Hemorrhoids
Hemorrhoids are swollen masses of tissue around the anus that contain enlarged blood vessels. They are often the result of increased pressure in the abdominal region, which can be caused by:
- Repeated straining during bowel movements, especially in people with chronic constipation.
- Pregnancy, due to increased abdominal pressure.
- Frequent bouts of diarrhea.
- Obesity.
- Lifting heavy objects incorrectly.
Some individuals develop hemorrhoids without any clear cause.
Types of Hemorrhoids
Internal Hemorrhoids
Internal hemorrhoids occur inside the rectum and often result in painless bleeding, especially during bowel movements. They are usually not visible to the naked eye. Occasionally, they may prolapse, or protrude from the anus, appearing as small, grape-like lumps that can typically be pushed back inside.
External Hemorrhoids
External hemorrhoids form outside the anal opening and are often associated with swelling and irritation. They may make it difficult to keep the area clean after defecation. In some cases, external hemorrhoids may develop a blood clot (thrombosis), leading to sudden pain, swelling, and a firm lump near the anus.
Many individuals experience both internal and external hemorrhoids.
Symptoms of Hemorrhoids
Hemorrhoid symptoms can range from mild discomfort to severe pain. They also depend on which type of hemorrhoid you have.
Common symptoms include:
- Bright red blood on toilet paper, in the stool, or in the toilet bowl after defecation.
- A soft lump that may protrude from the anus (in the case of a prolapsed internal hemorrhoid).
- Discomfort, swelling, itching, or irritation around the anus (associated with external hemorrhoids).
- Pain and swelling if a thrombosed external hemorrhoid develops.
Hemorrhoids rarely cause severe pain unless thrombosis occurs or if an internal hemorrhoid becomes prolapsed.
Diagnosis
Hemorrhoids are diagnosed through a physical examination of the anus, which may include:
- A visual inspection of the area.
- A digital rectal exam using a gloved finger.
- Viewing the inside of the anal canal with a short scope called an anoscope.
If rectal bleeding is present, it is crucial to rule out more serious conditions, such as colorectal cancer, through procedures like a flexible sigmoidoscopy or colonoscopy.
Duration
Hemorrhoid symptoms usually improve within a few days. In pregnant women, hemorrhoid symptoms typically resolve after childbirth. Thrombosed external hemorrhoids may take a few days to weeks to heal completely.
Prevention
To reduce the likelihood of developing hemorrhoids, it is essential to prevent constipation. Some strategies include:
- Increasing fiber intake: Aim for 25 to 30 grams of fiber daily from sources like vegetables, fruits, and whole grains. Alternatively, fiber supplements such as psyllium (Metamucil) or methylcellulose (Citrucel) can be helpful.
- Staying hydrated: Drink 6 to 8 glasses of water daily.
- Exercising regularly: Physical activity, such as brisk walking for 20 minutes each day, can promote regular bowel movements.
- Establishing a routine: Set a regular schedule for bowel movements, ideally after meals.
- Responding promptly to the urge: When you feel the need to have a bowel movement, do not delay.
When using the toilet, avoid sitting for long periods and straining. If you are prone to constipation, talk to your healthcare provider about a stool softener.
Treatment
At-Home Remedies
If you're experiencing discomfort due to hemorrhoids, try these self-care measures:
- Take fiber supplements to ease bowel movements.
- Use warm sitz baths (sitting in warm water for 15-20 minutes several times a day) to reduce discomfort.
- Apply cold compresses or ice packs for 10 minutes at a time to reduce swelling.
- Use over-the-counter creams or ointments that contain ingredients like lidocaine, witch hazel, or hydrocortisone.
- Clean the anal area gently after each bowel movement with soothing wipes or a cotton cloth moistened with warm water.
Medical Procedures
If hemorrhoid symptoms persist, your healthcare provider may recommend one of the following procedures:
- Rubber band ligation: A rubber band is placed around the base of an internal hemorrhoid to cut off its blood supply, causing it to shrink.
- Sclerotherapy: A chemical solution is injected into the hemorrhoid, shrinking it by interfering with blood flow.
- Coagulation therapies: Infrared light or electrical energy is used to destroy internal hemorrhoid tissue.
Surgical Options
For more severe cases, surgery may be necessary:
- Hemorrhoidectomy: The surgical removal of hemorrhoids, often recommended for large or recurring hemorrhoids.
- Hemorrhoid stapling: A less painful alternative to traditional hemorrhoidectomy, this procedure is used for internal hemorrhoids and involves stapling the hemorrhoid tissue. This lifts prolapsed hemorrhoids and cuts off blood supply in the area.
Treatment options
The following list of medications are related to or used in the treatment of this condition.
Prognosis
Hemorrhoids are generally not serious and typically only require treatment when symptoms become bothersome. Hemorrhoids that occur during pregnancy usually improve after delivery. In cases related to constipation, lifestyle and dietary changes often provide relief and prevent recurrence. If symptoms persist despite conservative treatments, medical or surgical interventions are usually effective.
Learn more about Hemorrhoids
Treatment options
Care guides
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.