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Hemorrhoids are swollen and inflamed veins in your anus and lower rectum, which may result from straining during bowel movements or from the increased pressure on these veins. Hemorrhoids may be located inside the rectum (internal hemorrhoids), or they may develop under the skin around the anus (external hemorrhoids).


Hemorrhoids are common. By age 50, about half of adults have experienced the itching, discomfort, and bleeding associated with hemorrhoids.

Hemorrhoid symptoms depend on where the hemorrhoids are located.

Internal hemorrhoids are inside the rectum and aren’t usually painful. However, straining passing stool can damage the hemorrhoid and cause it to bleed. Sometimes, straining will push an internal hemorrhoid through the anal opening, which can cause pain and irritation.

External hemorrhoids are under the skin around your anus and can itch or bleed. Sometimes an external hemorrhoid will form a clot when blood pools causing swelling, inflammation, and extreme pain.

Symptoms of hemorrhoids may include:

  • Painless bleeding during bowel movements — you might notice small amounts of bright red blood on your toilet tissue or in the toilet bowl
  • Itching or irritation
  • Pain or discomfort
  • Swelling
  • A lump near your anus, which may be sensitive or painful
  • Leakage of feces

Causes and Risk Factors

Hemorrhoids develop from pressure on the lower rectum, which causes swelling in the veins.

Factors that might cause increased pressure include:

  • Straining during bowel movements
  • A low-fiber diet
  • Sitting for long periods of time on the toilet
  • Chronic diarrhea or constipation
  • Obesity
  • Pregnancy
  • Anal intercourse

Age also plays a role in the possibility of developing hemorrhoids because the tissues that support the veins in your rectum and anus can weaken and stretch as you get older.

Diagnostic Tests

Bleeding during bowel movements is the most common sign of hemorrhoids, but don't assume that bleeding is coming from hemorrhoids without consulting a doctor.

Your doctor will start with a medical history, do a physical examination, and perform other tests to diagnose hemorrhoids and rule out more serious conditions or diseases.

Your doctor may also perform additional tests to aid in diagnosis including:

  • Anoscopy to view the rectum.
  • Colonoscopy to view the entire colon.
  • Sigmoidoscopy to view the sigmoid colon
  • Barium enema X-ray

Treatment and Procedures

Fortunately, many effective options, non-invasive techniques can treat hemorrhoids. Most people can get relief from symptoms using home treatments and lifestyle changes.

  • Eating a high-fiber diet to make stools softer and easier to pass
  • Drinking six to eight 8-ounce glasses of water or other nonalcoholic fluids each day
  • Sitting in a tub of warm water for 10 minutes several times a day
  • Exercising to prevent constipation
  • Not straining during bowel movements
  • Over-the-counter creams and suppositories to temporarily relieve the pain and itching

Your doctor may recommend additional treatments for hemorrhoids if the above treatments are ineffective.

  • Rubber band ligation which cuts off circulation to the hemorrhoid causing it to shrink
  • Sclerotherapy in which a chemical solution is injected into the blood vessel shrinking the hemorrhoid.
  • Infrared coagulation which uses heat to shrink the hemorrhoid

Large external hemorrhoids or internal hemorrhoids that do not respond to other treatments can be surgically removed.

Your health is our greatest concern. Please contact the Center for Colon & Rectal Surgery at 407.303.2615for a private consultation today.