Overview

Hemorrhoids (HEM-uh-roids), also called piles, are swollen veins in the anus and lower rectum. Hemorrhoids are similar to varicose veins. Hemorrhoids can develop inside the rectum (internal hemorrhoids) or under the skin around the anus (external hemorrhoids).

Symptoms

The symptoms of hemorrhoids usually depend on the type of hemorrhoid.

Internal Hemorrhoids

Internal hemorrhoids lie inside the rectum. You usually can’t see or feel them, and they rarely cause discomfort. But straining or irritation when passing stool can cause:

– Painless bleeding during bowel movements
– A hemorrhoid to push through the anal opening, called a prolapsed or protruding hemorrhoid (may result in pain and irritation)

External Hemorrhoids

External hemorrhoids develop under the skin around the anus. Symptoms might include:

– Itching or irritation in the anal region
– Pain or discomfort
– Swelling around the anus
– Bleeding

Thrombosed Hemorrhoids

Blood can pool in an external hemorrhoid and form a clot, called a thrombus. A thrombosed hemorrhoid can result in:

– Severe pain
– Swelling
– Inflammation
– A hard, discolored lump near the anus

When to See a Doctor

If you have bleeding during bowel movements or hemorrhoids that don’t improve after a week of home care, talk to your healthcare provider. Don’t assume rectal bleeding is due to hemorrhoids, especially if you have changes in bowel habits or stool color/consistency.

Seek emergency care if you have:

– Large amounts of rectal bleeding
– Lightheadedness
– Dizziness
– Faintness

Causes

The veins around the anus tend to stretch under pressure and may bulge or swell. Hemorrhoids can develop from increased pressure in the lower rectum due to:

– Straining during bowel movements
– Sitting for long periods
– Chronic diarrhea or constipation
– Obesity
– Pregnancy
– Anal intercourse
– Low-fiber diet
– Regularly lifting heavy items

Risk Factors

As people age, the risk of hemorrhoids increases. This is because the tissues that support the veins in the rectum and anus can weaken and stretch.

Complications

Complications of hemorrhoids are rare but may include:

– Anemia (rarely, ongoing blood loss from hemorrhoids may cause anemia)
– Strangulated hemorrhoid (when the blood supply to an internal hemorrhoid is cut off)
– Blood clot (sometimes a clot can form in a hemorrhoid, called a thrombosed hemorrhoid)

Prevention

The best way to prevent hemorrhoids is to keep your stools soft so they pass easily. To prevent hemorrhoids and reduce symptoms:

– Eat high-fiber foods (fruits, vegetables, whole grains)
– Drink plenty of fluids (6-8 glasses of water/day)
– Consider fiber supplements (psyllium or methylcellulose)
– Exercise regularly
– Avoid long periods of sitting
– Avoid straining during bowel movements

Diagnosis and Treatment

Consult a doctor for proper diagnosis. Treatment options are available.