Hemorrhoids

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What are hemorrhoids?

Hemorrhoids are swollen veins in your rectum or anus. The type of hemorrhoid you have depends on where it occurs.

  • Internal hemorrhoids involve the veins inside your rectum. Internal hemorrhoids usually don’t hurt but they may bleed painlessly.
  • Prolapsed hemorrhoids may stretch down until they bulge outside your anus. A prolapsed hemorrhoid may go back inside your rectum on its own. Or you can gently push it back inside.
  • External hemorrhoids involve the veins outside the anus. They can be itchy or painful and can sometimes crack and bleed.

Symptoms of hemorrhoids

If you have a hemorrhoid, you may feel a tender lump on the edge of your anus. You may also see blood on the toilet paper or in the toilet after a bowel movement. You may feel itchy in that area. Or you may feel pain. Pain is most likely to occur after a bowel movement or strenuous activity.

What causes hemorrhoids?

Hemorrhoids are caused by increased pressure in the veins of your anus or rectum. One of the main causes is straining when you’re trying to have a bowel movement. This may happen if you’re constipated or if you have diarrhea. It may also happen if you sit on the toilet too long. Hemorrhoids are also caused by obesity, heavy lifting, or any other activity that causes you to strain.

How are hemorrhoids diagnosed?

You likely already know if you have a hemorrhoid. It is often possible to diagnose hemorrhoids just by looking. But if you have internal hemorrhoids, a doctor can perform a quick exam to confirm it. He or she will use a gloved, lubricated finger to feel in and around your rectum. Your doctor may also order a sigmoidoscopy. During a sigmoidoscopy, he or she will insert a small camera to look into your rectum. They also may perform an anoscopy. A small instrument called an anoscope is inserted a few inches into the anus to examine the anal canal.

It is important to see your doctor if you notice bleeding from your rectum. You need to make sure the cause is hemorrhoids and not some other problem. Bleeding from your rectum or anus or bloody stools may be a sign of something more serious such as cancer.

Can hemorrhoids be prevented or avoided?

Just about everyone has hemorrhoids at some time. But some things may make you more likely to get them. People whose parents had hemorrhoids may be more likely to get them. Pregnant women often get hemorrhoids because of the strain from carrying the baby and from giving birth. Being very overweight or standing or lifting too much can make hemorrhoids worse.

Hemorrhoid treatment

Most of the time, hemorrhoid symptoms go away after a few days even without treatment. If not, treatment focuses on relieving the pain. Talk to your family doctor before using hemorrhoid medicine.

  • Take warm baths.
  • Clean your anus after each bowel movement. Do this by patting gently with moist toilet paper or moistened pads, such as baby wipes.
  • Use ice packs to relieve swelling.
  • Use acetaminophen (1 brand name: Tylenol), ibuprofen (1 brand name: Motrin), or aspirin to help relieve pain.
  • Apply a cream that contains witch hazel to the area or use a numbing ointment. You can use creams that contain hydrocortisone for itching or pain.

Will I need surgery?

Painful hemorrhoids usually stop hurting on their own in 1 to 2 weeks. If yours keep causing problems, talk with your doctor. Rubber band ligation can be used to treat internal hemorrhoids. It involves placing a small rubber band around the base of the hemorrhoid. This stops the flow of blood to the area and the hemorrhoid withers away. Internal hemorrhoids can be destroyed by injecting them with a chemical. You may need a hemorrhoidectomy (surgical removal of the hemorrhoid) if internal hemorrhoids are prolapsed or very large.

Living with hemorrhoids

Hemorrhoid symptoms may come and go. Many things can affect them, especially straining to have a bowel movement. Use these tips to help prevent constipation:

  • Include more fiber in your diet. Fresh fruits, leafy vegetables, and whole-grain breads and cereals are good sources of fiber.
  • Drink plenty of fluids (except alcohol). Eight glasses of water a day is ideal.
  • Exercise regularly.
  • Avoid laxatives, except bulk-forming laxatives such as Fiberall, Metamucil, etc. Other types of laxatives can lead to diarrhea, which can worsen hemorrhoids.
  • When you feel the need to have a bowel movement, don’t wait too long to use the bathroom.

Questions to ask your doctor

  • Are there any lifestyle changes I can do that can relieve or prevent hemorrhoids?
  • I saw blood on toilet paper. Is this serious?
  • Are having hemorrhoids a sign of another health condition?
  • Will I always have hemorrhoids?
  • Is there medicine I can take for hemorrhoids? Are there side effects?