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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.
External hemorrhoids are the most common and most troublesome. Hemorrhoids cause pain, severe itching, and difficulty sitting. Fortunately, they are treatable.
Symptoms of hemorrhoids include:
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.
Experts aren’t sure what causes hemorrhoids to develop. Possible factors include:
Hemorrhoids can be passed on genetically from parent to child, so if your parents had hemorrhoids, you’re more likely to get them. Consistent heavy lifting, being obese, or having other constant strain on your body can increase your risk of hemorrhoids.
Standing too much without taking a break to sit can cause hemorrhoids to develop. Consistent anal sexual intercourse and diarrhea can also increase your risk of hemorrhoids.
A visual examination of your anus may be enough to diagnose hemorrhoids. To confirm the diagnosis, your doctor may 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.
Treatment for hemorrhoids can occur at home or at a doctor’s office.
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 unbearable, use an over-the-counter medicated suppository, ointment, or cream to relieve the burning and itching.
Over-the-counter topical treatments, such as hydrocortisone or hemorrhoid cream, can ease your discomfort from hemorrhoids. Soaking your anus in a sitz bath for 10 to 15 minutes per day can also help.
Practice good hygiene by cleaning your anus with warm water during a shower or bath every day. But don’t use soap, as soap can aggravate hemorrhoids. Also avoid using dry or rough toilet paper when you wipe after a bowel movement.
If home treatments aren’t helping with your 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. This procedure should only be performed by a medical professional. Do not try this at home.
If rubber band ligation isn’t an option in your case, your doctor may perform injection therapy, or sclerotherapy. In this procedure, your doctor injects a chemical into the blood vessel directly. This causes the hemorrhoid to reduce in size.
To prevent or avoid worsening hemorrhoids, avoid straining during a bowel movement. Also, try to increase your water intake. Drinking enough water can keep your stool from hardening.
Use the restroom as soon as you feel a bowel movement coming on to prevent hemorrhoids from developing. Exercise regularly to prevent becoming constipated, and don’t sit for long periods, especially on hard surfaces like concrete or tile.
Consuming foods that are high in dietary fiber can minimize the risk of developing hemorrhoids in the future.
Good dietary fiber sources include:
Dietary fiber helps create bulk in the intestines, which softens the stool, making it easier to pass.
Complications from hemorrhoids are rare, but can include:
With proper treatment, you’ll likely experience an improvement. Following your doctor’s directions and maintaining a regimen, including exercise and avoiding sitting for long periods of time, that reduces hemorrhoid symptoms can also improve your outlook.
Written by: April Kahn and Tim Jewell
Medically reviewed on: Oct 07, 2016: Steve Kim, MD
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