Hemorrhoids and Down’s Syndrome
Though hemorrhoids are generally considered a mild health problem, they can make a person’s life miserable.
That goes double for someone who has serious learning disabilities and can’t always communicate what’s wrong adequately.
Because people with Down’s Syndrome suffer so many health problems that affect their quality of life, they can often suffer hemorrhoids in silence as well.
If they can’t or won’t communicate their problem, how can their caregivers do anything about it? Because of this, caregivers must take the responsibility of screening for and treating hemorrhoids if and when they come up.
Prevention is always the easiest, but sometimes just not enough.
Hemorrhoids aka Hemroids aka Piles in those with Down’s Syndrome
There are a couple of different reasons why people with Down’s Syndrome are a bit more prone to hemorrhoids, hemroids, piles than others are.
One of the biggest causes is, of course, the problem with obesity that the people with Down’s Syndrome often suffer from.
It’s an ongoing mystery why people with Down’s Syndrome suffer obesity more often than people without.
Current research even indicates that it has nothing to do with diet.
As far as we know, obesity happens to those with this genetic disorder due to the combination of a variety of metabolic disorders and the bare fact that they often don’t get as tall or large as those without.
Children with Down’s Syndrome need to eat as much as any other child in order to get the right amount of nutrients, but they often don’t grow as much as other kids, especially in early childhood and adolescence.
They have to ingest too many calories in order to get the protein, vitamins and minerals they need to develop properly.
Then, when they can’t “grow” it off, obesity results.
Diabetes mellitus and thyroid dysfunction are two other problems that people with Down’s Syndrome are prone to that contribute to obesity.
One of the core causes of hemorrhoids is abdominal pressure, and too much weight for body size certainly doesn’t help with that.
Another cause that people with Down’s Syndrome may be prone to hemorrhoids is because of high blood pressure.
We already know that people with Down’s Syndrome have particular problems with elevated cholesterol which leads to atherosclerosis. Long before atherosclerosis leads to fatal diseases, it generally creates high blood pressure.
High blood pressure, of course, also contributes to hemorrhoids.
People with Down’s Syndrome also often have other problems with their circulation from one thing or another. Anytime blood doesn’t circulate properly, hemorrhoidal veins around the anal area are usually the first site of symptoms and warning.
When the walls of the hemorrhoidal veins get too much pressure on them, a weak spot will give, and a hemorrhoid results.
Many people with Down’s Syndrome have a rather sedentary lifestyle due to physical disability, that can cause hemorrhoids to develop.
Whether from hypotonia, thyroid problem related fatigue, or developmental problems, people with Down’s Syndrome often don’t participate in as much physical activity as they really should.
They often sit for hours on end, even when involved in social activities.
In addition, it can be difficult for people with Down’s Syndrome to remember that they should do scheduled exercises.
Even if they participate in their physical therapy, most PT exercises are meant to strengthen muscles, not get the aerobic benefit of an elevated heart rate.
In addition, many people with Down’s Syndrome have congenital heart problems that may limit or even preclude most beneficial forms of exercise.
Extensive periods of sitting or standing are known to lead to problems with hemorrhoids.
Of course, the poor diet that many with Down’s Syndrome have is another cause and doesn’t help in the least.
Children with learning disabilities are even harder to get eating decently than those without.
This has exactly nothing to do with intelligence level and everything with the different ways the brain can be wired.
I have a young relative who suffers from Asperger’s Syndrome, which is a form of higher functioning autism. The child’s IQ tests well up in the genius range.
When he was younger, he would only eat a certain fast food restaurant’s chicken nuggets. If you tried to switch chicken nuggets on him, he knew, even if presented in the “correct” packaging. Something about the particular texture appealed to the way his brain was wired.
With many children, if you let them get hungry enough, they’ll eat. This is not always true of children with learning disorders, such as those with Down’s Syndrome.
This relative of mine would not eat anything else, even when really, really hungry. He also screeched so loud he gave his father hearing damage. His doctor said to let him have the chicken nuggets and gradually introduce better food. Don’t make him eat it, just introduce it.
After a year of presenting various foods for him to get familiar with, he’s now eating much better.
It took a solid year of letting him look at, sniff, poke at and get used to these new things in order for him to even try one.
He now eats a grand total of ten foods carefully picked by his doctor to ensure a reasonably complete diet.
