Information and Treatment for Hemorrhoids

What Are Hemorrhoids?

Hemorrhoids occur when the veins or blood vessels in and around your anus and lower rectum become swollen and irritated. This happens when there is extra pressure on these veins. Hemorrhoids, also called piles, can be internal or external.

What Causes Hemorrhoids?

Risk factors for hemorrhoid development include aging, obesity, depressive mood and, very commonly, pregnancy, especially in the last trimester. Carrying a baby and straining during labor put stress on the blood vessels in the pelvic area.

Constipation and prolonged straining during bowel movements are believed to cause hemorrhoids, as well as a low-fiber diet, spicy foods and alcohol intake.

Sitting for long periods, especially on the toilet, can lead to hemorrhoids, as can anal intercourse.

How Common Are Hemorrhoids?

Hemorrhoids are among the most common medical conditions, affecting an estimated 10 million Americans per year. About 50 percent of people will have hemorrhoids by age 50.

What Are the Common Signs and Symptoms of Hemorrhoids?

Signs and symptoms of hemorrhoids may include:

• painless bleeding during bowel movements – you may see small amounts of bright-red blood on your toilet tissue or in the toilet
• itching or irritation in your anal region
• pain or discomfort
• swelling around your anus
• a lump near your anus, which may be sensitive or painful (which may be a thrombosed hemorrhoid – one with clotted blood)

What Can I Do about Hemorrhoids?

The main goal of treatment is to reduce your symptoms. This may be done by:

• sitting in plain, warm water in a bathtub several times a day
• using ice packs to reduce swelling
• using hemorrhoid creams or medicines inserted into your rectum (suppositories)

Your health care provider may also suggest that you add more fiber and fluids to your diet to help soften your stools. He or she may also suggest that you take stool softeners or fiber supplements. With softer stools, you don’t have to strain during bowel movements, reducing pressure on your hemorrhoids.  

How Does a Doctor Treat Hemorrhoids?

Most hemorrhoids can be managed medically or with procedures in your doctor’s office. In severe cases, surgery may be required.

There are several techniques used to remove or reduce internal and external hemorrhoids. These include:

• Rubber band ligation: A rubber band is placed around the base of the hemorrhoid inside your rectum to stop blood flowing to the hemorrhoid. The hemorrhoid shrinks and goes away in a few days.
• Sclerotherapy: A chemical solution is injected around the blood vessel to shrink the hemorrhoid.
• Electrical coagulation, also called infrared photo coagulation: A special device uses a beam of infrared light to burn hemorrhoid tissue.
• Hemorrhoidectomy and hemorrhoidopexy: These procedures permanently remove your hemorrhoids.

When Should I Make an Appointment with a Specialist?

A colorectal surgeon can help with severe cases of hemorrhoids.

Talk to your doctor if you know you have hemorrhoids and they cause pain, bleed frequently or excessively, or don't improve with home remedies. Your physician will examine you and perform other tests to confirm hemorrhoids and rule out more serious diseases, such as colorectal cancer and anal cancer, which also may cause rectal bleeding. The Women’s Medicine Collaborative has specialists who can help.

Learn more about treatment for pelvic floor disorders at Brown University Health