Hemorrhoids are swollen and inflamed veins around the anus or in the lower rectum. External hemorrhoids are located on the skin around the outside of the anus, whereas internal hemorrhoids are within the lower rectum. Sometimes they become inflamed, painful, or uncomfortable. And when they do, it’s important to seek medical care, without delay.
When the blood vessels in the rectum become swollen, they're called hemorrhoids or piles. Hemorrhoids are a very common condition.
Causes and symptoms
Hemorrhoids develop for a number of different reasons. Some of the most common include chronic constipation or diarrhea, straining while having a bowel movement, low-fiber diet, pregnancy, obesity, heavy-lifting, and sitting on the toilet for long periods of time. Additionally, there is a hereditary component. If your parents had hemorrhoids that were problematic, chances are, you may experience similar challenges.
If your hemorrhoids are not bothering you, we don’t need to bother them. But if they become inflamed, painful, or uncomfortable, they can impact your quality of life and need to be addressed medically. Symptoms of inflamed hemorrhoids may include:
- Itching or irritation in the anal or rectum region
- Shooting pain or a burning sensation during bowel movements
- Swelling in and around the anus
- Bleeding or bright red blood noted on toilet paper after bowel movements
External hemorrhoids often bring on abrupt excruciating—and sometimes debilitating—pain. Bleeding and a formed clot that stretches the skin of the anal area are the cause of the pain.
Internal hemorrhoids are graded on a scale of one to four, with painful symptoms that increase as the grade does. They’re rarely painful, although you can experience some bleeding and burning.
Grade 1: Painless rectal bleeding
Grade 2: Pain and discomfort from prolapsing or protruding from the anal opening
Grade 3: Pain and discomfort from prolapsing or protruding from the anal opening that requires you to manually push them back inside
Grade 4: Pain and discomfort from hemorrhoids that are stuck in the prolapsed position and generally require surgery
Consult your primary care or family doctor if you are experiencing these signs and symptoms. Most of the time, they’re indications of hemorrhoids, which a primary care doctor can treat successfully. In some cases, however, your doctor may choose to refer you to a colorectal specialist or surgeon.
Controlling your symptoms
If you are experiencing constipation as a result of hemorrhoids, your doctor may be able to offer some recommendations to address and resolve this issue. Your doctor will likely recommend increasing the amount of fiber in your diet.
Food recommendations to increase your fiber intake include:
- Vegetables and fruits (especially fruits with peels)
- Foods with bran and oats (for example bran cereal or oatmeal)
- Nuts (chia seeds, flax seeds, pumpkin seeds, and almonds)
- Berries (raspberries, blackberries, strawberries, and blueberries)
Increasing your daily fluid intake can also help control or reduce constipation. Higher fluid absorption makes the stool softer and less painful to pass. Adults should drink 48 to 64 ounces of fluid per day.
Additionally, exercise aids the body in moving waste out appropriately. Our experts recommend going for a walk, bike ride, swim, or participating in other aerobic exercises as a way of achieving good colon health.
If you try these measures for a few weeks with no improvement, or if your symptoms change suddenly, seek guidance from your primary care physician or a colorectal specialist.
Getting help early not only can improve your quality of life, but it also can help identify and address potentially serious problems quickly and safely.
Hemorrhoids are usually visible to a physician who is conducting a physical exam. In some cases, it may be necessary to undergo a colorectal procedure to gather more information and confirm what type of medical treatment is ideal. Some of the most common procedures performed to gather this information are colonoscopies, sigmoidoscopies, and barium enema X-rays.
In some cases, an over-the-counter cream, ointment, or other medication may bring temporary relief. However, these remedies typically do not cure the hemorrhoid or prevent future flair ups. It is best to see a doctor so that a thorough evaluation can be completed and a plan of care can be created to treat and permanently resolve the problem.
What to expect during your visit
Our team is knowledgeable and experienced. We treat patients with hemorrhoids every single day. But equally important is that we take the time to listen to our patients – to really understand what they are experiencing and why they are seeking our care. We want our patients to feel comfortable – even when it comes to discussing topics like hemorrhoids, that are sometimes a bit uncomfortable to talk about. Our commitment to providing an excellent patient experience allows us to deliver thoughtful and compassionate care, and the best possible outcomes.
Q: How common are hemorrhoids?
A: Hemorrhoids are far more common than most people realize. Some people are unaware of their presence, while others become inflamed, painful, or uncomfortable. When they do, it is critical to seek the advice and care of a colorectal surgeon.
Q: Can I rely on at-home remedies?
A: There are over-the-counter creams, ointments, and other medications that may provide temporary relief. The key word, however, is "temporary." These remedies will not cure the hemorrhoid or prevent it from recurring. Seeking care from a medical professional is advised in order to develop the best treatment plan for you.
Q: Why should I see a doctor?
A: The truth is that many of the symptoms can be associated with more serious and, in some cases, life-threatening illnesses, such as colon cancer and rectal cancer. This is one of the reasons we strongly advise patients to see a doctor as soon as possible.