Hemorrhoids are normal veins around the anus or lower rectum that can become swollen, causing pain, itchiness and sometimes bleeding. Hemorrhoids are usually temporary and are not dangerous.
About 75% of people will have a hemorrhoid at some time in their lives.1 Factors that contribute to the formation of hemorrhoids include:
- Sitting for long periods of time
- Too little fiber in the diet
- Being overweight
- Lifting heavy objects
- Overuse of laxatives
- Frequent constipation and diarrhea
- Straining during bowel movements
- Certain conditions such as Crohn’s disease, ulcerative colitis and irritable bowel syndrome
Types of Hemorrhoids
The kind of hemorrhoid you have depends on its location.
- Internal hemorrhoids: These occur inside the rectum. They usually are not painful, but they may bleed. If they are pushed outside the rectum during bowel movements, they are called prolapsed hemorrhoids.
- External hemorrhoids: These hemorrhoids involve the veins in the anal opening or outside the anus. Sometimes they can bleed, and they can be itchy or painful. Blood clots can form in external hemorrhoids. A hemorrhoid outside the anus that has a blood clot in it is called a thrombosed external hemorrhoid.
Diagnosis of Hemorrhoids
Hemorrhoids can usually be diagnosed with a rectal and anal examination. The doctor will examine the anus and rectum to look for swollen blood vessels that indicate there are hemorrhoids. Sometimes, the doctor will do one of the following tests to look for hemorrhoids:
- Colonoscopy: The doctor inserts a colonoscope - an instrument with a light and a flexible tube - into the anus and rectum to see the inside of these areas, as well as the rest of the large intestine, which is called the colon.
- Sigmoidoscopy: This procedure is similar to a colonoscopy, except the sigmoidoscope is shorter. It lets the doctor see inside the rectum and sigmoid colon, which is the lower intestine that joins with the rectum.
The doctor will also do a complete physical examination, because bleeding from the anus may be a symptom of other diseases, such as colorectal cancer.
Most small hemorrhoids can be treated by making changes in lifestyle and eating habits. Painful hemorrhoids often stop hurting without treatment in one to two weeks.2
At-home treatments include:
- Corticosteroid creams and suppositories, available without prescription, can help control itching and pain. A cream with witch hazel or a hemorrhoid cream with numbing agent can also relieve symptoms.
- Over-the-counter medicines such as acetaminophen (Tylenol®) or ibuprofen (Advil®) can help ease pain.
- Bulk-forming laxative or stool softener can help prevent straining bowel movements and constipation.
- Soaking in a plain, warm-water bath several times a day for about 10 minutes can ease discomfort.
- Gently cleaning the anal area after bowel movements with moist toilet tissue or flushable wet‑wipes can also ease discomfort.
Equally important, to have regular bowel movements with normal stool, drink eight glasses of water a day, eat more fruits and vegetables to get dietary fiber, and exercise every day. Medical procedures to treat hemorrhoids include:
- Rubber band ligation: The doctor puts a special rubber band around the hemorrhoid’s base. Then, the rubber band cuts off the blood supply to the hemorrhoid so that the hemorrhoid shrinks.
- Infrared coagulation: The doctor applies heat to the hemorrhoid to shrink it.
- Hemorrhoidectomy: Surgery to remove extensive or severe internal or external hemorrhoids.
- Sclerotherapy: A chemical solution is injected into or around the blood vessel, which shrinks the hemorrhoid tissue. This is no longer commonly used.
Prevention of Hemorrhoids
Some steps can be taken to prevent hemorrhoids. These include:
- Eat more fiber, such as fresh vegetables and fruits and whole-grain foods.
- Avoid high-fat and sugary foods that can cause constipation, such as cheese, ice cream, doughnuts and cakes.
- Get enough exercise.
- Drink enough fluids, including eight glasses of water per day.
- National Digestive Diseases Information Clearinghouse (NDDIC): Hemorrhoids
- FamilyDoctor.org: Hemorrhoids