Anyone Can Get Them
Hemorrhoids aren’t a rare, strange condition. Many people — men and women alike — have them. It’s only when they swell and cause problems that you realize they’re there. About half of people bleed, have pain, or other symptoms by the time they turn 50. And women may get them during pregnancy.
What Are They?
You have clumps of veins in and around your anus and lower rectum that can stretch with pressure. When they swell or bulge, they’re called hemorrhoids. You can get them inside or just on the edge on the outside. They’re usually not serious, but they can be unpleasant.
What Causes Them?
We’re not sure exactly. You may be more likely to get them if you spend a lot of time on the toilet, perhaps because of diarrhea, or have a hard time going because you’re constipated. Straining to lift heavy things might be to blame. They’re more common as you get older and when you’re overweight or pregnant. If your parents had them, you may get them, too.
One of the most common signs is painless bleeding, usually when you go to the bathroom. You might notice a little blood on the toilet paper or in the bowl. Your bottom may itch, hurt, or have tiny bulges around your anus. Hemorrhoids aren’t the only reason for these symptoms, though. You should see your doctor to rule out other problems.
How Are They Diagnosed?
Your doctor will ask about your symptoms and look at your bottom for hemorrhoids. They may also put a gloved finger inside to check for them there. To get a closer look, they may use a small tube called an anoscope. Your doctor may also suggest tests, called flexible sigmoidoscopy or colonoscopy, to see inside your colon and rectum with a lighted, bendable tube.
Internal and External
When a hemorrhoid from inside pushes outside or “prolapses," it can bleed, hurt, and itch. It may go back in on its own as the swelling goes down, or you can gently nudge it back. A blood clot that forms in a hemorrhoid just under the skin outside is a thrombosis. It might get hard and sore and could bleed if it breaks. If the clot goes away, it may leave behind a little piece of skin called a skin tag that can bother you.
Food to Prevent and Relieve Them
Soften your stool with fiber: Eat more leafy vegetables, fresh fruits, beans, and whole-grain breads and cereals. (Your doctor may also suggest a fiber supplement.) Add fiber to your diet slowly since too much too fast can lead to gas and bloating. Drink lots of water to make it easier to go to the bathroom and avoid constipation.
Treatment at Home
Try nonprescription creams and wipes — or even a small ice pack — to ease pain and swelling. Soak in a bathtub filled with a few inches of warm water 2-3 times a day, or use a special “sitz bath" pan that fits onto your toilet seat. Then pat dry gently. An over-the-counter stool softener can make it easier to go.
Treatment by a Doctor
When at-home remedies don’t work, your doctor may put special rubber bands or rings around internal hemorrhoids to cut off the blood supply until they shrink. This process is ligation. They can use heat to get rid of internal hemorrhoids, known as coagulation. Your doctor could also inject a chemical into the swollen tissue to break it down. This is called sclerotherapy.
For very large hemorrhoids or those that just won’t go away, a surgeon could simply cut out the swollen tissues. This surgery, called a hemorrhoidectomy, usually works but often has a long, painful recovery. A newer procedure uses staples to hold hemorrhoids in place instead. It’s less painful, and you’ll get better faster.
- American Cancer Society: “Frequently Asked Questions About Colonoscopy and Sigmoidoscopy.”
- American Gastroenterological Association: “Living with Hemorrhoids."
- American Society of Colon & Rectal Surgeons: “Hemorrhoids.”
- Harvard Health Publications, Harvard Medical School: “Hemorrhoids and what to do about them."
- FamilyDoctor.org: “Hemorrhoids: Causes and Risk Factors."
- UpToDate: “Patient information: Hemorrhoids (Beyond the Basics)."