Hemorrhoids

Hemorrhoids are swollen veins around the rectum or anus. There are two types of hemorrhoids:

  • Internal hemorrhoids. These occur in the veins just inside the rectum. They may poke through to the outside and become irritated and painful.

  • External hemorrhoids. These occur in the veins outside the anus and can be felt as a painful swelling or hard lump near the anus.

CAUSES

  • Pregnancy.  

  • Obesity.  

  • Constipation or diarrhea.  

  • Straining to have a bowel movement.  

  • Sitting for long periods on the toilet.

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

  • Anal intercourse.

SYMPTOMS

  • Pain.  

  • Anal itching or irritation.  

  • Rectal bleeding.  

  • Fecal leakage.  

  • Anal swelling.  

  • One or more lumps around the anus.  

DIAGNOSIS

Your caregiver may be able to diagnose hemorrhoids by visual examination. Other examinations or tests that may be performed include:

  • Examination of the rectal area with a gloved hand (digital rectal exam).  

  • Examination of anal canal using a small tube (scope).  

  • A blood test if you have lost a significant amount of blood.

  • A test to look inside the colon (sigmoidoscopy or colonoscopy).

TREATMENT

Most hemorrhoids can be treated at home. 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:

  • Placing a rubber band at the base of the hemorrhoid to cut off the circulation (rubber band ligation).  

  • Injecting a chemical to shrink the hemorrhoid (sclerotherapy).  

  • Using a tool to burn the hemorrhoid (infrared light therapy).  

  • Surgically removing the hemorrhoid (hemorrhoidectomy).  

  • Stapling the hemorrhoid to block blood flow to the tissue (hemorrhoid stapling).  

HOME CARE INSTRUCTIONS

  • Eat foods with fiber, such as whole grains, beans, nuts, fruits, and vegetables. Ask your doctor about taking products with added fiber in them (fiber supplements).

  • Increase fluid intake. 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. Use wet toilet paper or moist towelettes after a bowel movement.  

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

  • Only take over-the-counter or prescription medicines as directed by your caregiver.  

  • Take warm sitz baths for 15–20 minutes, 3–4 times a day to ease pain and discomfort.  

  • Place ice packs on the hemorrhoids if they are tender and swollen. Using ice packs between sitz baths may be helpful.  

  • Put ice in a plastic bag.  

  • Place a towel between your skin and the bag.  

  • Leave the ice on for 15–20 minutes, 3–4 times a day.  

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

SEEK MEDICAL CARE IF:

  • You have increasing pain and swelling that is not controlled by treatment or 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.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

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