What are hemorrhoids?

Hemorrhoids, sometimes referred to as piles, are swollen or inflamed blood vessels around the lower rectum and anus. This condition is very common, so common that by age 50 about half of all people will have experienced hemorrhoid symptoms at least once. Hemorrhoids almost always come along with bright red blood covering stool and on toilet paper yet differ from rectal bleeding which may be a sign of more serious conditions such as colorectal cancer.  
Hemorrhoids are similar to varicose veins and can be quite painful if left untreated. Some patients may have symptomless hemorrhoids, these do not need to be treated unless they become painful or gain some other symptoms. Painful hemorrhoids can often be treated with simple home remedies and will disappear on their own, however, severe or persistent hemorrhoids can be treated with medication and other medical procedures to avoid complications.  
As briefly mentioned above, there are two types of hemorrhoids: internal and external. Internal hemorrhoids occur in the lower rectum, while external hemorrhoids occur around the anus beneath a layer of skin. Generally, external hemorrhoids are the more painful variety, because they can cause the layer of skin above them to erode and they can result in a blood clot. These clots lead to sudden intense pain, though they are usually not dangerous and dissolve on their own. Internal hemorrhoids are at risk of becoming prolapsed or extending through the anal cavity because of increased pressure.
Risk factors
  • Pregnancy: pregnant women experience more pressure on their lower digestive system and are at a higher risk of developing hemorrhoids
  • Obesity: obese patients also exert more pressure on their lower digestive system
  • Age: adults and the elderly are more at risk for hemorrhoids than children and young adults
Hemorrhoids can generally be diagnosed readily using a physical exam, especially if they are external or if a blood clot has formed. To diagnose internal hemorrhoids, your doctor may perform a digital examination and/or a visual inspection. The digital examination consists of the doctor inserting a gloved finger into the rectum to feel for any unusual growths. Since hemorrhoids can sometimes be too soft to feel, your doctor may use an anoscope (a small scope with a light attached) to observe the inside of your rectum and lower colon.
Occasionally, doctors will use a full colonoscopy to diagnose hemorrhoids. This is typically used when your symptoms are suggestive of an additional digestive system disorder such as colorectal cancer, or if you have never had a colonoscopy before.
Hemorrhoids can usually be treated very successfully using home remedies and over-the-counter medicines. Occasionally, surgery or other procedures may be recommended if your hemorrhoids are severe or persistent, or if complications occur.
Some common treatment options for hemorrhoids are:
  • Eat more fiber
  • Exercise more
  • Don't allow stool to back up- don't wait to go to the bathroom
  • Over-the-counter hemorrhoid creams
  • Sitz bath: a warm bath for the anal area
  • Keep the area clean
  • Over-the-counter pain relievers such as ibuprofen/acetaminophen
  • External hemorrhoid thrombectomy: small procedure to remove a blood clot
  • Rubber band ligation: doctor uses rubber bands to cut off the circulation to internal hemorrhoids
  • Hemorrhoidectomy: surgical removal of hemorrhoids
picture of internal and external hemorrhoids

  • "Hemorrhoids and What to Do about Them - Harvard Health." Harvard Health Blog, Harvard Health Publishing, Oct. 2013, www.health.harvard.edu/diseases-and-conditions/hemorrhoids_and_what_to_do_about_them.
  • "Hemorrhoids Treatment, Symptoms & More." Cleveland Clinic, The Cleveland Clinic Foundation, 2016, my.clevelandclinic.org/health/diseases/15120-hemorrhoids.
  • "Hemorrhoids | Piles." MedlinePlus, U.S. National Library of Medicine, 6 Dec. 2017, medlineplus.gov/hemorrhoids.html.
  • "Hemorrhoids." Mayo Clinic, Mayo Foundation for Medical Education and Research, 6 Mar. 2018, www.mayoclinic.org/diseases-conditions/hemorrhoids/symptoms-causes/syc-20360268.



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