Hemorrhoids: Signs, Diagnosis, and Treatment


What Are Hemorrhoids?

Hemorrhoids are swollen veins located around the anus or in the lower rectum. The Mayo Clinic reports that about half of adults have experienced the symptoms of hemorrhoids by the age of 50. 

Hemorrhoids can either be internal or external. Internal hemorrhoids develop within the anus or rectum. External hemorrhoids develop outside of the anus. Hemorrhoids are also known as piles.

Of the two forms of hemorrhoids, external hemorrhoids are the most common and the most troublesome. Hemorrhoids cause pain, severe itching, and difficulty sitting. The good news is that they’re treatable.

What Are the Symptoms of Hemorrhoids?


The symptoms of hemorrhoids include: 

  • extreme itching around the anus
  • irritation and pain around the anus
  • an itchy or painful lump or swelling near your anus
  • fecal leakage
  • a painful bowel movement
  • blood on your tissue after having a bowel movement

Although hemorrhoids are painful, they aren’t life-threatening and often go away on their own without treatment. If you have them often, you may develop symptoms of anemia such as weakness and pale skin due to blood loss, though this is rare.

What Causes Hemorrhoids?


Experts aren’t sure what causes hemorrhoids to develop. Several factors could be to blame, including: 

  • straining during a bowel movement
  • complications from chronic constipation
  • sitting on the toilet for a long time
  • a family history of hemorrhoids 

You’re also more likely to develop hemorrhoids if you’re pregnant. When the uterus enlarges, it presses on the vein in the colon causing it to bulge.

How Are Hemorrhoids Diagnosed?


A visual examination of your anus may be enough to diagnose hemorrhoids. To confirm the diagnosis, your doctor may wish to do a different examination to check for any abnormalities within the anus. This check is known as a digital rectal exam. During this exam, your doctor inserts a gloved and lubricated finger into your rectum. If they feel anything abnormal, they may order an additional test called a sigmoidoscopy.

A sigmoidoscopy involves your doctor using a small camera to diagnose an internal hemorrhoid. This small fiber-optic camera, called a sigmoidoscope, fits into a small tube and then inserts into your rectum. From this test, your doctor gets a clear view of the inside of your rectum so that they can examine the hemorrhoid up close.

What Are the Treatment Options for Hemorrhoids?


Treatment for hemorrhoids can occur at home or at a doctor’s office.

Pain Relief

To minimize pain, soak in a warm tub of water for at least 10 minutes every day. You can also sit on a warm water bottle to relieve the pain of external hemorrhoids. If the pain is too much to bear, you can use an over-the-counter medicated suppository, ointment, or cream to relieve the burning and itching.

Dietary Fiber

Home treatment can also include increasing your dietary fiber intake. Consuming foods that are high in dietary fiber can minimize the risk of developing hemorrhoids in the future. 

Good dietary fiber sources include:

  • whole wheat
  • brown rice
  • oatmeal
  • pears
  • carrots
  • buckwheat
  • bran 

Dietary fiber helps create bulk in the intestines, which softens the stool, making it easier to pass.

If you’re constipated, you can also use an over-the-counter fiber supplement to help soften your stool.

Medical Procedures

If home treatments aren’t helping your case of hemorrhoids, your doctor might recommend getting a rubber band ligation. This procedure involves the doctor cutting off the circulation of the hemorrhoid by placing a rubber band around it. This causes loss of circulation to the hemorrhoid, forcing it to shrink. You shouldn’t try this at home, however.

If rubber band ligation isn’t an option in your case, your doctor can inject a chemical into the blood vessel directly. This causes the hemorrhoid to reduce in size. This treatment is known as injection therapy or sclerotherapy.

What Are the Complications Associated with Hemorrhoids?

Complications Icon

Complications from hemorrhoids are rare but may include:

  • blood clots in the swollen vein
  • bleeding
  • iron deficiency anemia caused by blood loss

What Is the Long-Term Outlook?


With proper treatment, most people experience an improvement. Following your doctor’s directions and maintaining a regimen that reduces the symptoms of hemorrhoids can also improve your outlook. 

To help prevent or avoid exacerbating hemorrhoids, you should avoid straining during a bowel movement. Also, increase your water intake. Drinking adequate water can keep your stool from hardening.

You Asked, We Answered

  • Are there any bathroom habits that can help prevent the onset of hemorrhoids? If so, what are they?
  • Here are several helpful tips to prevent hemorrhoids. First, try to avoid getting constipated. Having a high-fiber diet, drinking plenty of fluids, and maintaining a daily routine in terms of bowel movements will help. Next, avoid sitting on the toilet for prolonged periods of time, i.e., don’t try to read the entire Sunday newspaper in one sitting. Finally, use high-quality, soft toilet paper when wiping after a bowel movement, and avoid over-wiping. If you can maintain all these habits, then your likelihood of getting hemorrhoids will definitely go down.

    - Steve Kim, MD

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