Hemorrhoids are swollen blood vessels in and around the anus and lower rectum. They stretch under pressure and are similar to varicose veins in the legs. Hemorrhoids are either internal or external.
Internal (inside) hemorrhoids develop inside the anus. They are painless and sometimes bleed a lot during bowel movements. They may also protrude during bowel movements. If they protrude from the anal opening and cannot be pushed back, they can cause severe pain.
External (outside) hemorrhoids
develop under the skin around the anus and can easily be felt or seen as a lump. They bleed when broken by straining, rubbing, or scratching.
In most cases, symptoms will go away within several days. Although many people have hemorrhoids, not all experience symptoms.
Common symptoms include:
Bleeding from the anus that may appear:
On the stool
On the toilet paper
In the toilet bowl
Anal itching and burning
Swelling and pain during bowel movements
Sensitive lumps of various sizes around the anus
The doctor will ask about your symptoms and medical history. A physical exam will be done. The doctor will examine the anus and rectum to look for swollen blood vessels and perform a digital rectal exam. This is done by inserting a gloved, lubricated finger into the rectum to feel for abnormalities. Sometimes, it is necessary to do the exam with the use of an endoscope that allows visualizing the rectal canal and other parts of the colon.
Bleeding from the rectum or blood in the stool can be a symptom of other diseases involving gastrointestinal tract or colon/rectal cancer. It is important to see a doctor if you have any rectal bleeding.
Initial medical treatment of hemorrhoids is aimed at relieving symptoms. Measures to reduce symptoms include:
Sitz baths—sitting in plain, warm water 2-3 times a day for about 10 minutes each time
Ice packs—putting cold packs on the anus for short durations to relieve pain and swelling
Medication—applying hemorrhoidal creams or suppositories to the affected area
—Eating more whole fresh fruit, raw, or cooked vegetables, and whole grains has been consistently shown to reduce hemorrhoid symptoms including bleeding. Also, if you enjoy spicy foods, you can continue eating them. Studies have shown that they do
worsen hemorrhoidal symptoms.
Fluids—drinking 6-8 (8-ounce) glasses of nonalcoholic fluids daily to soften stools
If these treatments provide insufficient relief, one of several nonsurgical procedures may be used to shrink or destroy the hemorrhoidal tissue. These procedures, which are generally performed in a doctor’s office, include:
Rubber band ligation
—a rubber band placed around the base of the hemorrhoid to cut off circulation and force the hemorrhoid to wither away within a few days
Sclerotherapy—a chemical solution is injected near the blood vessel to cause scarring and shrinkage of the hemorrhoid
Coagulation therapy—the use of electricity (direct current electrotherapy), laser, or infrared light (photocoagulation) to shrink the hemorrhoidal tissue
If nonsurgical procedures are either not an option or fail to resolve the problem, surgical management is the final option:
—This surgery involves permanent removal of hemorrhoids by cutting the hemorrhoidal tissue away. Some of the newest surgical treatments involve using stainless steel staples. While these treatments are favored by many surgeons, there is some evidence that more traditional techniques produce more consistent and long-lasting relief.
If you are diagnosed with hemorrhoids, follow your doctor's
The best way to prevent hemorrhoids is to keep stools soft so they pass easily. The following practices can help:
Alonso-Coello P, Guyatt G, Heels-Ansdell D, et al. Laxatives for the treatment of hemorrhoids.
Cochrane Database Syst Rev
Altomare DF, Rinaldi M, La Torre F, et al. Red hot chili pepper and hemorrhoids: the explosion of a myth: results of a prospective, randomized, placebo-controlled, crossover trial.
Dis Colon Rectum
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a