Hemorrhoids (also known as penyakit buasir in Malay) are swollen veins in your lower rectum and anus, forming a round or oval lump. There are two types of hemorrhoids, ones that develop inside the rectum (internal hemorrhoids), or under the skin around the anus (external hemorrhoids). Occasionally, the walls of these swollen veins stretch so thin they bulge and get irritated, especially during passing motion which causes pain and bleeding. It is a fairly common disease as nearly three out of four adults will have hemorrhoids, especially between the ages of 45 and 65. They often go away on their own, but in cases if they do not, effective treatment options are available. Most people will achieve relief with lifestyle changes and home remedies, while some may require medications (ubat buasir) or surgical procedures. The choice of treatment is based on the size, location of hemorrhoids, and the severity of your symptoms.
Often the mild symptoms of hemorrhoids can be relieved by practicing some simple lifestyle changes and home remedies. High-fiber foods such as fruits, vegetables, and whole grains should be a staple food in your diet as they soften your stool and increases its bulk, which helps you avoid straining during passing motion which worsens the symptoms of hemorrhoids. Drink seven to eight glasses of water every day, or if you are very active or living in a hot climate, you may need more. Regular soaking of your anal area in about 3 inches of plain warm water or sitz bath for about 10 to 15 minutes, two to three times a day especially after passing motion, helps to relieve pain, itching, reduce swelling in the area, and relax muscles around the anus. Pat gently to dry after the warm bath, or you can use a blow dryer on a cool setting if it feels better, make sure not to scrub or scratch the area. You can also try applying a cold pack on the tender area of hemorrhoid for a few minutes to numb it and reduce the swelling. Choose to wear loose, soft cotton underwear to keep the area aired out so that it does not aggravate the hemorrhoids. Sit on a pillow or cushion instead of a hard surface to ease swelling and prevent new hemorrhoids from forming, and get up every hour to move around for at least 5 minutes if you must sit for a long time.
With these remedies, hemorrhoids usually go away within a week or so. If they do not go away or you develop severe pain or bleeding, make sure to see a doctor. The best medicine that your doctor might suggest is over-the-counter topical treatment such as hemorrhoid cream or suppository containing 1% hydrocortisone to be applied over the hemorrhoid area, used together with wipes or ointments with witch hazel or a numbing agent, such as lidocaine, to soothe the pain and itch. However, make sure not to use any topical treatment with hydrocortisone for more than a week unless directed by your doctor, as it can thin your skin. Consider taking oral pain relievers, such as over-the-counter medications like acetaminophen, aspirin, or ibuprofen to temporarily help relieve your discomfort. You may also apply a little petroleum jelly just inside your anus before passing motion to make it hurt less. If you do not get enough fiber from food, your doctor may prescribe some fiber supplement or stool softener, however, do not take laxatives as they cause diarrhea which could irritate your hemorrhoid.
If your hemorrhoid does not get better with conservative treatments or even medications, your doctor may recommend doing some procedures to shrink or remove the hemorrhoids. Many of the procedures can be performed in the office, such as rubber band ligation, laser coagulation, or sclerotherapy injection. Some severe cases may need surgery such as hemorrhoid removal or hemorrhoid stapling. Your doctor will determine which of these procedures is the best option for you. Although medical treatments are effective, if you do not change your diet and lifestyle, hemorrhoids may return.