Person sitting on cactus

Many people may be in disbelief to learn that everyone has hemorrhoids. Hemorrhoids play a vital role in the function of the sphincter muscles. The blood vessels that make up hemorrhoids are a universal feature of the anal and rectal regions. However, according to Johns Hopkins, hemorrhoids can become problematic and present at least half of the population with unpleasant symptoms by 50. The good news is that preventative measures can reduce the risk of good hemorrhoids going bad.

What are Hemorrhoids

Hemorrhoids are a cushion of blood vessels in the anal canal that act as a seal when a bowel movement isn't occurring. Dr. Timothy Adams, a colorectal and general surgeon at General Physician, cites two hemorrhoid myths. 

Myth #1:

Only people with symptoms are patients with hemorrhoids. "Everyone has hemorrhoids. We're born with them, and we die with them. Even patients who undergo surgery to have them 'removed'," he says, "we're not removing them. - we're shrinking them." 

Myth #2:

Hemorrhoids are only there to be problematic. They're not; they help with your bowel function. They're why you don't poop your pants when you sneeze or cough. The problem arises when the hemorrhoids become symptomatic.

What types of Hemorrhoids are there?

There are two types of hemorrhoids, external and internal. External hemorrhoids occur in and around the anal canal, and internal hemorrhoids happen in the rectum. External hemorrhoids will often present with  symptoms including pain, itchiness, inflammation, and bleeding. Internal hemorrhoids typically lay dormant and do not present with symptoms.

There are a few factors that lead to symptomatic hemorrhoids. Dr. Adams explains, "It's all about gravity and pressure." Sitting on the toilet for long periods is a common cause for men. The pressure from a bowel movement and the lack of support from the cut-out seat is a combination that leads to bad hemorrhoids. For women, pregnancy and childbirth are the leading causes of painful hemorrhoids. 

Bowel movement avoidance is also another issue. Dr. Adams says that many of his patients are teachers and truck drivers. Because they cannot always leave their work when they need to relieve themselves, holding  in a BM leads to harder stools. Dr. Adams explains, "The longer the stool sits inside your rectum waiting for you to relieve it, the longer your body will evacuate water from the stool." Hard stools require more pressure to evacuate and irritate the anal canal.

Types of Treatments

The good news is that you can treat most hemorrhoids effectively at home. Dr. Adams says, "90% of the time, you can correct them by changing your dietary or physical habits." He emphasizes the "Big Three":  hydration, fiber, and exercise. 

  • Hydration helps soften your stools and lubricate your digestive tract. 
  • Fiber is excellent for colon health. 
  • Regular exercise helps with colon physiology producing better function and allowing for a better bowel movement. Dr. Adams suggests 20 minutes of activity (e.g., walking) three times a week.

Dr. Adams explains, "If you increase your fiber, but you aren't drinking more water, you will promote more irritation, leading you right back down the same road." Speak with your doctor about changes that are right for you based on your diet, exercise routine, and hydration levels.

Of course, these changes take time to heal the pathologic hemorrhoids. In the meantime, Dr. Adams states that you can use hydrocortisone and thorough cleaning to reduce irritation. He says, "Stool in and of itself is an irritant. If you cannot clean your anal area appropriately, then that stool starts to aggravate the hemorrhoids more." Dr. Adams recommends using a bidet (if you have access to one) or a warm sitz bath to clean yourself after a bowel movement. 

And though precious few have access to a bidet in the US, almost no one has the time to take a sitz bath after every BM. So wet wipes are a great substitute, and he recommends avoiding sitting on the toilet for long periods, too. 

When Surgical Treatment is Needed

Some symptomatic hemorrhoids require surgical intervention. However, surgery won't rid you of hemorrhoids; it's essential to maintain a healthy lifestyle and adhere to Dr. Adams' Big Three.

The most common surgical method used for internal hemorrhoids is ligation. The physician uses tools to place rubber bands around the hemorrhoids, reducing the blood flow in a controlled way that avoids strangulation and reduces the hemorrhoids' size. Other methods that work the same way are sclerotherapy and infrared treatment. However, these treatments are for internal hemorrhoids only.

If the doctor observes that external hemorrhoids are causing most of the symptoms, they will perform a hemorrhoidectomy. During the procedure, the surgeon physically removes the symptomatic hemorrhoids.  Surgery is a last resort for the most severe cases. 

Simple and practical lifestyle changes can restore hemorrhoids to good health. Remember, everyone has hemorrhoids. They help keep our anal canal healthy and functional. However, if your good hemorrhoids go bad, colorectal surgeons like Dr. Timothy Adams are standing by to help treat unpleasant symptoms. For more information or to make an appointment with Dr. Timothy Adams call 716-636-9004. Or Click Here for office locations and more information. 

Preventive health care is a multifaceted approach to a healthy lifestyle that incorporates various strategies to reduce risk for illness and disease. Screenings are a vital component of preventive care, even for yoaung men. Regardless of how fit a young man is or how healthy he feels, these screenings should be part of health care regimens for all men between the ages of 18 and 39.

  • Blood pressure: The U.S. Department of Health and Human Services (USDOH) and the National Institutes of Health (NIH) urge men between the ages of 18 and 39 to have their blood pressure checked at least once every two years. Many men already have their blood pressure checked during annual wellness visits, which all men should schedule regardless of their fitness levels and overall health. Men with preexisting conditions, including diabetes, heart disease, and kidney problems, may need more frequent blood pressure screenings. In addition, annual screenings are recommended if the top number is between 120 and 139 and/or the lower number is between 80 and 89.
  • Cholesterol: Men with no known risk factors for coronary heart disease are urged to get annual cholesterol screenings beginning at age 35. Men with known risk factors should begin receiving annual screenings at age 20. More frequent screenings might be necessary for individuals with diabetes, kidney problems, or heart disease.

