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:
A rash or hives
Difficulty breathing or swallowing
Extreme vomiting or stomach pain.
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:
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.
Applying a cold or hot compress to the perineal area may relieve itching, pain, and other symptoms.
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.
Sitz baths | Michigan Medicine
Hemorrhoids in pregnancy (2008)
Eating, diet, & nutrition for constipation | National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)