What are Hemorrhoids? Causes, Symptoms and Treatment

Hemorrhoids are like varicose veins. They’re swollen veins in the lower rectum and anus. This can make it feel itchy, uncomfortable, or cause bleeding.1 They might be inside the rectum or under the skin near the anus. And yes, more than half of folks over 50 in the US get them.2

What you feel depends on the type of hemorrhoid. But it might be painless blood when you use the restroom. Or it could be itching, irritation, pain, or seeing the area swollen or discolored.2

The pressure in the lower rectum goes up, leading to hemorrhoids. This happens when you’re pushing too hard on the toilet, are too heavy, expecting a baby, or not eating enough fiber.1

There are many ways to treat hemorrhoids. It could be making changes at home or having surgery, depending on how bad they are.

Key Takeaways

  • Hemorrhoids are swollen veins in the lower rectum and anus that can cause discomfort, itching, and bleeding.
  • Hemorrhoids are a common condition, affecting over half of people over 50 in the US.
  • Symptoms of hemorrhoids include painless bleeding, prolapsed hemorrhoids, itching, irritation, pain, swelling, and discoloration.
  • Hemorrhoids are caused by increased pressure in the lower rectum, often due to straining during bowel movements, obesity, pregnancy, or a low-fiber diet.
  • Treatment options range from home remedies to surgical procedures, depending on the severity of the hemorrhoids.

Overview of Hemorrhoids

Hemorrhoids are swollen veins in the rectum and anus’s lowest part.1 They can be inside your rectum (internal) or under the skin around the anus (external).1 Internal ones may not hurt but can bleed.1 External ones can be itchy and painful, and they might bleed.1 Prolapsed hemorrhoids come out from the anus, and thrombosed ones have a blood clot.

Definition and Types

Hemorrhoids are commonly known as piles.13 They affect veins in the rectum and anus. They are grouped into internal and external types.1 Internal ones are inside the rectum and are often painless but can bleed.1 External ones can be found under the skin around the anus, and they can hurt, itch, and swell.1

Similarities to Varicose Veins

Hemorrhoids and varicose veins have a lot in common.1 They both occur due to weakened vein walls and valves.1 This leads to blood pooling and the veins enlarging.1 The main difference is that hemorrhoids are in the lower rectum and anus, while varicose veins are in the legs.

Symptoms of Hemorrhoids

Internal Hemorrhoid Symptoms

Internal hemorrhoids are inside the rectum and might not show any signs. If there are symptoms, you might see bright red blood on toilet paper or in the toilet after a bowel movement.1 Sometimes, they can prolapse or stretch down to bulge outside the anus. This may cause pain and irritation.4

External Hemorrhoid Symptoms

External hemorrhoids form under the skin around the anus. You may notice itching, irritation, or pain in that area. There could also be swelling and bleeding.14

Thrombosed Hemorrhoid Symptoms

A thrombosed hemorrhoid happens when a blood clot forms in an external hemorrhoid. It leads to severe pain, swelling, and a hard, discolored lump near the anus.1

hemorrhoid symptoms

When to See a Doctor

If your hemorrhoid symptoms don’t get better after a week of home treatment, or if you see blood after going to the bathroom, it’s time to visit a doctor.5 Bleeding from the rectum can signal more serious issues like colorectal cancer. This is especially true if you notice any changes in how often or how normal your bowel movements are, or if your stool’s look is different.6 If you’re losing a lot of blood, feel dizzy, or faint, getting to an emergency room is critical.

6 You should also seek medical attention for hemorrhoids if there’s bleeding during or after bowel movements, not feeling better after a week, worsening symptoms, seeing or feeling a prolapsed hemorrhoid, or having pain that seems unlike hemorrhoid pain.

5 Other reasons to see a gastroenterologist may include bleeding from the rectum, constant pain, noticing your stool changing color, or feeling a lump around the anus.5 To diagnose hemorrhoids, the doctor might do a digital rectal exam and look inside with an anoscope.

5 It’s crucial to see a doctor if your symptoms continue or include bleeding. This is essential to make sure you’re not dealing with something more serious like colon cancer or inflammatory bowel disease.

