Hemorrhoids are enlarged (dilated) veins around the rectum. There are 2 types of hemorrhoids, and the type of hemorrhoid is determined by its location.  Internal hemorrhoids occur in the veins just inside the rectum. They are usually not painful, but they may bleed. However, they may poke through to the outside and become irritated and painful. External hemorrhoids involve the veins outside the anus and can be felt as a painful swelling or hard lump near the anus. They are often itchy and may crack and bleed. Sometimes clots will form in the veins. This makes them swollen and painful. These are called thrombosed hemorrhoids.


Causes of hemorrhoids include:

  • Pregnancy. This increases the pressure in the hemorrhoidal veins.

  • Constipation.

  • Straining to have a bowel movement.

  • Obesity.

  • Heavy lifting or other activity that caused you to strain.


Most of the time hemorrhoids improve in 1 to 2 weeks. However, if symptoms do not seem to be getting better or if you have a lot of rectal bleeding, your caregiver may perform a procedure to help make the hemorrhoids get smaller or remove them completely. Possible treatments include:

  • Rubber band ligation. A rubber band is placed at the base of the hemorrhoid to cut off the circulation.

  • Sclerotherapy. A chemical is injected to shrink the hemorrhoid.

  • Infrared light therapy. Tools are used to burn the hemorrhoid.

  • Hemorrhoidectomy. This is surgical removal of the hemorrhoid.


  • Increase fiber in your diet. Ask your caregiver about using fiber supplements.

  • Drink enough water and fluids to keep your urine clear or pale yellow.

  • Exercise regularly.

  • Go to the bathroom when you have the urge to have a bowel movement. Do not wait.

  • Avoid straining to have bowel movements.

  • Keep the anal area dry and clean.

  • Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver.

If your hemorrhoids are thrombosed:

  • Take warm sitz baths for 20 to 30 minutes, 3 to 4 times per day.

  • If the hemorrhoids are very tender and swollen, place ice packs on the area as tolerated. Using ice packs between sitz baths may be helpful. Fill a plastic bag with ice. Place a towel between the bag of ice and your skin.

  • Medicated creams and suppositories may be used or applied as directed.

  • Do not use a donut-shaped pillow or sit on the toilet for long periods. This increases blood pooling and pain.


  • You have increasing pain and swelling that is not controlled with your medicine.

  • You have uncontrolled bleeding.

  • You have difficulty or you are unable to have a bowel movement.

  • You have pain or inflammation outside the area of the hemorrhoids.

  • You have chills or an oral temperature above 102° F (38.9° C).


  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.