Hemorrhoids

What Are Hemorrhoids?

Hemorrhoids are swollen veins in the lowest part of your rectum and anus. Sometimes the walls of these blood vessels stretch so thin that the veins bulge and get irritated, especially when you poop.

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Swollen hemorrhoids are also called piles.

hemorrhoids

Hemorrhoids are one of the most common causes of rectal bleeding. They're rarely dangerous, but you should see your doctor to make sure you don’t have a more serious condition. Hemorrhoids often go away on their own, but treatments can also help.

Symptoms of Hemorrhoids

Internal hemorrhoids

Internal hemorrhoids are far enough inside your rectum that you can't usually see or feel them. They don't generally hurt because you have few pain-sensing nerves there. Symptoms of internal hemorrhoids include:

  • Blood on your poop, on toilet paper after you wipe, or in the toilet bowl
  • Tissue that bulges outside your anal opening (prolapse). This may hurt, often when you poop. You might be able to see prolapsed hemorrhoids as moist bumps that are pinker than the surrounding area. These usually go back inside on their own. Even if they don't, they can often be gently pushed back into place.

External hemorrhoids

External hemorrhoids are under the skin around your anus, where there are many more pain-sensing nerves. Symptoms of external hemorrhoids include:

A blood clot can turn a hemorrhoid purple or blue. This is called a thrombosis. It can hurt, itch, and bleed. When the clot dissolves, you may have a bit of skin left over, which could get irritated.

What Causes Hemorrhoids

You may be more likely to get hemorrhoids if other family members, like your parents, had them.

Pressure building up in your lower rectum can affect blood flow and make the veins there swell. That may happen from:

  • Pushing during bowel movements
  • Straining when you do something that's physically hard, like lifting something heavy
  • Extra weight, like obesity
  • Pregnancy, when your growing uterus presses on your veins
  • A diet low in fiber
  • Anal sex

People who stand or sit for long stretches of time are at greater risk, too.

You may get them when you have constipation or diarrhea that doesn't clear up. Coughing, sneezing, and vomiting could make them worse.

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Hemorrhoids Diagnosis

Your doctor will ask about your medical history and symptoms. They will probably need to do one or both of these examinations:

  • Physical exam. Your doctor will look at your anus and rectum to check for lumps, swelling, irritation, or other problems.
  • Digital rectal exam. Your doctor will put on gloves, apply lubrication, and insert a finger into your rectum to check muscle tone and feel for tenderness, lumps, or other problems.

To diagnose internal hemorrhoids or rule out other conditions, you might need a more thorough test, including:

  • Anoscopy. Your doctor uses a short plastic tube called an anoscope to look into your anal canal.
  • Sigmoidoscopy. Your doctor looks into your lower colon with a flexible lighted tube called a sigmoidoscope. They can also use the tube to take a bit of tissue for tests.
  • Colonoscopy. Your doctor looks at all of your large intestine with a long, flexible tube called a colonoscope. They can also take tissue samples or treat other problems they find.

Hemorrhoids Treatment

Hemorrhoid symptoms usually go away on their own. Your doctor’s treatment plan will depend on how bad your symptoms are.

Home remedies. Simple lifestyle changes can often relieve mild hemorrhoid symptoms within 2 to 7 days. Add fiber to your diet with over-the counter supplements and foods like fruit, vegetables, and grains. Try not to strain during bowel movements; drinking more water can make it easier to go. Warm sitz baths for 20 minutes several times a day can also make you feel better. Ice packs can ease pain and swelling.

Nonsurgical treatments. Over-the-counter creams and other medications relieve pain, swelling, and itching. Check with your doctor if you still have symptoms after a week of using these.

Surgical treatments. If you have large hemorrhoids, or if other treatments haven’t helped, you might need surgery. Your doctor can use chemicals, lasers, infrared light, or tiny rubber bands to get rid of them. If they’re especially large or keep coming back, your doctor might need to permanently remove them with a sharp tool called a scalpel.

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Hemorrhoids Prevention

To prevent hemorrhoid flare-ups, take steps including:

  • Eat fiber. It helps food pass through your system easier. A good way to get it is from plant foods: vegetables, fruits, whole grains, nuts, seeds, beans, and legumes.
  • Drink water. It will help you avoid hard stools and constipation, so you strain less during bowel movements. Fruits and vegetables, which have fiber, also have water in them.
  • Exercise. Physical activity, like walking a half-hour every day, keeps your blood and your bowels moving.
  • Don't wait to go. Use the toilet as soon as you feel the urge.
  • Don’t strain during a bowel movement or sit on the toilet for long periods. This puts more pressure on your veins.
  • Maintain a healthy weight.

 

WebMD Medical Reference Reviewed by Jennifer Robinson, MD on October 28, 2019

Sources

SOURCES:

FamilyDoctor.org: "Hemorrhoids Overview"; "Hemorrhoids Treatment"; "Hemorrhoids Causes & Risk Factors"; and "Hemorrhoidectomy for Thrombosed External Hemorrhoids."

National Digestive Diseases Information Clearinghouse: "Hemorrhoids."

Sneider, E. Surgical Clinics of North America, February 2010.

Harvard Health Publications: " Hemorrhoids and what to do about them."

National Institute of Diabetes and Digestive and Kidney Diseases: “Hemorrhoids.”

Mayo Clinic: “Hemorrhoids.”

Johns Hopkins Medicine: “Hemorrhoids.”

Cleveland Clinic: “Hemorrhoids.”

American Society of Colon and Rectal Surgeons: “Hemorrhoids.”

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