Causes of Hemorrhoids

Hemorrhoids happen when there is too much pressure in the lower rectum. This makes the veins there swell and get inflamed.1 Things that can cause this pressure include pushing too hard when going to the bathroom. Also, not being able to go often or going too much. Being pregnant, overweight, and lifting heavy things are other causes.1

Increased Pressure in the Lower Rectum

Pressure in the lower rectum can go up from several things. Some are pushing too hard when you use the bathroom. Sitting a lot, not going to the bathroom regularly, or going too much can also cause this. Being overweight, pregnant, doing anal sex, eating a diet low in fiber, and lifting heavy objects are more reasons.1 As we get older, our risk for hemorrhoids goes up too. This is because the tissues that support the veins in the rectum and anus can get weaker.1

Risk Factors

There are certain things that make us more likely to get hemorrhoids. These include getting older (45-65),4 having family members with hemorrhoids, being pregnant,3 not being very active, and health issues that cause not going to the bathroom easily.4 About3 half of all adults will have hemorrhoids by the time they are 50. Many women get them when they are pregnant.3 You’re more likely to get hemorrhoids if you’re pregnant, sit on the toilet too long, are overweight, do things that make you push a lot (like lifting heavy stuff), have family members who’ve had hemorrhoids, go through long periods of not going to the bathroom, have diarrhea often, or are between 45 and 65.3

Complications of Hemorrhoids

Every now and then, hemorrhoids can cause ongoing blood loss. This might lead to anemia. Anemia happens when a person’s body doesn’t have enough healthy red blood cells. This makes someone feel tired often, weak, and look pale.1


Hemorrhoids’ complications can be serious, like anemia or very painful conditions. As people get older, they are more at risk of having hemorrhoids.1

Strangulated Hemorrhoid

When an internal hemorrhoid loses its blood supply, it’s a strangulated hemorrhoid. This situation is extremely painful and may even need quick medical care.1

Blood Clot

At times, a blood clot occurs in an external hemorrhoid, leading to a thrombosed hemorrhoid. It ends up as a sore, swollen area near the anus but usually doesn’t pose a severe threat to health.1

Complications of Hemorrhoids

Preventing Hemorrhoids

To avoid hemorrhoids, it’s vital to make sure your bowel movements are effortless. You can do this by having a meal filled with fiber and drinking lots of water.1

Fruits, veggies, and whole grains are great for fiber. If you need more, try fiber supplements like psyllium. But, remember to drink extra water when you take them.1

Dietary Fiber and Fluids

Eating more fiber and staying hydrated are excellent ways to prevent hemorrhoids. Fiber adds bulk to your stools, making them smooth to pass. This lessens the pressure on those important veins.1

Drinking 6 to 8 glasses of water daily is also crucial. It aids in keeping stools from getting too hard. This guards against hemorrhoids.1

Avoiding Straining

Straining during bowel movements can be bad news. It builds up pressure in the rectal veins, potentially causing hemorrhoids.17 Avoid straining by letting nature take its course. Prolonged time on the toilet can have the same effect.17

Exercise and Weight Management

Staying active and keeping a healthy weight also play a big role. Moving your body helps with digestion and keeps your blood flowing smoothly.17 Being overweight can squeeze the veins near your anus, which isn’t good.1

If you’re carrying extra weight, shedding some pounds can lower your hemorrhoid risk.1

Diagnosis of Hemorrhoids

A doctor checks for hemorrhoids by looking at the anus and rectum. They want to see if there are any swollen veins or other issues.8 They might do a digital rectal exam too. This means they use a finger, covered with a glove and lubricant, to feel inside for lumps or pain.8

Additional Tests

To look deeper, doctors might do other tests. These could include an anoscopy, sigmoidoscopy, or colonoscopy.8 Anoscopy uses a short plastic tube to check the anal canal. Sigmoidoscopy views the lower part of the colon with a flexible tube. Colonoscopy looks at the whole colon.8 These thorough checks help confirm if it’s hemorrhoids and not something else causing the symptoms.

