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What are hemorrhoids?

Hemorrhoids are swollen veins in the lower rectum and anus, similar to varicose veins. Everyone has hemorrhoidal tissue. It becomes a problem only when the veins stretch under pressure and swell, which causes itching, discomfort, and bleeding. Hemorrhoids are one of the most common causes of rectal symptoms in adults and are highly treatable.

Internal vs. external hemorrhoids: what is the difference?

Location is what separates the two:

• Internal hemorrhoids form inside the rectum. You usually cannot see or feel them, and they often cause painless bleeding during bowel movements.
• External hemorrhoids form under the skin around the anus. They can itch, hurt, and swell, and a blood clot inside one can cause sudden, sharp pain.

What causes hemorrhoids?

Hemorrhoids develop when repeated pressure builds in the veins of the lower rectum. Common causes include:

• Straining during bowel movements
• Chronic constipation or diarrhea
• Sitting on the toilet for long periods
• Pregnancy, which adds pressure on the pelvic veins
• Heavy lifting done regularly
• A low-fiber diet

Risk also rises with age as the tissue supporting the veins weakens.

What are the symptoms of hemorrhoids?

Symptoms depend on the type. Internal hemorrhoids tend to cause:

• Bright red blood on toilet paper or in the bowl
• A hemorrhoid that pushes through the anus during a bowel movement

External hemorrhoids tend to cause:

• Itching or irritation around the anus
• Pain or discomfort, especially when sitting
• Swelling or a tender lump near the anus

How do you get rid of hemorrhoids?

Most hemorrhoids respond to home care, and stubborn cases have effective medical options. Treatment works in tiers:

• At home: add fiber and water to soften stools, take warm sitz baths, and use over-the-counter creams or witch hazel pads for short-term relief.
• In-office procedures: for hemorrhoids that persist, a provider can use rubber band ligation, sclerotherapy, or coagulation to shrink or remove them.
• Surgery: large or severe hemorrhoids may need surgical removal, called a hemorrhoidectomy.

Do hemorrhoids go away on their own?

Mild hemorrhoids often go away on their own within a few days to a couple of weeks, especially with home care that reduces straining. Hemorrhoids tied to ongoing pressure, such as chronic constipation or pregnancy, are more likely to return or persist until the underlying cause is addressed. Bleeding that continues or pain that worsens is a reason to see a provider.

When should you see a doctor about hemorrhoids?

See a provider if you have rectal bleeding for the first time, bleeding that does not stop, or pain that interferes with daily life. Rectal bleeding can also signal other conditions, so it should always be evaluated rather than assumed to be hemorrhoids. Connect with hemorrhoid specialists on Zocdoc near you and book a visit based on your insurance and availability.

Sources

• Cleveland Clinic: Hemorrhoids
• American Gastroenterological Association, GI Patient Center: Hemorrhoids
• American Gastroenterological Association: Clinical Practice Update on the Diagnosis and Treatment of Hemorrhoids

The content herein is provided for general informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Medical information changes constantly, and therefore the content on this website should not be assumed to be current, complete or exhaustive. Always seek the advice of your doctor before starting or changing treatment. If you think you may have a medical emergency, please call your doctor or 9-1-1 immediately.