Priyanka Chugh, MD, is board-certified gastroenterologist with a background in internal medicine. She practices with Trinity Health of New England in Waterbury, Connecticut.
Hemorrhoids are a common but aggravating condition involving swollen and inflamed veins in the rectum or anus. Depending on their location, they often result in unrelenting discomfort, pain, itchiness, and bleeding. While sometimes caused by straining during bowel movements, hemorrhoids are also associated with obesity, pregnancy, and other conditions.
A high-fiber diet and over-the-counter (OTC) stool softeners can help alleviate related constipation, and topical creams might also be recommended by your doctor. In some cases, however, a procedure such as sclerotherapy or hemorrhoidectomy may be recommended, although the latter is rare these days.
Hemorrhoids are associated with bowel movement problems. Chronic constipation, diarrhea, straining during bowel movement, and sitting for a long time on the toilet exert stress on veins that drain blood from the colon and rectum. The ensuing rise in blood pressure can cause them to slip from muscles and connective tissues meant to hold them in place, leading to the formation of a hemorrhoid.
Hemorrhoids can be internal or external. Internal hemorrhoids are inside the rectum and cannot be seen. External hemorrhoids are on the outside of the anus and form a hard lump. If the hemorrhoid becomes inflamed and engorged with blood, it may appear bluish-purple.
Hemorrhoids typically resolve in time with treatment to relieve symptoms and prevent recurrence. In more severe cases, they may require nonsurgical treatments, such as rubber band ligation, sclerotherapy, or infrared coagulation, to shrink the hemorrhoid. Surgery is reserved for the most severe cases.
Most of the time, hemorrhoids go away on their own. The pain and discomfort can last anywhere from a few days to a few weeks. If you have painful hemorrhoids that aren’t responding to over-the-counter treatments and last longer than two weeks, talk to your doctor.
A hemorrhoid can be inside or outside of the anus. Internal hemorrhoids do not usually have symptoms because of a lack of sensory nerve endings in the rectum. An external hemorrhoid may feel like a hard lump that is smaller than a marble accompanied by anal pain, burning, tenderness, and itchiness. Typically only irritated during a bowel movement, more severe hemorrhoids may hurt more frequently.
Yes. Hemorrhoids are swollen veins in the lower rectum that can cause bleeding. You may notice bright red blood on the toilet paper after wiping, on the stool itself, or in the toilet bowl after a bowel movement. If you experience bleeding from your rectum, call your doctor’s office as bleeding can be a sign of a more serious condition.
A blood clot is a gel-like clump of coagulated blood. Clotting is an important part of the healing process—it allows a cut to stop bleeding. Sometimes blot clots form within arteries or veins, creating a dangerous and potentially life-threatening situation if the clot blocks the flow of blood to essential organs.
Coagulation is the process of making blood clot. When you get a cut, coagulation proteins bind together to stop the bleeding. Coagulation is also a medical procedure that forms a blood clot and is used to treat severe cases of hemorrhoids.
Dietary fiber, also called bulk and roughage, is a type of carbohydrate found in plants. Fiber comes in two forms: soluble and insoluble fiber. Dietary fiber adds bulk to the diet, makes you feel full faster, and helps prevent constipation.
Prolapse is a bulging or falling out of a body part, typically due to weakened supportive tissue. Rectal prolapse occurs when the last portion of the colon protrudes beyond the anus and is visible outside the body.
A strangulated hemorrhoid is a complication of hemorrhoids where the blood supply to an internal hemorrhoid is cut off and the hemorrhoid is strangulated. This can result in extreme pain.
Explore an interactive model that shows a cross-section of a human rectum, and how hemorrhoids can develop in the anal canal (internal hemorrhoids) or the tissue around the anus (external hemorrhoids).
American Academy of Family Physicians. Hemorrhoids. Updated November 10, 2017.
National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms & causes of hemorrhoids. Updated October 2016.
American Society of Colon & Rectal Surgeons. Rectal prolapse expanded version.
American Society of Colon & Rectal Surgeons. Hemorrhoids.
Lohsiriwat V. Treatment of hemorrhoids: A coloproctologist's view. World J Gastroenterol. 2015;21(31):9245-9252. doi:10.3748/wjg.v21.i31.9245
U.S. National Library of Medicine: MedlinePlus. Blood clots. Updated September 28, 2020.
U.S. National Library of Medicine: MedlinePlus. Dietary fiber. Updated September 18, 2020.