Hemorrhoids

Overview and Facts about Hemorrhoids

Hemorrhoids are a common condition affecting your anus and rectum, in which the veins become swollen and sensitive. Straining during bowel movements, poor digestive health or increased internal pressure due to pregnancy are factors contributing to the development of hemorrhoids.

While hemorrhoids are not considered dangerous, in some cases a blood clot may form inside the swollen vein (called a thrombosed hemorrhoid), causing severe discomfort and pain.

Symptoms and Signs of Hemorrhoids

Signs and symptoms of hemorrhoids depend on their location: whether the hemorrhoid is internal (inside the rectum) or external (in the skin around the anus).

Thrombosed hemorrhoids occur when a blood clot forms in the vein, resulting in a hard lump associated with severe swelling, inflammation, and pain.

Signs and symptoms of hemorrhoids include:

• A lump near the anus, which is painful or sensitive
• Bleeding during bowel movements
• Itching or irritation of the anus
• Pain or discomfort
• Swelling around the anus

Causes and Risk Factors of Hemorrhoids

Hemorrhoids develop when the veins around the anus or lower rectum become inflamed and bulge due to pressure. Pressure in this area may be increased as a result of:

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

Hemorrhoids occur more frequently with age as the tissue around your anus and rectum become weaker, failing to support the veins that supply this region.

Tests and Diagnosis of Hemorrhoids

To diagnose hemorrhoids, your doctor will perform a visual examination to see if the hemorrhoids are external in nature. Internal hemorrhoids are diagnosed through a digital examination of your anal canal, meaning the doctor will insert a gloved finger into your rectum to feel for lumps or unusual growths.

If you demonstrate risk factors for colorectal cancer or have symptoms that suggest a different digestive health problem, a colonoscopy may be recommended.

Treatment and Care for Hemorrhoids

Hemorrhoids can often be treated with simple home remedies that help relieve swelling and inflammation. These include:

• Applying cold compresses to relieve swelling
• Eating a high-fiber diet to help improve your digestive health and soften the stool
• Keeping the skin around the anus clean
• Soaking in a warm sitz bath two to three times a day
• Using moist towelettes instead of dry toilet paper
• Using witch hazel as a numbing agent

Over-the-counter topical creams or suppositories may also help with inflammation, while pain relievers like acetaminophen, aspirin or ibuprofen can temporarily alleviate discomfort.

For a thrombosed hemorrhoid, a doctor may remove the clot by cutting and draining the inflamed vein. Other minimally invasive procedures include:

• Coagulation techniques that use a laser or heat to cause the hemorrhoid to shrivel.
• Rubber band ligation, in which rubber bands are used to cut off circulation to the hemorrhoid
• Sclerotherapy, in which a chemical solution is injected into the hemorrhoid, causing it to shrink

In more serious cases, surgery may be required to remove the hemorrhoid and surrounding tissue.