The term hemorrhoids refers to a condition in which the veins around the anus or lower rectum are swollen and inflamed.
Hemorrhoids are common in both men and women. About half of the population has hemorrhoids by age 50.
There are several groups of veins that surround the rectum and anus -- one group is known as internal hemorrhoidal veins, the other is known as external hemorrhoidal veins. The underlying cause of hemorrhoids is increased pressure within these veins.
There are two types of hemorrhoids, and each type is named for the veins that are affected. The internal type is caused by increased pressure within the internal hemorrhoidal veins; the external type is caused by increased pressure within the external hemorrhoidal veins.
There are a number of conditions that can increase the pressure within the hemorrhoidal veins. While these conditions are not causes of hemorrhoids, they are considered risk factors.
Risk factors include:
- Straining to move stool, or other poor bowel habits such as sitting for long periods
- Pregnancy
- Aging
- Chronic constipation or diarrhea
- Anal intercourse
- Cirrhosis
- Obesity
- A high-fat, low-fiber diet.
(Click Causes of Hemorrhoids for more information.)
The symptoms vary among different people, and not all people with hemorrhoids experience symptoms. In most cases, the symptoms will go away within a few days. Symptoms also vary based on the type of hemorrhoid.
Internal Hemorrhoids
The most common symptom of
internal hemorrhoids is bright-red blood covering the stool, on the toilet paper, or in the toilet bowl.
Other symptoms may include:
- Feeling of vague anal discomfort
- Feeling of fullness after a bowel movement.
Pain is not a common symptom of this type of hemorrhoid.
External Hemorrhoids
Unlike internal hemorrhoids, which are usually not painful, the external type can be quite painful. For a person with an
external hemorrhoid, symptoms may also include:
(Click Hemorrhoid Symptoms for more information.)
A thorough evaluation and proper diagnosis by the doctor is important any time bleeding from the rectum or blood in the stool occurs. Bleeding may also be a symptom of other digestive diseases, including
colon cancer or
rectal cancer.
As part of making a diagnosis, the doctor will examine the anus and rectum to look for swollen blood vessels that indicate hemorrhoids, and also perform a digital rectal examination with a gloved, lubricated finger to feel for abnormalities.
In some cases, making a diagnosis may require closer evaluation of the rectum with an anoscope -- a hollow, lighted tube useful for viewing internal hemorrhoids -- or a proctoscope, useful for more completely examining the entire rectum.
To rule out other causes of gastrointestinal bleeding, the doctor may examine the rectum and lower
colon (sigmoid) with
sigmoidoscopy or the entire colon with
colonoscopy. Sigmoidoscopy and colonoscopy are diagnostic procedures that also involve the use of lighted, flexible tubes inserted through the rectum.
In most cases, treatment for hemorrhoids is focused on:
- Relieving symptoms
- Relieving pressure by increasing fiber and fluids
- Modifying bowel habits.
In infrequent cases when this conservative treatment is not successful, a hemorrhoid surgery or procedure may be recommended.
Hemorrhoids are common among pregnant women. The pressure of the fetus in the abdomen, as well as hormonal changes, can cause the hemorrhoidal vessels to enlarge. These blood vessels are also placed under severe pressure during childbirth. For most women, however, hemorrhoids caused by pregnancy are a temporary problem.
The best ways to prevent hemorrhoids includes:
- Keeping stools soft so they pass easily, thus decreasing pressure and straining
- Emptying bowels as soon as possible after the urge occurs.
Exercise, including walking, and increased fiber in the diet help reduce
constipation and straining by producing stools that are softer and easier to pass.