  • Diabetes: Risk factors and warning signs will dictate if men between the ages of 18 and 39 require diabetes screening. For example, the U.S. National Library of Medicine (USNLM) notes that a BMI over 25 is considered overweight, which is a risk factor for diabetes. Men who fall into this category should be screened for diabetes starting at age 35. (The USNLM urges Asian American men to be screened if their BMI exceeds 23). Providers also may test men’s blood sugar levels if their blood pressure is 120/80 or higher and/or if they have a first degree relative with diabetes or a history of heart disease.

  • Infectious disease: The USNLM urges all individuals, including healthy young men, to be tested for hep C, an infectious disease caused by the HCV virus that primarily affects the liver, at least once between the ages of 18 and 79. Doctors also may recommend additional screenings for sexually active young men, who may be tested for syphilis, chlamydia, HIV, and other infections.

  • Testicular cancer: The National Cancer Institute reports that testicular cancer is the most commonly diagnosed cancer in men between the ages of 15 and 34. The USNLM advises against testicular self-exams, so young men should discuss testicular cancer screenings with their physicians, especially if they notice any changes in the size or shape of their testicles.

  • Dental checkup: Men are encouraged to visit the dentist twice a year for an exam and cleaning. Dentists can determine if more frequent visits are necessary.

Preventive health care is vital for everyone, including men between the ages of 18 and 39. 

Man giving thumbs up

There’s a lot of discussion about certain cancer screenings, like mammograms, colonoscopies and skin checks (as there should be). But what about screening for lung cancer, which is the leading cause of cancer death in the U.S.?  

To find out more about lung cancer screening, we sat down with Dr. Yaron Perry, a thoracic surgeon with Great Lakes Cancer Care Collaborative, Division Chief of Thoracic Surgery at the University at Buffalo, and Medical Director of Comprehensive Center for Thoracic Malignancies and the Co-Director of Robotic Surgery.


Q: Who should be screened for lung cancer?

A: First and foremost, long-time smokers. If You are between the ages of 50-80 years old and you’ve smoked for 20 or more pack years, most insurance companies will cover lung cancer screening because it’s so important to have done. A pack-year is smoking an average of one pack of cigarettes per day for one year. For example, a person could have a 20 pack-year history by smoking one pack a day for 20 years or two packs a day for 10 years.

Next would be kids and spouses of smokers who have lived in the home with second-hand smoke for 20 or more years. Their risk of developing cancer is almost as high as if they were smoking themselves. We’ll get into more on that in a minute. 

The third group of people for whom lung cancer screening is important would be those who have been exposed to cancer-causing materials in the workplace, like asbestos, silica dust, and diesel engine exhaust. 

Currently there is no Insurance coverage for lung cancer screening for those exposed to second-hand smoke and workplace risk factors varies, but many plans consider both groups high-risk and may offer coverage. Check with your insurance provider before scheduling a screening appointment. 


Q: I’m a smoker, but I feel fine. Can’t I just wait and see my doctor if I start to feel sick?

A: No. The best way to cure lung cancer is to find it early. But the time symptoms appear, it’s really too late. People who fall into the high-risk categories I mentioned really need to be pro-active about lung screening to give themselves the best chance at a long, healthy life. 


Q: What are the risks to people who live with smokers?

A: Second-hand smoke is almost as dangerous as smoking yourself. In fact, in parts of China, most women don’t smoke but their husbands do—and the rates of lung cancer are relatively high in Asian women mainly because of the second-hand exposure inside the home. Spouses, children, and even pets of smokers are at risk of developing infections and cancers of the airways and lungs from the cigarette smoke they inhale inside of the house. 


Q: What about e-cigarettes and marijuana—are they risk factors for lung cancer?

A: The short answer is we’re not sure yet, but probably. The American Cancer Society considers both to be uncertain or unproven risks for lung cancer. But if you think about what’s happening when people use e-cigarettes or smoke pot, they’re still putting things into their lungs that aren’t supposed to be there. 

The THC itself in marijuana may not be harmful, but it’s still plant matter that’s being burned and inhaled like a cigarette. The technology behind vaping creates a vapor that carries a finer particulate than smoke, which allows the substances to be inhaled deeper into parts of the lungs that are even more delicate and susceptible to harm. 

We’ll know more in 10 to 20 years when researchers can look at the data and determine the long-term effects of these habits. I don’t consider either of them safe, especially because both are marketed toward young people. Starting unhealthy habits earlier just increases the risk of long-term damage and disease. 


Q: How do doctors screen for lung cancer?

A: We use a technology called low-dose computed tomography, or a low-dose CT scan. It’s a non-invasive imaging procedure with less radiation than a routine chest x-ray 20 years ago. During the scan, the patient lies on a table while a machine captures images of the lung tissue, which we’ll examine for areas of concern. The procedure only takes a few minutes and is totally painless. 


Q: Where can I schedule an appointment for a lung cancer screening?

A: Patients can call the Great Lakes Cancer Care Collaborative Call Center at (716) 884-3000. My colleagues and I represent a lot of different cancer care specialties from screening to treatment, and we all work together to provide patients with the most collaborative and effective cancer care in Western New York.