Family Health|Women
External hemorroidectomy|flexible sigmoidoscopy|hemorrhoids|Internal hemorrhoidectomy|Vascular Disorders


Last Updated September 2023 | This article was created by editorial staff and reviewed by Deepak S. Patel, MD, FAAFP, FACSM

What are hemorrhoids?

Hemorrhoids are swollen or inflamed veins in your rectum or around your anus. They are very common, especially in people who are pregnant. The type of hemorrhoid you have depends on where it occurs.

  • Internal: involve the veins inside the anus at the rectum. They usually don’t hurt but may bleed during a bowel movement.
  • Prolapsed: often stretch down until they swell outside the anus. It may shrink back inside the rectum on its own, or you can gently push it back inside.
  • External: involve the veins outside the anus. They can be itchy or tender and can sometimes crack and bleed. A blood clot may form which can be painful and uncomfortable.

Symptoms of hemmorroids

If you have a hemorrhoid, you may feel a tender lump on the edge of your anus. You may also see blood in the toilet or on toilet paper after a bowel movement. You may feel pain or itchiness in that area. Pain is most likely to occur with bowel movements (especially hard stools) or strenuous activities, like lifting something heavy.

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 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?

It’s often possible to identify hemorrhoids if you feel or see a lump, especially if outside the anus. A doctor can perform a rectal exam to confirm internal hemorrhoids. They will use a gloved, lubricated finger to feel in and around your rectum. An additional procedure may be needed for a better evaluation. During a sigmoidoscopy, the doctor will insert a small camera to look inside your rectum. During an anoscopy, a small instrument called an anoscope is inserted a few inches into the anus to examine the anal canal.

It’s 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?

Hemorrhoids are a common problem, but not always preventable. People whose parents had hemorrhoids may be more likely to get them. Pregnant women often get them because of the strain from carrying the baby and giving birth. Being overweight or standing or lifting too much can make hemorrhoids worse.

Hemorrhoid treatment

Most of the time, symptoms go away on their own after a few days. If not, treatments at home focus on relieving the pain. Talk to your doctor before using hemorrhoid medicine.

Here are some things you can do to help ease your symptoms:

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

Painful hemorrhoids usually stop hurting in 1 to 2 weeks. Talk to your doctor if the pain continues or if the hemorrhoids persist. 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 fades 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, but do not strain with activity.
  • 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

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