Introduction
Hemorrhoids are swollen veins in the anus and rectum that can cause pain, itching, and bleeding. They are a common condition, affecting many adults at some point in their lives. Hemorrhoids can be located inside the rectum (internal hemorrhoids) or under the skin around the anus (external hemorrhoids).
Causes
Hemorrhoids are usually caused by increased pressure in the lower rectum due to:
- Straining during bowel movements
- Chronic constipation or diarrhea
- Obesity
- Pregnancy
- Sitting for long periods on the toilet
- Aging (as tissues weaken)
- Anal intercourse
Symptoms
Symptoms of hemorrhoids can vary depending on the type and severity:
- Internal hemorrhoids:
- Painless bleeding during bowel movements (bright red blood on toilet paper or in the toilet bowl)
- Prolapse (protrusion) of the hemorrhoid through the anal opening, which may cause pain and irritation
- External hemorrhoids:
- Painful swelling or a hard lump around the anus
- Itching or irritation in the anal area
- Bleeding if the hemorrhoid becomes thrombosed (forms a blood clot)
Diagnosis
Diagnosis is usually based on:
- Medical history and physical examination
- Visual inspection of the anal area
- Digital rectal examination
- Anoscopy or sigmoidoscopy to examine the rectum and lower colon
Treatment Options
Treatment for hemorrhoids depends on the severity of symptoms:
- Self-care measures:
- Eating a high-fiber diet and drinking plenty of fluids to soften stools
- Using over-the-counter creams, ointments, or suppositories to relieve pain and itching
- Taking warm sitz baths
- Avoiding straining during bowel movements
- Medical procedures:
- Rubber band ligation (placing a rubber band around the base of the hemorrhoid to cut off blood supply)
- Sclerotherapy (injecting a chemical solution into the hemorrhoid to shrink it)
- Coagulation techniques (using laser, infrared, or radiofrequency energy to destroy the hemorrhoid)
- Hemorrhoidectomy (surgical removal of the hemorrhoid) for severe or persistent cases
Prevention
To help prevent hemorrhoids:
- Eat a high-fiber diet
- Drink plenty of fluids
- Avoid straining during bowel movements
- Exercise regularly
- Maintain a healthy weight
- Avoid sitting for long periods on the toilet
When to Seek Medical Care
Seek medical attention if you experience:
- Rectal bleeding that is heavy or persistent
- Severe pain or swelling around the anus
- Symptoms that do not improve with self-care measures
Takeaway
Hemorrhoids are a common condition that can cause discomfort and bleeding. Most cases can be managed with self-care measures, but medical procedures may be needed for more severe or persistent symptoms.