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.
The blood vessels around the anus swell and may bleed or cause other symptoms. The exact cause of hemorrhoids is not always clear.
A person may have hemorrhoids for years without experiencing any symptoms.
If symptoms do occur, they most often include: a lump around the anusmucus-like discharge from the rectumrectal bleeding, which may be seen as red streaks on the toilet paper or blood in the toilet bowlrectal pain and itching
Hemorrhoids are dilated blood vessels, but the reasons why they occur are not always clear. Some types of hemorrhoids run in families.
Other factors that increase a person's risk for hemorrhoids include: alcoholismanal intercoursechronic diarrheacancer of the rectum or colona diet that lacks fiberfrequent coughing and sneezingliver disease, such as cirrhosisloss of muscle tone in the rectum due to aging and rectal surgeryobesityjobs that require standing or sitting for long periods of timepregnancystraining due to constipation
One of the best ways to avoid hemorrhoids is to prevent the pressure and straining that come from constipation.
The following actions can reduce the impact of hemorrhoids: avoiding sitting in one place for long periods of timedrinking six to eight glasses of fluid each dayeating a diet high in fiberexercising regularlylimiting the time one spends on the toiletmaintaining a healthy body weight
Many times, hemorrhoids are related to liver disease caused by alcohol abuse. It is important to drink alcohol only in moderation if at all.
To diagnose hemorrhoids, the healthcare professional will start with a medical history and physical exam. As part of the exam, he or she will feel for internal hemorrhoids by inserting a lubricated finger into the rectum. This is called a digital rectal exam.
Sometimes a hollow, lighted tube called an anoscope is used to view internal hemorrhoids.
To rule out other disorders, the healthcare professional may order a sigmoidoscopy or proctoscopy. These tests also use a lighted tube, but look further inside the bowel than the rectum. Blood tests may also be needed.
If hemorrhoids are not effectively treated, they tend to worsen and infections may develop as a result. An anorectal abscess or anal fissure could result. A person may also lose the ability to control his or her bowel movements. If bleeding continues, a low red blood cell count, called anemia, can develop.
Hemorrhoids are not contagious and pose no risk to others.
Many times hemorrhoids resolve without any type of treatment.
The following measures can help to ease pain, decrease swelling, and regulate bowel movements: over-the-counter hemorrhoidal creams, lotions, or suppositories to relieve painice packs to reduce the swellingstool softeners or laxatives to prevent constipationsitting in a warm tub or sitz bath three to four times a day
If hemorrhoids are severe or treatment is not effective, the healthcare professional may recommend hemorrhoid surgery. A variety of procedures can be used to remove hemorrhoids or reduce their size.
Medicines used to treat hemorrhoids may cause allergic reactions. Surgery can be complicated by bleeding, infection, or allergic reaction to the anesthetic.
Symptoms may subside for a time if you prevent straining during a bowel movement. However, flare-ups of hemorrhoids are common. Hemorrhoid surgery may provide a permanent cure for the problem.
The healthcare professional will check for further problems by doing a digital exam during a regular check-up. Any new or worsening symptoms should be reported.
Professional Guide to Diseases, Sixth Edition. Springhouse: Springhouse Corporation, 1998.
Griffith, H. Winter. Instructions for Patients. Philadelphia:W.B. Saunders Company,1994.
NIH Publication No. 95-3021, National Digestive Disease Information Clearinghouse, 2 Information Way, Bethesda, MD 20892