Hemorrhoids are swollen veins. They are found in and around the anus and lower rectum. The veins get stretched out when they're under pressure.
The types are:
- External—Grow under the skin around the anus. They can easily be felt or seen as a lump. They also bleed when broken by straining, rubbing, or scratching.
- Internal—Grow inside the anus. They are painless, but can bleed a lot during bowel movements. They may also pop out or prolapse from the anal canal. If this happens and they can't be pushed back, it can cause severe pain. The internal type is graded based on prolapse severity.
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Hemorrhoids are more common in older adults. Your chances are also higher for:
- Having any of the problems listed above
- Chronic diarrhea
- Sitting on the toilet for long periods of time
- Having people in your family who have hemorrhoids
- Chronic coughing
- Long term use of enemas or laxatives
- Having liver disease
Not everyone will have symptoms. They may range from mild to severe. The most common are:
Bleeding, which may be seen:
- On the stool
- On the toilet paper
- In the toilet bowl
- Anal itching and burning
- Swelling and pain during bowel movements
- Sensitive lumps of various sizes around the anus
Bleeding can be a sign of other health conditions, some serious. If you are bleeding, call your doctor so you can find the cause.
How hemorrhoids are treated depend on the problems. It mainly starts with easing symptoms. Sometimes they go away on their own or with basic care. Your doctor may try one or more of these:
Self-care may be enough. This involves:
- Sitz baths—sitting in plain, warm water 2-3 times a day for about 10 minutes each time
- Ice packs—putting cold packs on the anus for short periods of time to ease pain and swelling
- Medicines—using creams and suppositories
- High-fiber diet —eating more fresh fruit, raw or cooked vegetables, and whole grains
- Fluids—drinking plenty of fluids will help soften stools
If self-care doesn't work, your doctor may advise:
- Rubber band ligation—A rubber band is placed around the base of the hemorrhoid. The band cuts off blow flow. After a few days the it will wither away.
- Sclerotherapy—A chemical mix is injected near the vein. The chemicals will cause scar and shrink the vein.
- Coagulation therapy—Electricity, laser, or infrared light is used to shrink the tissue.
- Hemorrhoidectomy—Surgical removal is done if none of the other methods work.
To help lower your chances of hemorrhoids:
- Empty bowels as soon as possible after you feel the urge.
- Don't strain while having a bowel movement.
- Don't sit on the toilet for long periods of time, including reading.
- Slowly increase your fiber intake to 30-35 grams a day. Eat fruits, vegetables, beans, and whole grains. Consider using supplements if you need to.
- Drink 6-8 glasses of water or fluids without caffeine a day.
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
Edits to original content made by Denver Health.
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American Gastroenterological Association https://www.gastro.org
American Society of Colon and Rectal Surgeons https://www.fascrs.org
Canadian Association of Gastroenterology https://www.cag-acg.org
The College of Family Physicians of Canada https://www.cfpc.ca
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