Overview, Causes, & Risk Factors
Hemorrhoids are swollen blood vessels that are found in and around the anus and lower
rectum. They can be internal, which means inside the anus. Or, they may be external, which means they are found
outside the anus.
What is going on in the body?
The blood vessels around the anus swell and may bleed or
cause other symptoms. The exact cause of hemorrhoids is not always clear.
What are the causes and risks of the condition?
Hemorrhoids are related to dilated blood vessels, but the exact cause is not always clear. Some types of
hemorrhoids run in families. Other factors that increase your risk for
cancer of the rectum or colon
a diet that lacks fiber
liver disease, such
loss of muscle tone in the rectum due to aging and rectal surgery
jobs that require standing or sitting for long periods of time
straining due to constipation
Symptoms & Signs
What are the signs and symptoms of the condition?
You may have hemorrhoids for years without them causing any health problems. If
you do have symptoms, they most often include:
a lump around the anus
mucus-like discharge from the rectum
rectal bleeding, which may be seen as red streaks on the toilet paper or blood in the toilet bowl
rectal pain and itching
Diagnosis & Tests
How is the condition diagnosed?
To diagnose hemorrhoids, your doctor will start with a medical history and physical exam.
As part of the exam, your doctor will feel for internal hemorrhoids by inserting a lubricated finger into
your rectum. This is called a digital exam. Sometimes your doctor may use a hollow, lighted tube called an
to view internal hemorrhoids. To rule out other disorders, he or she may
order a sigmoidoscopy
or proctoscopy. These tests also use
a lighted tube, but look at your bowel, rather than your rectum. Your doctor may also order blood tests.
Prevention & Expectations
What can be done to prevent the condition?
One of the best ways to avoid hemorrhoids is to prevent the pressure and straining
that come from constipation. To lessen the impact
of your hemorrhoids, take these actions:
avoid sitting in one place for long periods of time
drink six to eight glasses of fluid each day
eat a diet high in fiber
limit the time you spend on the toilet
maintain a healthy body weight
Many times, hemorrhoids are related to liver disease caused by alcohol abuse.
It's important to avoid alcohol
intake or, if you must drink, to do so only in moderation.
What are the long-term effects of the condition?
If hemorrhoids are not effectively treated, you may develop infections as a result.
You are at risk for an anorectal
abscess or anal fissure.
You may also lose the ability to control your bowel movements. If bleeding
continues, a low red blood cell count, called anemia,
What are the risks to others?
Hemorrhoids are not contagious and pose no risk to others.
Treatment & Monitoring
What are the treatments for the condition?
Many times, hemorrhoids resolve without any type of treatment. Take these measures to ease your pain,
decrease swelling, and regulate your bowel movements:
use hemorrhoidal creams, lotions, or suppositories to relieve pain
apply ice packs to reduce the swelling
take stool softeners or laxatives to prevent constipation
sit in a warm tub or sitz bath three to four times a day
If hemorrhoids are severe or treatment is not effective, the
doctor may recommend hemorrhoid surgery.
A variety of procedures can be used to remove hemorrhoids or reduce their size.
What are the side effects of the treatments?
Medicines used to treat hemorrhoids may cause allergic reactions. Surgery
can cause bleeding, infection, or allergic reaction
What happens after treatment for the condition?
Symptoms may subside for a time if you prevent straining when
you have a bowel movement. However, flare-ups of hemorrhoids are common.
Hemorrhoid surgery may provide a permanent cure
for the problem.
How is the condition monitored?
The doctor will check for further problems by doing a digital
exam during your regular check-ups. Always report any new or worsening symptoms
to your doctor.