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Hemorrhoids are painful, swollen and inflamed veins around the anus or in the lower rectum. The rectum is the last part of the large intestine leading to the anus. The anus is the opening at the end of the digestive tract where bowel contents leave the body.

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.

Hemmorrhoids result from increased pressure in the veins of the anus. The pressure causes the veins to swell, making them painful, particularly when you are sitting.

Hemorrhoids are not dangerous or life threatening.

Drawing of the rectum and anus with an internal hemorrhoid and an external hemorrhoid labeled.
Symptoms of hemorrhoids include the following:

  • Anal itching
  • Anal ache or pain, especially while sitting
  • Bright red blood on toilet tissue, stool, or in the toilet bowl. 
  • Pain during bowel movements.
  • One or more hard tender lumps near the anus

Symptoms usually go away within a few days, and some people with hemorrhoids never have symptoms.

How hemorrhoids are diagnosed:

The doctor will perform a physical exam to look for visible hemorrhoids. A digital rectal exam with a gloved, lubricated finger and an anoscope—a hollow, lighted tube—may be performed to view the rectum.

Additional exams may be done to rule out other causes of bleeding, especially in people age 40 or older. For example:

  • Colonoscopy. 
  • Sigmoidoscopy.
  • Barium enema x ray:  A contrast material called barium is inserted into the colon to make the colon more visible in x-ray pictures.

Treatment

  • At-home Treatments
    • Simple diet and lifestyle changes often reduce the swelling of hemorrhoids and relieve hemorrhoid symptoms. Eating a high-fiber diet can make stools softer and easier to pass, reducing the pressure on hemorrhoids caused by straining. Fiber is a substance found in plants. The human body cannot digest fiber, but fiber helps improve digestion and prevent constipation. Good sources of dietary fiber are fruits, vegetables, and whole grains. (For more fiber foods, click here.)On average, Americans eat about 15 grams of fiber each day.3 The Academy of Nutrition and Dietetics (formerly the American Dietetic Association) recommends 25 grams of fiber per day for women and 38 grams of fiber per day for men.3
    • Doctors may also suggest taking a bulk stool softener or a fiber supplement such as psyllium (Metamucil) or methylcellulose (Citrucel).
    • Other changes that may help relieve hemorrhoid symptoms include
      • Drinking six to eight 8-ounce glasses of water or other nonalcoholic fluids each day
      • Sitting in a tub of warm water for 10 minutes several times a day
      • Exercising to prevent constipation
      • Not straining during bowel movements
      • Witch hazel (applied with cotton swabs) can reduce itching. Other steps to reduce itching include:
      • Wear cotton undergarments
      • Avoid toilet tissue with perfurmes or colors. Use baby wipes instead.
      • Try not to scratch the area.
      • Sitz baths can help you to feel better. Sit in warm water for 10 to 15 minutes.
    • Over-the-counter remedies such as:
      • Corticosteroid creams to help reduce pain and swelling 
      • Hemorrhoid creams with lidocaine to help reduce pain 
      • Stool softeners help reduce straining and constipation
      • Suppositories may temporarily relieve the pain and itching of hemorrhoids. 
      • These treatments should only be used for a short time because long-term use can damage the skin.
  • Medical Treatment
    • If at-home treatments do not relieve symptoms, medical treatments may be needed. Outpatient treatments can be performed in a doctor’s office or a hospital. Outpatient treatments for internal hemorrhoids include the following:
      • Rubber band ligation. The doctor places a special rubber band around the base of the hemorrhoid. The band cuts off circulation, causing the hemorrhoid to shrink. This procedure should be performed only by a doctor.
      • Sclerotherapy. The doctor injects a chemical solution into the blood vessel to shrink the hemorrhoid.
      • Infrared coagulation. The doctor uses heat to shrink the hemorrhoid tissue.
    • Large external hemorrhoids or internal hemorrhoids that do not respond to other treatments can be surgically removed.

When to call your doctor or other health care provider

Call your health care provider if hemorrhoid symptoms do not improve with home treatment. You should also be seen if you have rectal bleeding. 

Call 911 if you lose a lot of blood, or if you are bleeding and feel dizzy, lightheaded, or faint.