Hemorrhoids

Hemorrhoids are swollen veins in the wall of your rectum and anus. Your rectum is the last part of your digestive system where stool is stored until you pass it. Your anus is the hole in your buttocks where your stool comes out.

• The swollen veins are caused by too much pressure in the vein

• Hemorrhoids may be inside the rectum and anus where you can't see them (internal hemorrhoids) or swell outside of the anus (external hemorrhoids)

• Hemorrhoids can cause pain or bleeding

• Most symptoms go away without treatment

Pressure in the veins in your rectum or anus can cause hemorrhoids. This pressure can be from:

• Being overweight

• Pregnancy

• Lifting heavy objects

• Constipation (trouble passing stool) or diarrhea (loose, watery stool) for a long time

• Sitting on the toilet too long or pushing too hard while passing stool

Symptoms of hemorrhoids can include:

• Lumps on your anus, which may become painful or swollen

• Bleeding from the anus or rectum with or without pain, particularly when you pass stool

• Mucus (thick fluid) in your rectum that may make you feel like you haven’t finished passing stool

• Itching

Doctors can see external hemorrhoids easily. They may use an anoscope (a short tube doctors use to look at your rectum) to see internal hemorrhoids.

If you're bleeding from your anus or rectum, doctors may look at the lower bowel with a longer scope to see if there's another cause for the bleeding.

Hemorrhoids only need treatment if they cause symptoms.

Banding a Hemorrhoid

Some internal hemorrhoids are removed by tying them off with rubber bands in an outpatient procedure called rubber band ligation. The instrument used (ligator) consists of forceps surrounded by a cylinder with ¼-inch (½-centimeter) rubber bands placed on one end. The ligator is inserted into the anus through an anoscope (a short, rigid viewing tube), and the hemorrhoid is grasped with the forceps. The cylinder is slid upward over the forceps and the hemorrhoid, pushing the rubber bands off the cylinder and around the base of the hemorrhoid. The rubber bands cut off the hemorrhoid's blood supply, causing it to wither and drop off painlessly in a few days. One hemorrhoid is ligated about every 2 weeks. Several treatments may be required. Sometimes, multiple hemorrhoids can be ligated at a single visit.

Treatment to help with symptoms include:

• Stool softeners

• Laxatives if you're constipated

• Sitting in a tub of just enough warm water to cover your anus (sitz bath) for 10 to 15 minutes a few times a day

• Pain medicines

• Numbing cream that you put in your anus

Treatments to remove hemorrhoids can include:

• A shot that causes scarring in the hemorrhoid and destroys it

• Using heat, electric current, or a laser to destroy the hemorrhoid

• Tying the hemorrhoid with special rubber bands, which makes the hemorrhoid fall off

• Sometimes, surgery to remove hemorrhoids

• Sometimes, surgery to remove a blood clot in a hemorrhoid that causes severe pain

To prevent hemorrhoids from coming back, even after treatment, you should:

• Eat more fiber

• Drink plenty of fluids

• Exercise

• Go to the toilet when you feel you have to—don't wait

• Don't sit on the toilet for a long time or strain to pass stool

• Keep your anus clean