Treatment Options for Hemorrhoids

People can often soothe mild hemorrhoid symptoms at home. They do this by:

  • Adding more fiber and water to their diet to make stools softer9
  • Using creams, ointments, or suppositories bought over-the-counter to ease swelling and pain
  • Enjoying warm sitz baths
  • Putting ice packs on the swollen area

If hemorrhoids are serious or don’t get better, non-surgical options exist. These include:

  • Using an injection to shrink the hemorrhoid10
  • Placing a rubber band around it to cut off its blood and make it drop off10
  • Healing the hemorrhoid with a laser or heat to stop its blood flow10

When non-surgical treatments aren’t enough, surgery might be necessary. The doctor can choose from methods like:

  • Hemorrhoidectomy, which involves cutting out the hemorrhoid10
  • Stapled hemorrhoidopexy, an operation that moves the hemorrhoid back into place10
  • Infrared coagulation, where an infrared light reduces the size of the hemorrhoid10

Deciding on the right treatment depends on many factors. These include how severe the hemorrhoids are, a person’s health history, and their own choices. Speaking with a healthcare professional is key to finding the best hemorrhoid treatment for you.

What are Hemorrhoids?

Hemorrhoids are swollen and inflamed veins in the rectum and anus. They come in two types: internal and external.4

Internal vs. External Hemorrhoids

Internal hemorrhoids are inside the rectum, often unnoticed but they may bleed.4 External ones form under anus’s skin. They hurt, itch, and make the area swell.4

Prolapsed and Thrombosed Hemorrhoids

Prolapsed hemorrhoids extend outside the anus and can be painful.4 Thrombosed hemorrhoids happen when a blood clot blocks an external one, causing a lot of pain, swelling, and color changes.4

Alternative Treatments for Hemorrhoids

Herbal Remedies

Some people find relief in herbal supplements for treating [herbal remedies for hemorrhoids, alternative hemorrhoid treatments]. Witch hazel is commonly used for its quick, soothing effects when applied on the skin11. Other herbs like goldenrod, gotu kola, and yarrow are also known, but they need more study to confirm how well they work11.

Dietary Supplements

Fiber supplements help by making sure stools are soft and easy to pass11. This can prevent and treat [supplements for hemorrhoids, alternative hemorrhoid treatments]. Additionally, probiotic supplements aim to improve gut health, which might ease hemorrhoid symptoms11.

Before starting any new supplement, it’s wise to first chat with a doctor. They can provide guidance tailored to your health needs.

Living with Hemorrhoids

Hemorrhoids are common, with 1 in 20 Americans affected.4 Over half of those over 50 have them.4 They can be ongoing, but there are ways to cope and reduce their impact on your life.

Preventing Flare-ups

Maintaining healthy bowel habits is key to avoid flare-ups.4 This includes a diet rich in fiber and plenty of water. Avoiding straining when you use the bathroom keeps stools soft, lessening vein pressure.4

Daily walks improve blood flow and bowel health, preventing hemorrhoids.4 It’s also important to keep a healthy weight and not delay bathroom visits. These habits lower the chance of hemorrhoid issues.4

Managing Discomfort

If hemorrhoids cause pain, you can ease it with over-the-counter products.4 Creams, pads, or suppositories can reduce swelling.4

A cold pack on the area or warm sitz baths lessen discomfort. Using a special cushion when you sit can also help.4 Some find relief in natural solutions like witch hazel in baths.4

Even though hemorrhoids can be bothersome, these tips for prevention and care can improve your life.4 If things don’t get better, seeing a doctor is important for the right care.4


Many people, especially as they get older, get affected by hemorrhoids. A study showed that 39% of those getting routine cancer checks had hemorrhoids. More than half had no symptoms. Even though hemorrhoids can be uncomfortable, you can handle them with home care, lifestyle changes, and treatments.

To tackle hemorrhoids, it’s vital to know why they happen, their signs, and how to treat them. They are common in people between 45 and 65. Over a quarter of women get them during pregnancy. Eating lots of fiber, drinking plenty of water, and not straining during bowel movements can stop hemorrhoids from forming.

