What are hemorrhoids?
Hemorrhoids are swollen veins located around the anus or in the lower rectum. About 50 percent of adults experience the symptoms of hemorrhoids by the age of 50 and many seek hemorrhoid treatment.
Hemorrhoids can either be internal or external. Internal hemorrhoids develop within the anus or rectum. External hemorrhoids develop outside of the anus. Hemorrhoids are also known as piles.
External hemorrhoids are the most common and most troublesome. Hemorrhoids may cause pain, severe itching, and difficulty sitting. Fortunately, they’re treatable.
What are the symptoms of hemorrhoids?
Symptoms depend on the type of hemorrhoids you have.
Internal hemorrhoids can cause:
- blood on the tissue after having a bowel movement
- skin that sticks out of the anus during bowel movements
External hemorrhoid symptoms include:
- extreme itching around the anus
- uncomfortable lump(s) or swelling near your anus
- aches or pain around the anus, especially when sitting
Hemorrhoids often don’t cause pain. However, sometimes external hemorrhoids can form a blood clot on the skin. This is known as a thrombosed hemorrhoid. Internal hemorrhoids can also prolapse. That means they won’t retract back into the anus. Both prolapsed and thrombosed hemorrhoids can cause significant pain.
Although hemorrhoids can be quite uncomfortable, they aren’t life threatening and often go away on their own without treatment.
If you ever have bleeding or black bowel movements, see your primary doctor or gastroenteroloogist. Bleeding can be caused by something other than hemorrhoids and must be evaluated. Also see your doctor if hemorrhoids don’t get better within 1 week of home treatment.
What are the causes and risk factors for hemorrhoids?
Hemorrhoids occur when there’s too much pressure on the veins around your anus. Possible causes and risk factors include:
- straining during a bowel movement
- sitting for a long period of time, especially on the toilet
- having chronic constipation or diarrhea
- having a family history of hemorrhoids
- engaging in consistent heavy lifting or other activities that strain your body
- having obesity
- having anal sexual intercourse, which can irritate hemorrhoids
- being pregnant (an enlarged uterus presses on the vein in the colon, causing it to bulge)
- being over the age of 50
How are hemorrhoids diagnosed?
A visual examination of your anus may be enough to diagnose hemorrhoids. To confirm the diagnosis, your doctor may do a different examination to check for any abnormalities within the anus.
This check is known as a digital rectal exam. During this exam, your doctor inserts a gloved and lubricated finger into your rectum.
Depending on your risk factors for gastrointestinal disease, your doctor may order an additional test like an anoscopy, sigmoidoscopy, or colonoscopy.
Each of these tests involves your doctor using a small camera to diagnose any abnormalities in your anus, rectum, or colon.
An anoscopy examines the inside of your anus, a sigmoidoscopy examines the last 2 feet (50 centimeters) of your colon, and a colonoscopy explores the entire colon.
In these tests, a small fiber-optic camera fits into a small tube that’s inserted into your rectum. With this test, your doctor gets a clear view of the inside of your rectum so that they can examine the hemorrhoid up close.
What are the treatment options for hemorrhoids?
You can have hemorrhoids treated at home or at a doctor’s office.
To minimize pain, soak in a warm tub of water for at least 10 minutes every day. You can also sit on a warm water bottle to relieve the pain of external hemorrhoids.
If the pain is unbearable, use an over-the-counter (OTC) medicated suppository, ointment, or cream to relieve the burning and itching. You can find hemorrhoid suppositories online or in stores.
If you’re constipated, you can also use an OTC fiber supplement to help soften your stool. Two common supplements of this type are psyllium and methylcellulose.
OTC topical treatments, such as hydrocortisone or hemorrhoid cream, can ease your discomfort from hemorrhoids. Witch hazel pads can offer hemorrhoid relief as well.
You can buy both hydrocortisone and hemorrhoid cream online.
Soaking your anus in a sitz bath for 10 to 15 minutes per day can also help.
Practice good hygiene by cleaning your anus with warm water during a shower or bath every day. But don’t use soap, as soap can aggravate hemorrhoids. Also avoid using dry or rough toilet paper when you wipe after a bowel movement.
Using a cold compress on your anus can help reduce hemorrhoid swelling. Pain relievers, such as acetaminophen, ibuprofen, or aspirin can also alleviate the pain or discomfort.
If home treatments aren’t helping with your hemorrhoids, your doctor might recommend getting a rubber band ligation. This procedure involves the doctor cutting off circulation to the hemorrhoid by placing a rubber band around it.
This causes loss of circulation to the hemorrhoid, forcing it to shrink. This procedure should only be performed by a medical professional. Don’t try this by yourself.
If rubber band ligation isn’t an option in your case, your doctor may perform injection therapy, or sclerotherapy. In this procedure, your doctor injects a chemical into the blood vessel directly. This causes the hemorrhoid to reduce in size.
To prevent or avoid worsening hemorrhoids, avoid straining during a bowel movement. Also, try to increase your water intake. Drinking enough water can keep your stool from hardening.
Use the restroom as soon as you feel a bowel movement coming on to prevent hemorrhoids from developing. Exercise regularly to prevent becoming constipated, and avoid sitting for long periods, especially on hard surfaces like concrete or tile.
Consuming foods that are high in dietary fiber can minimize the risk of developing hemorrhoids in the future.
Good dietary fiber sources include:
- whole wheat
- brown rice
Dietary fiber helps create bulk in the intestines, which softens the stool, making it easier to pass.
Complications from hemorrhoids are rare, but can include:
- blood clots in the swollen vein
- iron deficiency anemia caused by blood loss
- infection of an external hemorrhoid
- skin tags, or excess skin when an external hemorrhoid goes away
With proper treatment, you’ll likely experience an improvement. Following your doctor’s directions and maintaining a regimen, including exercising and avoiding sitting for long periods of time, can also improve your outlook.
Hemorrhoids are enlarged and bulging veins in and around the anus and rectum. They’re very common and caused by strain on the rectal veins. Risk factors include experiencing chronic constipation, pushing during bowel movements, having a family history of hemorrhoids, and being pregnant.
Most hemorrhoids go away on their own. Treatments usually focus on relieving symptoms and may include taking warm baths and using a hydrocortisone or a hemorrhoid cream or suppository. Exercising, drinking plenty of water, and eating more fiber can all help relieve constipation and prevent hemorrhoids from forming in the future.