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OVERVIEW

What are hemorrhoids?

Hemorrhoids are swollen or inflamed veins in your rectum or around your anus. They are very common, especially in people who are pregnant.  The type of hemorrhoid you have depends on where it occurs.

• Internal: involve the veins inside the anus at the rectum. They usually don’t hurt but they may bleed during a bowel movement.
• Prolapsed: often stretch down until they bulge outside the anus. It may go back inside your rectum on its own, or you can gently push it back inside.
• External: involve the veins outside the anus. They can be itchy or tender and can sometimes crack and bleed. A blood clot may form which can be painful and uncomfortable.

SYMPTOMS

If you have a hemorrhoid, you may feel a tender lump on the edge of your anus. You may also see blood on the toilet paper or in the toilet after a bowel movement. You may feel pain or itchiness in that area. Pain is most likely to occur with bowel movements (especially hard stools) or strenuous activities, like lifting something heavy.

CAUSES & RISK FACTORS

What causes hemorrhoids?

Hemorrhoids are caused by increased pressure in the veins of your anus or rectum. One of the main causes is straining when you’re trying to have a bowel movement. This may happen if you’re constipated or if you have diarrhea. It may also happen if you sit on the toilet too long. Hemorrhoids can also be caused by obesity, heavy lifting or any other activity that caused you to strain.

DIAGNOSIS & TESTS

How are hemorrhoids diagnosed?

It’s often possible to identify hemorrhoids if you feel or see a lump, especially if outside the anus. A healthcare provider can perform a rectal exam to confirm internal hemorrhoids. They will use a gloved, lubricated finger to feel in and around your rectum. An additional procedure may be needed for a better evaluation. During a sigmoidoscopy, a small camera is inserted to look inside your rectum.

It’s important to contact your healthcare provider if you notice bleeding from your rectum. You need to make sure the cause is hemorrhoids and not some other problem. Bleeding from your rectum or anus or bloody stools may be a sign of something more serious such as cancer.

PREVENTION

Can hemorrhoids be prevented or avoided?

Hemorrhoids are a common problem, but not always preventable. People whose parents had hemorrhoids may be more likely to get them. Pregnant women often get them because of the strain from carrying the baby and giving birth. Being overweight or standing or lifting too much can make hemorrhoids worse.

TREATMENT

Most of the time, symptoms go away on their own after a few days. If not, treatments at home focus on relieving the pain.

Here are some things you can do to help ease your symptoms:

• Take warm baths.
• Clean your anus gently after each bowel movement. Do this by by patting gently with moist toilet paper or moistened pads such as baby wipes.
• Use cold or ice packs to relieve swelling.
• Use acetaminophen (one brand name: Tylenol), ibuprofen (one brand name: Motrin) or aspirin to help relieve pain.
• Apply a cream that contains witch hazel to the area or use a numbing ointment. Creams that contain hydrocortisone can be used for itching or pain.

Painful hemorrhoids usually stop hurting in 1 to 2 weeks. Contact your healthcare provider if the pain continues or if the hemorrhoids persist. Rubber band ligation can be used to treat internal hemorrhoids. It involves placing a small rubber band around the base of the hemorrhoid. This stops the flow of blood to the area and the hemorrhoid fades away. Internal hemorrhoids can also be destroyed by injecting them with a chemical. A hemorrhoidectomy (surgical removal of the hemorrhoid) may be needed if internal hemorrhoids are prolapsed or very large.

Living with hemorrhoids

Hemorrhoid symptoms may come and go. Many things can affect them, especially straining to have a bowel movement. Use these tips to help prevent constipation:

• Include more fibre in your diet. Fresh fruits, leafy vegetables, and whole-grain breads and cereals are good sources of fibre.
• Drink plenty of fluids (except alcohol). Eight glasses of water a day is ideal.
• Exercise regularly, but do not strain with activity.
• Avoid laxatives, except bulk-forming laxatives such as Metamucil. Other types of laxatives can lead to diarrhea, which can worsen hemorrhoids.
• When you feel the need to have a bowel movement, don’t wait too long to use the bathroom.