It’s unclear why our culture considers so many matters concerning our body’s natural processes to be taboo, but unfortunately this reluctance to have a dialogue about certain topics places some folks at risk. A friend recently told me a story about her grandmother’s plight to hide a hemorrhoid from her family. The grandmother was too embarrassed to talk about the condition. This led not only to a rather humorous story of her hiding various creams around the house, but also to a surgical procedure that could have easily been prevented had she spoken up earlier. It’s an embarrassing subject for most but even more so for older adults who are already struggling with the loss of their independence. We know for a fact that hemorrhoids are more common among older adults, but do we know why? Do we even know what they really are or how they come about?

Let’s set aside our discomfort for a moment and discuss this topic – and let’s make sure we fully understand what might happen to you as well as what might be happening to someone in your care.

What are hemorrhoids?

Hemorrhoids are just a fancy name for anal veins that become swollen or irritated and cause discomfort. There are internal and external hemorrhoids, and minor rectal bleeding and itching can occur with either. In some cases, the skin in the area can become irritated by the additional fluid of an external hemorrhoid and a rash can develop. One common symptom of an internal hemorrhoid that is protruding externally is the feeling of being full, experiencing the continual need for bowel movements, but not being able to have a bowel movement.

What causes them?

Numerous factors such as straining during a bowel movement, constipation, diarrhea, obesity, pregnancy, poor diet, and prolonged standing and/or sitting are just a few of the many causes of hemorrhoids.

Why are they more common in older adults?

Older adults experience hemorrhoids more than younger folks due to two opposing factors: persistent constipation and soilage/incontinence. Often a diet high in fiber in older adults is exchanged for a diet consisting of softer and easier to chew foods. This lack of fiber leads to constipation, which leads to strained bowel movements or use of laxatives – both of which can produce some very irritated veins. The second factor, incontinence, is typically due to the fact that the anal sphincter muscles weaken with age and often cause excessive leakage that irritates the anal veins.


The easiest way to prevent this uncomfortable condition is to increase the amount of fiber in your diet so that you don’t end up constipated. A diet high in fruits, vegetables, and whole grains is essential. If chewing hard foods is a problem, try steaming vegetables until tender before resorting to the blender or food processor. Fruits like apricots, kiwis, bananas, and berries are nice and soft as well as fibrous. Remember that fruits can be blended into a smoothie. Fiber supplements are also easy to use. There are chewable fiber tablets or you can purchase pysllium husks to add to smoothies or sprinkle in soups.

Drink water people! Get those eight glasses of water a day in your routine to keep things moving along as well as to keep you hydrated!

Avoid laxatives. Instead, try more natural solutions like prunes, prune juice, or stool softeners.


The key to finding the right treatment is to first know what kind of hemorrhoid you have – and that involves a visit to the doctor.

If symptoms are mild, a sitz bath multiple times a day and a donut pillow are recommended to relieve the pressure of sitting. There are also a number of over-the-counter treatments in the form of creams, astringents, wipes, suppositories, and protectants to help relieve pain and shrink external hemorrhoids.

If symptoms are more severe, a fixative procedure can be done where the blood flow is cut off from the hemorrhoid. It’s typically an outpatient procedure.

A hemorrhoidectomy is a surgical procedure performed on internal hemorrhoids when the pain and bleeding cannot be controlled by any other form of treatment.

Even though hemorrhoids are typically not life threatening, the condition can get worse if left untreated. Because symptoms mimic those of other more serious conditions, it’s always a good idea to visit your doctor for a checkup instead of self-diagnosing.

Information taken from

Carrie Robertson
Research & Community Education

Chicago Skilled Nursing
Chicago Senior Living