal obstruction, intolerance to components and fructose.

Pros and cons

neutral odor and taste; convenient dosing.

waste packaging.

Laxatives with psyllium

Psyllium is the seed coat of psyllium ovata or Plantago ovata. This shell consists of almost 80% soluble fiber, which, when it enters the intestines, attracts moisture, swells and acquires the consistency of a gel. Due to this, the volume of intestinal contents increases, and it freely leaves the body in a natural way. In addition, psyllium serves as food for beneficial intestinal microflora and helps to avoid dysbacteriosis ⁴ .

Drink plenty of water while taking psyllium medications. It is worth noting that psyllium has a low level of evidence.

Phytomucil Norm

This dietary supplement contains 2 active ingredients – psyllium husk and plum fruit pulp. Soluble psyllium fiber helps form soft stools and aids in bowel cleansing. Homemade plum fruits contain insoluble dietary fiber – they stimulate the mucous membrane of the colon and improve its peristalsis.

BAA is produced in the form of granules, which are packaged in individual sachets of 5 g. The bioadditive is indicated for use as an additional source of fiber and flavonoids for constipation, irritable bowel syndrome with a predominance of constipation, hemorrhoids, rectal fissures.

Among contraindications are individual intolerance, acute inflammatory diseases and obstruction of the gastrointestinal tract, children under 3 years of age. The dietary supplement is approved for use in pregnant and lactating women.

Pros and cons

2 active ingredients in formulation; can be for children from 3 years old, women during pregnancy and lactation.

high price in the segment; small package size.

Psyllium

Dietary supplement in the form of capsules contains psyllium husk in the amount of 750 mg. The dietary supplement serves as a source of soluble and insoluble dietary fiber, which increases stool volume and stimulates intestinal contractility. Also, Psyllium can be an additional source of dietary fiber for people who suffer from constipation and follow a diet low in fiber.

Contraindications : individual intolerance, pregnancy and lactation, age under 18 years.

Pros and cons

high content of psyllium in 1 capsule.

small package.

Psyllium Husks Fiber

A dietary supplement from a popular brand is available in the form of capsules, each containing 500 mg of psyllium. The dietary supplement is intended to improve intestinal motility, as it helps to increase the volume of intestinal contents and make it softer. After entering the digestive tract, the dietary fibers of psyllium “swell” – the manufacturer reports that this allows you to create a feeling of satiety and reduce the number of absorbed calories.

BAA is not recommended to be taken during pregnancy and lactation, as well as in case of individual intolerance and under the age of 18 years.

Pros and cons

well-known manufacturer; big package.

is sometimes out of stock.

How to choose a laxative for colon cleansing

– Of course, anyone can choose a laxative for themselves – after all, prescriptions are not required for them. But it is better to entrust this to a specialist, – emphasizes gastroenterologist Liliya Sagdutdinova . – Only a doctor, taking into account his education and experience, can choose the most effective medicine for a particular patient from a number of good drugs.

If you dare to solve the problem yourself, it is very important to first study the list of contraindications indicated in the instructions. Ignoring this is fraught with serious consequences.

What if the laxative doesn’t help?

– For patients who do not respond well to laxatives, a prokinetic 5-HT4 agonist is recommended. In general, to avoid problems with constipation, you need to move more (at least walk – at least 60 minutes a day), drink more water (30 ml per 1 kg of body weight), and add foods consisting of insoluble dietary fiber to the diet – for example, wheat bran, our expert adds.

Photo: market.yandex.ru, KP

Sources:

1. Clinical aspects of the use of lactulose in the practice of a gastroenterologist.