Hemorrhoids
What Are Hemorrhoids?
Hemorrhoids are swollen and inflamed blood vessels in the rectum or anus. They can develop inside the rectal canal (internal hemorrhoids) or under the skin around the anus (external hemorrhoids). Hemorrhoids are common and may occur due to increased pressure in the lower rectum or straining during bowel movements.
While hemorrhoids can be uncomfortable, they are usually not serious and can often be treated with lifestyle changes, over‑the‑counter remedies, or medical procedures when needed.
Causes and Risk Factors
Hemorrhoids develop when veins in the anus or lower rectum stretch under pressure. Common causes and risk factors include:
- Chronic constipation or straining during bowel movements
- Sitting for long periods, especially on the toilet
- Pregnancy and childbirth
- Obesity
- Aging and weakened tissue support
- Heavy lifting or frequent straining
Signs and Symptoms
Symptoms of hemorrhoids may vary depending on the type and severity, but often include:
- Pain or irritation around the anus
- Itching or discomfort in the anal area
- Bright red blood on toilet tissue or in the toilet bowl
- Swelling or lumps near the anus
- Mucus discharge after bowel movements
External hemorrhoids may be painful, especially if a blood clot forms (thrombosed), while internal hemorrhoids may bleed without causing pain.
Diagnosis
Diagnosis typically begins with a discussion of symptoms and a physical examination. Your provider may perform one or more of the following:
- Visual inspection of the anal area
- Digital rectal exam to feel for abnormalities
- Anoscopy to visualize internal hemorrhoids
- Colonoscopy or sigmoidoscopy when needed to rule out other causes of bleeding or symptoms
Treatment Options
Treatment for hemorrhoids depends on symptom severity and may include:
- Lifestyle and diet changes — increased fiber, hydration, and regular bowel habits
- Topical treatments and warm sitz baths to relieve pain and itching
- Medicated suppositories or creams
- Minimally invasive procedures — rubber band ligation, sclerotherapy, or infrared coagulation
- Surgical hemorrhoidectomy for large or persistent hemorrhoids that do not respond to conservative treatment
Most cases improve with conservative measures, but some patients benefit from procedural interventions to reduce symptoms and prevent recurrence.
