Hemorrhoids, also known as piles, are distended and swollen veins located in the lowest part of your rectum and anus, just below the lining of the mucous membranes. They are like varicose veins in the legs.

While hemorrhoids have several causes, sometimes it is unknown how they develop. They occur when the walls of the veins stretch so thin that they become irritated and bulge. Approximately three out of four adults will experience hemorrhoids at some point in time.

There are both external and internal hemorrhoids. Internal piles develop inside of the rectum while external hemorrhoids form under the skin surrounding the anus.

Usually, you cannot see or feel internal ones, and they may not hurt because of the lack of many pain-sensing nerves in this area. Bleeding may be the only way that you discover you have them. On the other hand, external ones tend to bleed and hurt. Below you’ll find more information about hemorrhoids and how to treat them.

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Complications with Hemorrhoids

Occasionally, hemorrhoids will prolapse or grow and bulge through the anal sphincter to the outside. They appear as moist bumps that are pinker than the area around them. These hemorrhoids are often painful, too. Prolapsed hemorrhoids typically recede on their own but may need to be pushed back into place.

Sometimes, a clot can develop within a hemorrhoid, and this is called a thrombosed hemorrhoid. They are tremendously painful but not dangerous. However, the may need to be drained and lanced.

Thankfully, there are many treatment options for hemorrhoids. Many people find they can reduce their symptoms using over-the-counter solutions and changes to their lifestyle.

Causes of Hemorrhoids

Family history may contribute to the likelihood that you’ll get hemorrhoids at some point in your life. They are caused by pressure building up in the lower part of the rectum that affects blood flow. As a result, the veins swell.

They are commonly associated with straining during bowel movements, sitting on the toilet long periods of time, and chronic constipation. These actions hinder blood flow and cause it to pool, thus enlarging the veins. Here is a list of other causes:

  • Low-fiber diet
  • Obesity
  • Chronic diarrhea
  • Anal intercourse
  • Pregnancy
  • People who sit or stand for a long time
  • Straining when lifting heavy objects

Hemorrhoids are more likely to develop as we age because the supporting tissues of the veins in the anus and rectum can stretch and weaken over time.

Recent research illustrates that patients with hemorrhoids typically have a higher-than-normal resting anal canal tone. In essence, this smooth muscle is usually tighter than average in people with hemorrhoids. Constipation increases these problems since straining increases the pressure inside the anal canal. This pressure pushes the piles against the anal sphincter muscle.

Hemorrhoid Symptoms

Hemorrhoid systems vary depending on where they are located. Here are some possible symptoms:

  • Discomfort, pain, or itching of the anus and surrounding area
  • Swelling in the anal region
  • A painful or sensitive lump close to your anus
  • Painful bleeding, especially during bowel movements, you may even notice blood in the toilet or on your toilet paper

How Hemorrhoids are Diagnosed

Diagnosing hemorrhoids is relatively simple. Your doctor will talk to you about your medical history and perform a physical exam as well as a digital rectal exam if necessary. The later would be to look for blood in your stool. The physician may use an anoscope to look at the anal canal. This is a hollow plastic tube with a light so the doctor can see inside the rectum easier.

If there is blood found in your stool or rectal bleeding, your doctor may order a colonoscopy or flexible sigmoidoscopy to rule colon cancer or polyps. These tests are relatively common, especially in people 45 and older. The sigmoidoscopy allows your doctor to view the sigmoid or lower part of the colon. Colonoscopies look at the entire colon using a flexible, lighted tube with a camera on it.

A barium X-ray may also show your physician the outline of your entire colon. First, a barium enema is inserted than an X-ray technician takes X-rays of the lower part of your gastrointestinal system.

Hemorrhoid Treatment

Hemorrhoids often flare and get better without special procedures or surgery. It’s best to start with changes to your lifestyle. Also, there are products available over-the-counter that can alleviate symptoms. Always consult your doctor if you’re pregnant before you change your diet, physical routine, or medicine.

Eat a High Fiber Diet

Unless you have other medical problems that dictate a special diet, the best treatment for hemorrhoids is a high fiber diet. Eat fewer processed foods and more nuts, whole grains, fruit, and vegetables to help avoid constipation. A stool softener or fiber supplement may also alleviate hemorrhoid issues. Beware of laxatives because diarrhea is a side effect, and this irritates hemorrhoids more.

Try to drink 8 glasses of water every day. It’s critical that you introduce new foods gradually so that you avoid gas. If your doctor recommends surgery or prescription medicine, you’ll likely still need to make dietary changes.


Aerobic exercise may help stimulate healthy bowel function. For example, take a brisk 20 to 30 minute walk every day.

Sitz Bath for Hemorrhoids

This is a warm bath specifically for the hips and buttocks. You can obtain a small tub that fits over the typical toilet seat or sit in a bathtub in a few inches of warm water. Doctors recommend taking a 20-minute bath after every bowel movement as well as two or three more times daily. After each bath carefully pat the anus and buttocks dry. Do not wipe or rub hard.

Topical Treatment for Hemorrhoids

Hemorrhoid creams are available over-the-counter temporarily relieve the pain because they contain a local anesthetic. Tucks pads (witch hazel wipes) soothe the pain and itching.

Hemorrhoid Procedures

Rubber band ligation is the most common procedure utilized for hemorrhoids. It uses an elastic band that the doctor places around the hemorrhoids base. This causes it to shrink while the tissue around it scars at it heals, keeping the hemorrhoid in place. Usually, this takes anywhere from two to four procedures done several weeks apart.

If you have large hemorrhoids or they exhibit persistent, severe symptoms, your doctor may advise surgery. A hemorrhoidectomy is performed by making an incision in the internal and external hemorrhoid tissue and any problematic blood vessels in the area. It does require general anesthesia, but there is no overnight hospital stay.

Another method involves staples and is called the stapled hemorrhoidopexy. A surgeon fastens the hemorrhoids in the correct position using a stapling device. This procedure is also done in one day under general anesthesia.