Hemorrhoids are swollen cushions of tissue in the anus or lower part of the rectum. They contain many arteries and veins.
Hemorrhoids are very common. They result from increased pressure on the anus. This can occur during pregnancy, childbirth, and due to constipation. The pressure causes the normal anal cushions to swell. This tissue can bleed, often during bowel movements.
Hemorrhoids may be caused by:
Hemorrhoids may be inside or outside the body.
Hemorrhoids are usually not painful, but if a blood clot forms, they can be very painful.
Common symptoms include:
Most of the time, a doctor can often diagnose hemorrhoids simply looking at the rectal area. External hemorrhoids can often be detected this way.
Tests that may help diagnose the problem include:
Treatments for hemorrhoids include:
Things you can do to reduce itching include:
Sitz baths can help you to feel better. Sit in warm water for 10 to 15 minutes.
If your hemorrhoids do not get better with home treatments, you may need some type of office treatment, such as heat treatment, to shrink the hemorrhoids. This is called infrared coagulation. This may help avoid surgery. Another type of office treatment that may help is rubber band ligation.
If these treatments are not enough, some type of surgery may be necessary, such as removal of the hemorrhoids (hemorrhoidectomy). These procedures are generally used for patients with severe bleeding or prolapse who have not responded to other therapy.
The blood in the hemorrhoid may form clots. This can cause tissue around it to die. Surgery is often needed to remove hemorrhoids with clots.
Rarely, severe bleeding may also occur. Iron deficiency anemia can result from long-term blood loss.
Call for your health care provider if:
Get medical help right away if:
Constipation, straining during bowel movements, and sitting on the toilet too long raise your risk for hemorrhoids. To prevent constipation and hemorrhoids, you should:
Rectal lump; Piles; Lump in the rectum
Sneider EB, Maykel JA. Diagnosis and management of symptomatic hemorrhoids. Surg Clin North Am. 2010 Feb;90(1):17-32, Table of Contents.
Nelson H. Anus. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap 53.
Updated by: Joshua Kunin, MD, Consulting Colorectal Surgeon, Zichron Yaakov, Israel. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.
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