What Are Hemorrhoids?

Hemorrhoids are swollen and inflamed veins in the rectum or anus (the very far end of the digestive tract where poop comes out). You may or may not be able to see hemorrhoids.

They may cause itching or bleeding, depending on the location. Over-the-counter (OTC) treatments can often help with swelling and effectively manage hemorrhoids. Surgery may sometimes be needed to remove the swollen blood vessels.

This article discusses the symptoms, causes, diagnosis, and treatment of hemorrhoids.

Types of Hemorrhoids

Hemorrhoids are divided into three types, depending on where they are located. They have similar causes and treatments and are:

• Internal hemorrhoids: Occur inside the body at the lower point of the intestines (the veins bulge out of the lining of the rectum and anus)
• External hemorrhoids: Occur in the skin surrounding the anus on the outside of the body
• Thrombosed hemorrhoids: Can be external or internal and occur when a blood clot forms inside a hemorrhoid

What Are the Symptoms of Hemorrhoids?

In most cases, the symptoms of hemorrhoids depend on their type and location. Most people find the symptoms mild and can often be treated with home remedies.

External Hemorrhoids

The symptoms of external hemorrhoids include:

• Itching around the anus
• One or more hard bumps under the skin around the anus
• Pain or aching near the anus, often worse with sitting down

Internal Hemorrhoids

Internal hemorrhoids are often not painful. Symptoms include blood when pooping, blood on your stool, or blood in the toilet or on the toilet paper when you wipe.

Another symptom is a prolapsed hemorrhoid that dangles from the intestines and falls out of the anal opening.

What Causes Hemorrhoids?

Healthcare providers do not understand why some people get hemorrhoids, and others do not. People get hemorrhoids due to increased pressure in the veins of the far end of the intestine (rectum or anus). However, there are some common behaviors and health conditions that may make you more likely to develop hemorrhoids, including:

• Pushing or straining when you poop
• Sitting on the toilet for a long time
• Constipation, especially over time
• Diarrhea, especially over time
• A diet low in fiber
• Getting older (the tissues in the rectum and anus get weaker)
• Pregnancy
• Frequent heavy lifting (due to straining and pressure)
  
• Being overweight or obese

How Do I Know If I Have Hemorrhoids?

Your healthcare provider can diagnose hemorrhoids. In most cases, they will:

• Take a medical history
• Physically examine your anus and the skin around it
• Perform a digital rectal exam
• Use an internal scope (if needed) to visualize the inside of the anus and rectum

How to Treat Hemorrhoids

If you think you have hemorrhoids, get a confirmation from your healthcare provider. Some other serious medical conditions have similar symptoms and require medical care.

In many cases, home remedies are enough to manage hemorrhoids. For some people, more invasive medical treatments are needed.

Home Remedies

If cleared by your provider, you can treat your hemorrhoids at home. Some possible ways to help hemorrhoids go away include:

• Increasing the fiber in your diet
• Taking a fiber supplement
• Drinking more water or other fluids (not alcohol)
• Avoiding pushing or straining while pooping
• Sitting on the toilet for shorter periods
• Sitting in warm water (sitz bath) several times a day for relief

Several OTC medications can help treat hemorrhoids. Always check with your provider to ensure these treatments are safe for you to use. Some people find the following helpful:

• Pain relievers
• Hemorrhoid creams or ointments
• Hemorrhoid suppositories (inserted into the rectum)
• Stool softeners
  

Medical Treatment

If your hemorrhoids do not improve with home remedies, or you have heavy bleeding or a blood clot, you may need medical treatment. A provider can often treat hemorrhoids at an outpatient center or hospital. Some common medical interventions for hemorrhoids include:

• Ligation (banding): A small surgical rubber band is placed at the bottom of the hemorrhoid to cut off blood flow to the tissue; after about a week, the hemorrhoid falls off, and a scar forms.
• Injection: A needle is used to put a solution directly into the hemorrhoid to cause it to shrink.
• Stapling and suturing: Staples and stitches are used to shrink the hemorrhoid tissue.
• Hemorrhoidectomy: Surgical removal of hemorrhoids is performed in an operating room under anesthesia.

Depending on the severity of your hemorrhoids and their symptoms, your provider will discuss possible treatment options with you and review the risks and benefits of each.

Hemorrhoids During Pregnancy

Hemorrhoids are common during pregnancy. It is estimated that up to half of pregnant people will have hemorrhoids. During pregnancy, hemorrhoids come from several causes, including increased blood volume, constipation, and pressure from the uterus on the rectum.

Check with a provider to ensure any treatments chosen are safe for you and the baby.

Complications and Outlook

Hemorrhoids are a common digestive system issue and are often easily managed with home remedies. There are a few complications that can be severe and require medical attention, including:

• Blood clot in the hemorrhoid
• Infection in an open area (sore or ulcer) of an external hemorrhoid
• Strangulated hemorrhoid (loss of blood flow to a prolapsed hemorrhoid)
• Bleeding and blood loss (anemia)
  

How to Prevent Hemorrhoids

Recommendations for preventing hemorrhoids are based on reducing or avoiding the things that cause them. Focus on:

• Eating adequate fiber in your diet
• Avoiding pushing or straining when pooping
• Drinking plenty of fluids
• Using OTC stool softeners if needed
• Preventing diarrhea and constipation as much as possible
• Spending less time sitting on the toilet
  

Tips for Managing Hemorrhoids

Hemorrhoids typically get better within a few days to a week, especially if you can reduce or avoid factors that increase the pressure in your rectum and anus. If your hemorrhoids are painful, OTC treatments may be helpful.

A sitz bath may help relieve discomfort in the anus and inflamed tissues. You may find three to four sitz baths daily help you manage your symptoms.

Avoid sitting too long, whether on the toilet or a chair. Walk around every hour or so. Increasing your physical activity can help improve your bowel motility. And consider changing positions when you have a bowel movement. Some people find a squatting position more comfortable than a traditional sitting position.