What are hemorrhoids?
Hemorrhoids are a natural part of everyone’s body. They are vascular cushions located in the rectal opening and anus that can enlarge over time and cause irritation and bleeding.
Hemorrhoids can be internal or external:
- Internal hemorrhoids form in the lining of the anus and lower rectum.
- External hemorrhoids lie beneath the skin near the opening of the anus.
What causes hemorrhoids?
Hemorrhoids occur following too much pressure on the veins around the anus. This can be caused by:
- Straining during bowel movements
- Sitting on the toilet for long periods of time
- Chronic constipation or diarrhea
- A low-fiber diet
- Weakening of the supporting tissues in your anus and rectum, which can happen with aging and pregnancy
- Frequently lifting heavy objects
- Anal intercourse
Who is at risk for hemorrhoids?
Your risk of hemorrhoids increases with ageing because the tissues that support the veins in your rectum and anus can weaken and stretch over time. This can also happen when you’re pregnant given that the baby’s weight puts pressure on the anal region.
What are the symptoms of hemorrhoids?
Symptoms depend on whether your hemorrhoids are internal or external.
Internal hemorrhoids can be associated with:
- Rectal bleeding that can manifest as bright red blood in your stool, on toilet paper or in the toilet bowl following a bowel movement
- Prolapse, or hemorrhoid that has fallen through your anal opening. Prolapsed hemorrhoids can cause pain and discomfort.
External hemorrhoids can be associated with:
- Anal itching
- Hard, tender lumps near your anus
- Anal pain, especially when sitting
How are hemorrhoids diagnosed?
To diagnose hemorrhoids, your health care providers might administer:
- A physical exam: Providers can often diagnose enlargement of the external hemorrhoids by looking at the area around your anus.
- A digital rectal exam to check for internal hemorrhoids. The provider will insert a lubricated, gloved finger into the rectum to feel for anything that is abnormal.
- Procedures such as an anoscopy (a small scope that is gently inserted to look at internal hemorrhoids)
How are hemorrhoids treated?
For many people, symptoms of external hemorrhoids go away within a few days.
At-home treatment can include:
- Eating foods that are high in fiber
- Taking a stool softener or a fiber supplement
- Drinking enough fluids
- Not straining during bowel movements
- Not sitting on the toilet for long periods of time
- Taking over-the-counter pain relievers
- Taking warm baths several times a day to help relieve pain
- Using over-the-counter hemorrhoid creams, ointments or suppositories to relieve mild pain, swelling and itching of external hemorrhoids
If at-home treatments aren’t working, hemorrhoids can be removed through a surgical procedure called hemorrhoidectomy.
What are the possible complications of hemorrhoids?
Complications of hemorrhoids are rare but can include:
- Strangulated hemorrhoid, or when the blood supply to an internal hemorrhoid is cut off, causing extreme pain
- Blood clot in a hemorrhoid, which can cause an extremely painful bulge near the anus.
- Hemorrhoids. (2019). https://www.mayoclinic.org/diseases-conditions/hemorrhoids/symptoms-causes/syc-20360268
- Hemorrhoids. (2016). https://medlineplus.gov/hemorrhoids.html