He doesn’t like change to a level and degree most people find maddening. So many people with learning problems are like this with their diet.
The upshot is that if someone with Down’s Syndrome happened to develop one of the learning disorders that creates this level of resistance to change, you need to talk to his or her doctor about diet.
This is one of the reasons diagnosis of learning disorders is so important.
If your child or loved one has one of the learning problems that contributes to a high level of change related anxiety, withholding food until they eat decently can actually be a problem.
They can get so stubborn they literally give themselves malnutrition.
Of course, some people also just want the junk food, whether they have Down’s Syndrome or not.
On the other hand, if the person you’re caring for does not suffer one of these, more normal diet tactics can be used.
No dessert until good food gets eaten is a popular and common one.
Reason for those who can comprehend is another.
Adults with Down’s Syndrome can often comprehend basic nutrition if it’s explained to them well.
Remember, each individual with Down’s Syndrome will react to the genetic disorder in a completely unique way and requires individual assessment.
Yet another contributing factor is the number of medications many people with Down’s Syndrome have to take in order to manage other health problems.
Oral medications have to pass through the gastrointestinal tract in order to work. When they do, they often irritate the lining of the stomach or intestines.
Constipation and diarrhea are two of the most common medication side effects in existence. The more medications someone takes, the higher the likelihood that constipation or diarrhea will develop, and both often contribute to hemorrhoids. In fact, if someone takes multiple medications, either constipation or diarrhea can be compounded.
Straining on the toilet is another cause of hemorrhoids in those with Down’s Syndrome
As if all of these weren’t enough to deal with, it can be rather difficult to convince someone with Down’s Syndrome to not strain continuously on the toilet if he or she feels the need to pass a bowel movement.
Many have a hard time understanding things like constipation or diarrhea, and getting the idea across to wait till later can cause a great deal of anxiety as the person fears embarrassment and tries to deal with discomfort.
The only solution to these problems is to create an environment where the person you’re caring for can express discomfort about anything freely.
Children often especially hate problems like constipation and diarrhea. They often don’t want to quit playing, and they also often fear the pain of having a bowel movement.
If hemorrhoids should occur, this anxiety and fear get even worse.
Only by creating a home atmosphere of comfort and trust will you get the important clues to a problem with hemorrhoids.
Ask questions often and in enough detail to get useful answers. Be especially careful to not get annoyed or appear judgmental if a problem does come up.
Symptoms of hemorrhoids in those with Down’s Syndrome
What are the things we, as caregivers, need to llok for that may suggest the existence of hemorrhoids in our kids with Down’s Syndrome – or our adults with Down’s Syndrome?
First, you can have have hemorrhoids and be symptom free, but generally, if hemorrhoids aren’t bothering the person, there probably not a concern.
The symptoms of hemorrhoids I would look for in those specifically with Down’s Syndrome would be:
Blood on underpants or in toilet bowl, grimaces in pain for no obvious reason, has trouble sitting still, easily agitated and quick tempered, complains of pain in bottom area, resists or fears going to toilet.
If you suspect hemorrhoids, always involve the persons doctor for proper diagnosis.
Treatment of hemorrhoids in those with Down’s Syndrome
If hemorrhoids should become a problem, then the course of treatment is basically the same as for anyone else.
Increase dietary fiber to the recommended 25 to 30 grams per day, and increase water consumption along with it.
Fresh fruits, vegetables, whole grain breads and beans are all sources of dietary fiber.
If you can’t get that much into the daily diet through food, you may consider fiber supplements made of flax hulls or psyllium seed, some of which now come in relatively tasty wafers.
In addition, develop an exercise plan that will work and can be performed on a regular basis.
If heart issues are at stake, work with the cardiologist in charge.
Remind your child or loved one to get up and walk around every two hours or so while at home.
Should those not work by themselves to solve the problem, there are a multitude of hemorrhoid treatments out there that may help. Some are herbal, some work through exterior means.
There are a ton of hemorrhoid creams on the market today to assist with external hemorrhoids, and some medications are available by mouth to help internally.
The upshot is that hemorrhoids are both preventable and treatable. No one should have to suffer the pain, discomfort and embarrassment of having them, and especially not in silence, whether they have Down’s Syndrome or not.
Research and Main write by Loni Ice, minor editing by Donald Urquhart