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Slideshow: What Are Hemorrhoids?

What Are Hemorrhoids?

You have clumps of veins in and around your anus and lower rectum that can stretch and swell with pressure. When these veins get swollen or bulge, they’re called hemorrhoids. They can be inside or just on the outside. They're usually not serious, but can sometimes hurt, itch, or bleed.

Hemorrhoid Symptoms

One of the most common signs of hemorrhoids is painless bleeding -- usually when you go to the bathroom. You might notice a little blood on the toilet paper or in the bowl. You may also have itching, pain, or tiny bulges around your anus. Because there can be many reasons for these symptoms, see your doctor as soon as you notice any of them. That way, you can rule out other problems.

What Causes Them?

We're not sure what exactly causes hemorrhoids. You could have them if you get constipated or have diarrhea often. Straining to lift heavy objects or to go to the bathroom might be to blame. You might be more likely to get them if you spend a lot of time on the toilet. Hemorrhoids are also more common as you get older and if you are overweight. If you're pregnant or your parents had them, you may get them, too.

How Are They Diagnosed?

Your doctor will ask you about bleeding, itching, or other symptoms. He will look at your bottom for hemorrhoids. He may also put a gloved finger inside to check for them there. To take a closer look, he may use a small tube called an anoscope. Your doctor may also suggest a flexible sigmoidoscopy or colonoscopy. These tests let your doctor look inside your colon and rectum with a lighted, flexible tube to rule out other causes for your symptoms.

Internal

Veins inside your rectum can grow large or swell. Even if they bleed, internal hemorrhoids usually don't hurt. Sometimes they can swell and stick out just outside your body. This is called a prolapsed hemorrhoid and can be painful or itchy. 

External

Hemorrhoids can form just underneath the skin near your anus. These can also itch and hurt. They might bleed. You might feel a lump if a blood clot forms inside one. That is called a thrombosis and it, too, can hurt. 

Prolapse and Thrombosis

When an internal hemorrhoid is pushed outside or "prolapses," it can bleed and be painful and itchy. When the swelling goes down, it may go back in on its own or you can gently nudge it back. If a blood clot forms in a hemorrhoid outside your body, it might get hard and sore. It can bleed if it breaks. The clot might go away and leave behind a little piece of skin -- called a skin tag -- that can bother you.

Food Can Help

What you eat can help prevent hemorrhoids or at least ease symptoms. Add high-fiber foods to soften your stool. Try to get more leafy vegetables, fresh fruits, beans, and whole-grain breads and cereals. Your doctor may also suggest a fiber supplement. Add it slowly because too much at once can cause gas or bloating. Drink lots of water to help prevent constipation and to make it easier to go to the bathroom.

Treatment at Home

Try nonprescription creams and wipes -- or even a small ice pack -- to ease pain and swelling. Soak in a bathtub filled with a few inches of warm water 2-3 times a day and then pat dry gently. There are also special "sitz baths" you can place directly in your toilet seat. Try a stool softener to make it easier to go.

MedicalTreatment

If at-home remedies don't work, your doctor can help. She may put special rubber bands or rings around internal hemorrhoids to cut off the blood supply until they shrink. This process is ligation. Another option uses heat to get rid of internal hemorrhoids, this is known as coagulation. Your doctor may also inject a chemical into the swollen tissue to break it down. This is called sclerotherapy.

Surgery

For very large hemorrhoids or those that just won't go away, you might need surgery. In the most basic type the swollen tissues are simply cut out. This surgery, called a hemorrhoidectomy, usually works but often has a long, painful recovery. A newer surgery is less painful with a faster recovery. It uses staples to hold hemorrhoids in place instead of removing them.

Anyone Can Get Them

Hemorrhoids aren't a rare, strange condition. Many people -- men and women alike -- have them. It's only when they swell and cause problems that you realize they're there. About half of people bleed, have pain, or other symptoms by the time they turn 50. Women may have them during pregnancy.

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Understanding Hemorrhoids -- Diagnosis and Treatment

Nutrition and Diet

Prevent constipation by following a high-fiber diet. Meals and snacks should consist primarily of vegetables, fruit, nuts, and whole grains. Limit processed foods and meats. If this is a big change for you, introduce the new foods slowly, to avoid gas.

If you aren't able to eat enough high-fiber food, supplement your diet with stool softeners or bulk-forming agents, such as fiber supplements. Avoid laxatives, which may cause diarrhea that can further irritate the swollen veins.

Drink at least seven to eight glasses of water each day; if your life is especially active or you live in a hot climate, you may need to drink more water. Check with your health care provider about your fluid needs if you have any medical problems or take medication.

Monitor your sodium intake. Excess salt in the diet causes fluid retention, which leads to swelling in the veins, including hemorrhoids.

Hemorrhoid Home Remedies

  • Try not to sit for hours at a time, but if you must, take breaks: Once every hour, get up and move around for at least five minutes. A soft cushion may make sitting more comfortable and ease hemorrhoid pressure and pain.
  • Insert petroleum jelly just inside the anus to make bowel movements less painful.
  • Dab witch hazel, a soothing anti-inflammatory agent, on irritated hemorrhoids to reduce pain and itching, or use over-the-counter anti-hemorrhoidal creams or ointments.
  • Resist the temptation to scratch hemorrhoids, as it makes everything worse: The inflamed veins become more irritated; the skin around them becomes damaged; and the itching itself intensifies. Instead, to help stop the itching, apply an over-the-counter 1% hydrocortisone cream to the skin (not inside the anus -- on the outside only) and a cold pack. Over-the-counter hemorrhoidal creams may relieve itching too.
  • If you need a pain reliever, try Tylenol. Avoid ibuprofen and aspirin, which foster bleeding.
  • Bathe regularly to keep the anal area clean, but be gentle: Excessive scrubbing, especially with soap, can intensify burning and irritation.
  • Don't force a bowel movement. Sit on the toilet for five minutes and if it doesn't happen, try again later. When wiping, be gentle. If toilet paper is irritating, try dampening it first, or use cotton balls or alcohol-free baby wipes. You may prefer washing yourself and then dabbing the area dry.
  • When performing any task that requires exertion, be sure to breathe evenly. It's common to hold your breath during exertion, and if you do, you're straining and contributing to hemorrhoid pain and bleeding.

 

Reviewed by Melinda Ratini, DO, MS on September 29, 2014

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This tool does not provide medical advice. See additional information: Disclaimer

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