Hemorrhoids (pronounced HEM-uh-roids), are swollen veins in your anus and lower rectum. They are also called piles and are similar to varicose veins.
Hemorrhoids have a number of causes, but most often, the cause is unknown, and they may result from straining during bowel movements or from the increased pressure on these veins during pregnancy.
Hemorrhoids are very common and may be located inside the rectum (internal hemorrhoids), or they may develop under the skin around the anus (external hemorrhoids).
Sometimes, hemorrhoids don’t cause symptoms but at other times they cause itching, discomfort and sometimes bleeding.
By midlife, hemorrhoids often become an ongoing complaint, and by age 50, about half the population has experienced one or more of the classic symptoms, which include rectal pain, itching, bleeding, and possibly prolapsed. Prolapsed hemorrhoids protrude through the anal canal.
Hemorrhoids are rarely dangerous, but they can be a recurrent and painful intrusion.
Types of Hemorrhoids
There are two kinds of hemorrhoids:
- Internal ones, which occur in the lower rectum, and
- External hemorrhoids, which develop under the skin around the anus.
- Thrombosed hemorrhoids: blood may pool in external hemorrhoid and form a clot (thrombus) that can result in severe pain, swelling, inflammation and a hard lump near your anus.
External hemorrhoids are the most uncomfortable because the overlying skin becomes irritated and erodes, and if a blood clot forms inside external hemorrhoid, the pain can be sudden and severe.
You might also feel or see a lump around the anus, and the clot usually dissolves, leaving excess skin tag, which may itch or become irritated.
Internal hemorrhoids are typically painless, even when they produce bleeding, but they may also prolapse, or extend beyond the anus, causing several potential problems.
When hemorrhoid protrudes, it can collect small amounts of mucus and tiny stool particles that may cause an irritation and wiping constantly to try to relieve the itching can worsen the problem.
Symptoms Of Hemorrhoids
Hemorrhoid symptoms usually depend on the location, and may include:
- Painless bleeding during bowel movements
- you might notice small amounts of bright red blood on your toilet tissue or in the toilet
- Itching in your anal region
- Pain or discomfort
- Swelling around the anus
- A lump near the anus, which may be sensitive or painful
The veins around your anus tend to stretch under pressure and may bulge or swell. The swelling can develop from increased pressure in the lower rectum due to the following:
- Straining during bowel movements
- Sitting on the toilet for long periods of time
- Chronic diarrhea or constipation
- Anal intercourse
- Low-fiber diet
- Age: Hemorrhoids are more likely with aging because the tissues that support the veins in your rectum and anus can weaken and stretch.
Complications of hemorrhoids are very rare but include:
- Strangulated hemorrhoid
Why Do Hemorrhoids Bleed?
Straining or passing a particularly hard stool can damage the surface of hemorrhoid. This can cause it to bleed and can happen with both internal and external hemorrhoids. In some cases, a thrombosed hemorrhoid can burst if it becomes too full. This will also result in bleeding.
Prevention and Treatment
The best way to prevent hemorrhoids is to keep your stools soft, so they pass easily, and to prevent hemorrhoids and reduce symptoms of hemorrhoids, follow the following tips:
- Eat high-fiber foods.
- Eat more fruits, vegetables, and whole grains, since doing so softens the stool and increases its bulk, which will help you avoid the straining that can cause hemorrhoids.
- Add fiber to your diet slowly to avoid problems with gas.
- Drink plenty of fluids (drink 8 glasses of water and other liquids, not alcohol) each day to help keep stools soft.
- Consider fiber supplements, as studies have shown that over-the-counter fiber supplements, such as Metamucil and Citrucel, improve overall symptoms and bleeding from hemorrhoids, as they help keep stools soft and regular. Drink plenty of water, otherwise, the supplements can cause constipation or make constipation worse.
- Don’t strain, as straining and holding your breath when trying to pass a stool creates greater pressure in the veins in the lower rectum.
- Go as soon as you feel the urge to pass a bowel movement.
- Exercise, and stay active to help prevent constipation and to reduce pressure on veins, which can occur with long periods of standing or sitting. Exercise will also help you to lose excess weight that may be contributing to your hemorrhoids.
- Avoid long periods of sitting, as sitting too long, particularly on the toilet, can increase the pressure on the veins in the anus.
- Take a sitz bath, which involves soaking your anal area in a few inches of warm water. For extra relief, you may add some Epsom salts to the water.
- Use moist wipes, since toilet paper can be rough and irritating to external hemorrhoids.
- Use a cold pack, wrap it with a towel and sit on it to reduce inflammation and calm the area. Apply for no longer than 20 minutes at a time.
- Use an over-the-counter product, and you can also apply a topical cream to external hemorrhoids. Use a medicated suppository for internal hemorrhoids.
- Treat the clot, and if the clot is more recent, hemorrhoid can be surgically removed or the clot withdrawn from the vein in a minor office procedure performed by a surgeon.