What are hemorrhoids?
Hemorrhoids are swollen and inflamed veins around the anus or in the lower rectum. External hemorrhoids are located under the skin around the anus. Internal hemorrhoids develop in the lower rectum. Internal hemorrhoids may protrude, or prolapse, through the anus. Most prolapsed hemorrhoids shrink back inside the rectum on their own. Severely prolapsed hemorrhoids may protrude permanently and require treatment. Chronic constipation, straining with bowel movements, sitting on the toilet for a long time, lifting heavy weights, pregnancy and a low fiber diet can contribute to hemorrhoids.
What are the symptoms of hemorrhoids?
Symptoms can depend on the type of hemorrhoid you have. The two types are internal or external hemorrhoids. Internal hemorrhoids don’t usually cause problems but if there is irritation or straining with bowel movements it can cause bleeding; which might show up on toilet paper or in the toilet. If a hemorrhoid becomes prolapsed, it can often cause pain, discomfort, and anal itching. External hemorrhoids cause bleeding, painful swelling or itching around the anus. Sometimes blood can pool with external hemorrhoids which can cause a hard, painful lump to form. Make sure you talk to your doctor if you any rectal bleeding, blood in the toilet or blood on toilet paper as this can be a sign of something more serious.
How are hemorrhoids diagnosed?
A doctor can perform a physical exam to look for visible external hemorrhoids. A digital rectal exam might be performed to see if you have internal hemorrhoids. A colonoscopy or sigmoidoscopy can also be used to diagnosis hemorrhoids, usually if you have symptoms suggestive of another disease or have risk factors for colon cancer.
How are hemorrhoids treated?
Often, at home medications and simple diet changes can help treat hemorrhoids. Over the counter hemorrhoid creams or suppositories can help relieve any pain or swelling. A diet high in fruits, vegetables, whole grains along with drinking plenty of water can help keep your stool soft and avoid straining. You can also take a fiber supplement like Metamucil or Citrucel.
If at‐home treatments do not relieve symptoms, other medical treatments may be needed.
- Rubber band ligation (hemorrhoid banding) : The doctor places a special rubber band around the base of the hemorrhoid. The band cuts off circulation, causing the hemorrhoid to shrink.
- Sclerotherapy: The doctor injects a chemical solution into the blood vessel to shrink the hemorrhoid.
- Coagulation: The doctor uses heat to shrink the hemorrhoid tissue.
- Surgery: While rare, surgery can be an option to remove large external hemorrhoids or internal hemorrhoids that do not respond to other treatments.
Source
Mayo Clinic. 2023. Hemorrhoids. https://www.mayoclinic.org/diseases-conditions/hemorrhoids/symptoms-causes/syc-20360268
