What are Hemorrhoids?

Hemorrhoids, also known as piles, are swollen veins in the lower part of the anus and rectum, similar to varicose veins. When the walls of these vessels are stretched, they become irritated.

Hemorrhoids have a number of causes, although often the cause is unknown. They may result from straining during bowel movements or from the increased pressure on these veins during pregnancy. Hemorrhoids can either be internal or external. Internal hemorrhoids develop within the anus or rectum. External hemorrhoids develop outside of the anus. Hemorrhoids are also known as piles.

Hemorrhoids are very common, with about 50 percent of adults experiencing the symptoms of hemorrhoids by age 50.

External hemorrhoids are the most common and most troublesome. Hemorrhoids cause pain, severe itching, and difficulty sitting. Fortunately, many effective options are available or treatment.

What are the Symptoms of Hemorrhoids?

Signs and symptoms of hemorrhoids include:

  • Painless bleeding during bowel movements. You might notice small amounts of bright red blood on your toilet paper or in the toilet bowl.
  • Itchingor irritation in the anal area.
  • Discomfort, pain or soreness in the anal region.
  • Lumpsprotruding from the anal region.
  • Swelling in the anal region.
  • Feces may leak out unintentionally.

Although hemorrhoids are painful, they aren’t life-threatening and often go away on their own without treatment. If you have them often, you may develop symptoms of anemia, such as weakness and pale skin due to blood loss, though this is rare.

Hemorrhoid Types

Hemorrhoids can be either internal or external:

Internal hemorrhoids

Internal hemorrhoids are deep inside the rectum and not visible from outside. They are normally painless. Often, the first sign that internal hemorrhoids are present is rectal bleeding.

Straining can sometimes push an internal hemorrhoid so that it protrudes through the anus, this is called a protruding or prolapsed hemorrhoid and can be painful.

External hemorrhoids

External hemorrhoids are under the skin around the anus and are therefore visible. Because there are more sensitive nerves in this part of the body, they are normally more painful. Straining when passing a stool may cause them to bleed.

What causes Hemorrhoids?

Experts aren’t sure what causes hemorrhoids to develop. Possible factors include:

  • Straining during bowel movements
  • Sitting for long periods of time on the toilet
  • Chronic diarrhea or constipation
  • Obesity
  • Pregnancy
  • Anal intercourse
  • Low-fiber diet

Hemorrhoids are more likely with aging because the tissues that support the veins in your rectum and anus can weaken and stretch.

Hemorrhoid Diagnosis

A visual examination of your anus may be enough to diagnose hemorrhoids. To confirm the diagnosis, your doctor may do a different examination to check for any abnormalities within the anus. This check is known as a digital rectal exam. During this exam, your doctor inserts a gloved and lubricated finger into your rectum. If they feel anything abnormal, they may order an additional test called a sigmoidoscopy.

A sigmoidoscopy involves your doctor using a small camera to diagnose an internal hemorrhoid. This small fiber-optic camera, called a sigmoidoscope, fits into a small tube and then inserts into your rectum. From this test, your doctor gets a clear view of the inside of your rectum so that they can examine the hemorrhoid up close.

Hemorrhoid Treatment Options

Treatment for hemorrhoids can occur at home or at a doctor’s office.

Pain relief

To minimize pain, soak in a warm tub of water for at least 10 minutes every day. You can also sit on a warm water bottle to relieve the pain of external hemorrhoids. If the pain is unbearable, use an over-the-counter medicated suppository, ointment, or cream to relieve the burning and itching.

Fiber supplements

If you’re constipated, you can also use an over-the-counter fiber supplement to help soften your stool. Two common supplements of this type are psyllium and methylcellulose.

Home remedies

Symptoms can be relieved in the following ways. However, they will not eliminate the hemorrhoids:

  • Topical creams and ointments. Over the counter creams or suppositories, which contain hydrocortisone, are available; there are also pads which contain witch hazel, or a topical numbing agent.
  • Ice packs and cold compresses. Applying these to the affected area may help with the swelling.
  • Sitz bath using warm water. The sitz bath is placed over the toilet. Some pharmacies sell them. These may relieve the burning or itching symptoms.
  • Moist towelettes. Dry toilet paper may aggravate the problem.
  • Analgesics– some painkillers, such as aspirin, ibuprofen, and acetaminophen (Tylenol) may alleviate the pain and discomfort.

Medical procedures

If home treatments aren’t helping with your hemorrhoids, your doctor might recommend getting a rubber band ligation. This procedure involves the doctor cutting off the circulation of the hemorrhoid by placing a rubber band around it. This causes loss of circulation to the hemorrhoid, forcing it to shrink.

If rubber band ligation isn’t an option in your case, your doctor may perform injection therapy, or sclerotherapy. In this procedure, your doctor injects a chemical into the blood vessel directly. This causes the hemorrhoid to reduce in size.

Preventing Hemorrhoids

The best way to prevent hemorrhoids is to keep your stools soft, so they pass easily. To prevent hemorrhoids and reduce symptoms of hemorrhoids, follow these tips:

  • Nutrition. Eating plenty of fiber-rich foods, such as fruits and vegetables, as well as whole grains, means stools will nearly always be soft. Similarly, drinking plenty of fluids (excluding alcohol) helps keep stools soft. Over the counter fiber supplements also ease constipation.
  • Straining. When using the toilet, try not to strain, this creates pressure in the veins in the lower rectum.
  • Go when needed. You should not wait if you need to use the toilet. The longer the wait, the drier the stools will be.
  • Physical activity. Sitting or standing still for long periods of time puts pressure on the veins. Physical activity also helps stool move through the bowel, so bowel movements are more regular.
  • Keep body weight down. Being overweight significantly raises your risk of having hemorrhoids.

Hemorrhoid Prognosis and Complications

Complications from hemorrhoids are rare, but can include:

  • Blood clots in the swollen vein
  • Bleeding
  • Iron deficiency, anemia caused by blood loss

With proper treatment, you’ll likely experience an improvement. Following your doctor’s directions and maintaining a regimen, including exercise and avoiding sitting for long periods of time, that reduces hemorrhoid symptoms can also improve your outlook.

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