If your symptoms don’t go away or get worse, see a doctor.12 For painful internal hemorrhoids, rubber band ligation is a treatment option. It has a 72% success rate for both new and old cases. By combining self-care with professional help, you can beat hemorrhoids. This way, your health and life quality won’t be as affected.


What are hemorrhoids?

Hemorrhoids are swollen veins at the rectum’s lowest part. They cause discomfort, itching, and bleeding. Like varicose veins, they can be inside the rectum (internal hemorrhoids) or under the skin of the anus (external hemorrhoids).

What are the types of hemorrhoids?

There are main two types: internal and external hemorrhoids. Internal ones are inside the rectum. External types grow under the skin around the anus. There are also prolapsed hemorrhoids that come out of the anus and thrombosed ones that have a blood clot.

What are the symptoms of internal and external hemorrhoids?

Internal hemorrhoids mostly cause bleeding without pain during bowel movements. External hemorrhoids can itch, irritate, and are painful. They may swell and bleed. Thrombosed hemorrhoids lead to serious pain, swelling, and a lump near the anus.

When should I see a doctor for hemorrhoids?

If home treatments don’t fix the symptoms within a week, see a doctor. Rectal bleeding also requires medical attention. It might not be from hemorrhoids. Emergency care is needed for heavy bleeding, lightheadedness, or fainting.

What causes hemorrhoids?

Increased pressure in the lower rectum mainly causes hemorrhoids. This can be due to straining, being overweight, pregnant, or not eating enough fiber. Risks increase with age, a family history, inactivity, and certain health conditions.

What are some complications of hemorrhoids?

Continued blood loss may lead to anemia. A strangulated hemorrhoid can cause severe pain. It needs urgent treatment. A blood clot in an external hemorrhoid creates a painful, swollen lump.

How can I prevent hemorrhoids?

Keep stools soft by eating plenty of fiber, drinking water, and not straining. A healthy, active life and maintaining a proper weight also reduce the risk of hemorrhoids.

How are hemorrhoids diagnosed?

Doctors diagnose hemorrhoids with a physical exam. They look at the anus and rectum. They might also do a digital rectal exam or recommend tests like anoscopy, sigmoidoscopy, or colonoscopy.

What are the treatment options for hemorrhoids?

Home remedies help mild symptoms such as more fiber and water, OTC creams, and ice packs. Severe or persistent cases may need non-surgical treatments or surgery if these fail.

Are there any alternative treatments for hemorrhoids?

Some look to herbal supplements like witch hazel, goldenrod, gotu kola, and yarrow. But proof of their help is slim. Fiber supplements and probiotics may relieve symptoms too.

How can I manage hemorrhoids and prevent flare-ups?

Maintain healthy bowel habits, a high-fiber diet, good hydration, and regular exercise to lessen flare-ups. When symptoms occur, OTC creams, warm baths, cold compresses, and a hemorrhoid cushion can ease discomfort.

Source Links

  1. https://www.mayoclinic.org/diseases-conditions/hemorrhoids/symptoms-causes/syc-20360268
  2. https://www.healthline.com/health/hemorrhoids
  3. https://www.hopkinsmedicine.org/health/conditions-and-diseases/hemorrhoids
  4. https://www.webmd.com/digestive-disorders/understanding-hemorrhoids-basics
  5. https://www.houstonmethodist.org/blog/articles/2022/apr/when-to-see-a-doctor-for-hemorrhoids/
  6. https://www.medstarhealth.org/blog/5-signs-its-time-to-seek-care-for-hemorrhoids
  7. https://health.clevelandclinic.org/5-simple-ways-you-can-prevent-hemorrhoids
  8. https://www.niddk.nih.gov/health-information/digestive-diseases/hemorrhoids/diagnosis
  9. https://www.aafp.org/pubs/afp/issues/2018/0201/p172.html
  10. https://www.mayoclinic.org/diseases-conditions/hemorrhoids/diagnosis-treatment/drc-20360280
  11. https://www.stlukes-stl.com/health-content/medicine/33/000077.htm
  12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4755769/