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Hemorrhoids are swollen, inflamed veins around the anus or in the lower rectum. There are two kinds:

  • external hemorrhoids, under the skin around the anus;
  • internal hemorrhoids, in the lining of the anus and lower rectum.

Causes

Hemorrhoids form when there is too much pressure on the veins around the anus, from:

  • straining during bowel movements, or sitting on the toilet for a long time;
  • chronic constipation or diarrhea;
  • a low-fiber diet;
  • weakening of the supporting tissues of the anus and rectum, which can come with aging and pregnancy;
  • frequently lifting heavy objects.

Symptoms

TypePossible symptoms
Externalanal itching; one or more hard, tender lumps near the anus; anal pain, especially when sitting. Too much straining, rubbing or cleaning can make it worse. For many people, symptoms clear within a few days
Internalbleeding from the rectum, seen as bright red blood in the stool, on toilet paper or in the bowl; prolapse, a hemorrhoid that has fallen through the anal opening. Usually painless unless prolapsed, when it may cause pain and discomfort

Home treatment

Most hemorrhoids can be treated at home:

  • eat high-fiber foods, or take a stool softener or fiber supplement;
  • drink enough fluids every day;
  • don't strain during bowel movements or sit on the toilet for long;
  • take over-the-counter pain relievers;
  • take warm baths several times a day to ease pain, either a regular bath or a sitz bath, a plastic tub that lets you sit in a few inches of warm water;
  • use over-the-counter creams, ointments or suppositories for mild pain, swelling and itching of external hemorrhoids.

When to see a provider

See a health care provider if symptoms last after a week of home treatment, or if you have bleeding from the rectum. Hemorrhoids often cause bleeding, but so can other conditions, including Crohn's disease, ulcerative colitis, colorectal cancer and anal cancer, so the cause needs to be found.

Diagnosis. A provider takes a medical history and does a physical exam; external hemorrhoids can often be seen. A digital rectal exam, with a lubricated, gloved finger, checks for internal hemorrhoids, and a procedure such as an anoscopy may be done.

Medical treatment. If home care doesn't help, several in-office procedures can cause scar tissue to form in the hemorrhoids, cutting off their blood supply so they usually shrink. Severe cases may need surgery.

Prevention

The same habits help prevent hemorrhoids: high-fiber foods or a fiber supplement or stool softener, enough fluids, no straining, and not sitting on the toilet for long periods.

Sources

  • MedlinePlus, produced by the U.S. National Library of Medicine, "Hemorrhoids": https://medlineplus.gov/hemorrhoids.html — drawing on the National Institute of Diabetes and Digestive and Kidney Diseases (NIH).
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Лицензия: CC0 1.0 (общественное достояние) · По материалам medlineplus.gov

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