Hemorrhoids are swollen veins around your anus or lower rectum. Hemorrhoids can be internal or external. Internal hemorrhoids are inside of the rectum. External hemorrhoids are outside of the anal opening. Hemorrhoids can sometimes be painful or itchy. They can also bleed during bowel movements.
Explore the interactive 3-D diagram below to learn more about external and internal hemorrhoids.
If your hemorrhoids are small, your symptoms may clear up in a few days without treatment. You may also need to make simple diet and lifestyle changes.
Some internal hemorrhoids become so enlarged that they stick out of the anus. These are called prolapsed hemorrhoids. Prolapsed hemorrhoids can take longer to heal and may require treatment from a doctor.
Some women will develop hemorrhoids during pregnancy. This is because the increased pressure in your abdomen, especially in the third trimester, may make the veins in your rectum and anus larger. Pregnancy hormones may also make it more likely for your veins to swell. If you develop hemorrhoids during pregnancy, your symptoms may last until you give birth.
You may have no noticeable symptoms from internal hemorrhoids. Sometimes, a bowel movement may irritate an internal hemorrhoid and cause bleeding. If the internal hemorrhoid is pushed outside of your anal opening, you may have bleeding during bowel movements and symptoms in the anal area that include:
- a lump
These are the same symptoms you’ll experience if you have external hemorrhoids.
If you have hemorrhoids, lifestyle changes may help them heal faster. One cause of hemorrhoids is straining during bowel movements. Adding more high-fiber foods to your diet, such as vegetables, fruits, and whole grains, can help soften your stool and make it easier to pass. You should also drink plenty of water to help relieve constipation and reduce straining during bowel movements.
Here are some additional things that may help relieve symptoms:
- Minimize the time you sit on the toilet.
- When you feel the urge to move your bowels, go as soon as possible.
- Put your feet on a small stool during bowel movements to change the position of your rectum.
- If you’re pregnant, sleep on your side. This will help relieve some of the pressure around your anus.
- Ask your doctor about taking a stool softener or a fiber supplement, such as psyllium (Metamucil) or methylcellulose (Citrucel). A tablespoon of mineral oil added to food can also help soften stools.
- Keep the anal area clean. Take regular showers, and use moist wipes to clean the area around your anus after you pass a bowel movement.
- Use a sitz bath or sit in a warm tub for a few minutes to bathe the anal area.
You may also try using over-the-counter (OTC) topical medications to ease discomfort, such as phenylephrine hemorrhoidal gel (Preparation H). These products are used if the hemorrhoids are bulging and inflamed. Limit use of products that contain steroids because long-term use may cause thinning of the skin around the anus. If OTC medications aren’t helping, talk with your doctor to see if you need additional treatment.
Small hemorrhoids often clear up without treatment or with home treatment and lifestyle changes. If you’ve continued problems or complications, such as bleeding, you should see your doctor. Your doctor can rule out other causes of bleeding during bowel movements, such as colon or anal cancer. If your symptoms become severe, your doctor may recommend medical procedures to remove or shrink the hemorrhoids.
Your doctor may recommend a minimally invasive outpatient treatment. Outpatient treatments are treatments that your doctor performs in their office. Some treatments include the following:
- Rubber band ligation is the most common nonsurgical treatment, and it involves your doctor tying a tight band around the base of the hemorrhoid to cut off the blood supply. Eighty percent of people who receive treatment for hemorrhoids have this type of treatment.
- During coagulation, your doctor uses infrared light, heat, or extreme cold to shrink the hemorrhoid.
- During sclerotherapy, your doctor injects a chemical to shrink the hemorrhoid.
If you have severe hemorrhoids or hemorrhoids that don’t respond to in-office medical treatments, you may need a doctor to surgically extract them. This has been shown to provide symptom relief and reduce future outbreaks.
The risk factors for hemorrhoids are mostly related to increased pressure on the anal and rectal veins. A family history of hemorrhoids may increase your risk. The risk factors include:
- anal intercourse
- frequent constipation or diarrhea
- spending too long sitting on the toilet
- not having enough dietary fiber
- overusing enemas or laxatives
- straining during bowel movements
Once you’ve had hemorrhoids, they can return. Researchers haven’t conducted many studies on the rate of recurrence. Researchers in one study in 2004 compared the rate of recurrence of hemorrhoids in 231 people. Some of the study participants received treatment at home, and others had surgery to remove their hemorrhoids. Hemorrhoids recurred in 6.3 percent of the people who had surgery and in 25.4 percent of the people who received at-home treatment.
Changes in diet and your daily routine can help keep hemorrhoids from returning. Home treatments to relieve hemorrhoid symptoms can also prevent future flare-ups. Follow these tips:
- Eat the recommended amount of high-fiber foods and drink plenty of fluids to keep your stools soft and prevent straining during bowel movements. You can also speak with your doctor about taking a stool softener.
- Exercise regularly, which will help keep your bowel movements on a more regular schedule.
- If you’re overweight, lose weight to reduce the pressure on the veins in your rectum and anus.
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