An illustration of a peach meant to symbolize hemorrhoid pain

Rectal problems can be uncomfortable to talk about—even with a doctor. As a result, people often don’t get help, and they suffer needlessly.

Some evidence also suggests that these problems become more common with time. “The muscles and ligaments of the pelvic floor and rectum may weaken with age,” says Elena Ivanina, D.O., a gastroenterologist at Lenox Hill Hospital in New York. By age 50, about half of Americans have noticeable hemorrhoids, for instance.

Fortunately, common rectal problems are treatable. Here’s what you need to know about how to prevent—and treat—these conditions at home and when to see your doctor.

Hemorrhoids

Often arising after constipation or diarrhea, hemorrhoids develop when the veins inside the rectum or around the outside of the anus become swollen. Though they can be painful, some people don’t know they have them until they notice blood in or around their stool or on toilet tissue. (If you have rectal bleeding, see your doctor; it can also indicate colorectal cancer.)

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Most hemorrhoids will go away on their own within a few weeks or less. In the meantime, “avoid straining or sitting on the toilet for too long,” Ivanina says. And consider an over-the-counter (OTC) stool softener, such as docusate (Colace), to make bowel movements easier, as well as warm baths and pain relievers such as ibuprofen to relieve short-term pain.

Talk to your doctor before using an OTC steroid cream, such as Preparation H, because long-term use may affect blood pressure. In serious cases, hemorrhoids can prolapse or protrude; a gastroenterologist or colorectal surgeon can perform an office procedure that provides relief.

Constipation

“It’s a misconception that you need to have a bowel movement every day. Many healthy people do not,” says Arnold Wald, M.D., a gastroenterologist at the University of Wisconsin School of Medicine and Public Health.

But if constipation—fewer than three bowel movements a week, the feeling that you can’t fully empty your bowels, or having lumpy or hard stools—is making you uncomfortable, a few simple steps can help get things moving.

Exercise promotes normal bowel function, according to Wald, and increasing your intake of fluids and fiber (aim for 25 grams or more per day) can help make stools easier to pass. Try eating more high-fiber foods, such as fruits, vegetables, and whole grains.

OTC laxatives can provide relief for some, Wald says. First, try polyethylene glycol (MiraLax and generic), an osmotic laxative. Stimulant laxatives, such as Ex-Lax, tend to cause more side effects and shouldn't be used long term. Side effects can include bloating, cramping, and diarrhea.

Talk to your doctor if you need laxatives regularly or if constipation persists after exercise and dietary changes. Many medications—including antacids, diuretics, opioids, and some depression meds—can worsen constipation. The fix could be as simple as substituting a different drug.

Fecal Incontinence

An estimated 5.5 million Americans experience fecal incontinence, according to the American College of Gastroenterology. The problem is more common in elderly adults and in postmenopausal women who gave birth vaginally.

A gastroenterologist can help address the symptoms. He or she may order a test called an anorectal manometry to test pelvic floor, rectal, and anal sphincter function.

Treatment typically involves exercises or biofeedback to retrain and strengthen the muscles of the pelvic floor and rectum. Avoiding greasy foods and foods that give you gas may help to control leakages, too.

Anal Itching

Common skin conditions such as psoriasis can affect the area around the anus and cause itching, as can fungal infections, pinworm, yeast infections, and, rarely, skin or anal cancers, Wald says. Poor bathroom hygiene (not wiping well) can also contribute.

Avoid using medicated or scented wipes, which can further irritate the skin, and be sure to keep the area clean and dry. If itching persists, see your doctor for an evaluation.

Editor’s Note: This article also appeared in the June 2019 issue of Consumer Reports On Health.