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What are hemorrhoids?

A hemorrhoid is a swollen vein that has formed in the anal canal or near the anus opening. This problem can be quite painful but is common and not usually serious. In fact, millions of Americans currently suffer from hemorrhoids and more than half the population will develop a hemorrhoid over their lifetime. Hemorrhoids can fall into two categories:

Internal Hemorrhoid – A swollen vein inside of the anal canal.

  • Internal hemorrhoids often are small, but they can be large and bulge out of the anus. If they bulge out and are squeezed by the anal muscles they can be particularly painful, even more so if the muscle cuts off the hemorrhoids blood supply.

External Hemorrhoid – A swollen vein surrounding the opening of the anus.

  • If blood pools under the skin of the external hemorrhoid and clots it will form a hard, painful lump called a thrombosed hemorrhoid.

What causes hemorrhoids?

A hemorrhoid is caused by too much pressure on the veins in the pelvic and rectal area. The veins in the pelvic and rectal region are under constant pressure, anything that increases that pressure has the ability to strain the tissue that supports the veins and result in a hemorrhoid. This pressure can be an acute occurrence such as straining during a bowel movement or a persistent pressure that weakens the tissue that supports the veins in the anal canal as is common with those that are overweight.

Causes for hemorrhoids:

  • Heredity
  • Sitting on the toilet for a long period of time
  • Hurrying to complete a bowel movement or pushing extra hard to move a stool
  • Persistent diarrhea or constipation
  • Pregnant women can get hemorrhoids during the last 6 months of pregnancy. Straining to push the baby out during labor can make hemorrhoids worse.
  • Being overweight especially in the abdomen and pelvis
  • Medical conditions such as long-term heart and liver disease may cause blood to pool in the abdomen and pelvic area, enlarging the veins.

Hemorrhoids Symptoms

As discussed above hemorrhoids can fall into two classifications, internal or external.

Internal Hemorrhoid

  • Rectal bleeding (The most common symptom of internal hemorrhoids)
  • Bright red streaks of blood on the toilet paper or bright red blood in the toilet bowl after a bowel movement. Blood also may be visible on the surface of the stool.
  • Mucus on the toilet paper or stool (especially if the internal hemorrhoid has bulged out of the anal cavity)
  • Itching

External Hemorrhoid

  • Rectal pain occurs mainly with external hemorrhoids.
  • If blood pools under the skin of the hemorrhoid and clots it will form a hard, painful lump called a Thrombosed hemorrhoid.
  • You might also notice streaks of blood on the toilet paper after passing a stool.
  • Itching

Other symptoms of internal hemorrhoids may include:

  • Skin irritation – Large hemorrhoids that bulge from the anus may secrete mucus, causing mild irritation.
  • Feelings of not fully emptying your bowels – You may still feel the urge to pass stool right after having a bowel movement. This uncomfortable feeling is caused by the bulging of the hemorrhoid in the end portion of the large intestine (anal canal). In general, the larger the hemorrhoid, the greater the discomfort.
  • Pain. Most internal hemorrhoids are not painful – Internal hemorrhoids often are small, but they can be large and bulge out of the anus. If they bulge out and are squeezed by the anal muscles they can be particularly painful, even more so if the muscle cuts off the hemorrhoids blood supply.

Pain, recent changes in bowel movement behavior or stool characteristics, or rectal bleeding are also symptoms of more serious conditions such as colon, rectal, or anal cancer. People who have these symptoms, especially those age 50 or older or those with a family history of colon cancer, need to talk to their doctors.

Other ailments with similar symptoms include:

How to get rid of hemorrhoids …

The first step in getting rid of your hemorrhoids is to stop the pressure that caused the hemorrhoid in the first place. Eliminate excessive straining, especially when passing a stool. Mild symptoms can be lessened by increasing the amount of fiber and fluids in your diet. Hemorrhoid symptoms will decrease in two to seven days, and the firm lump should recede within four to six weeks. You might also consider any of these methods for reducing hemorrhoid pain and speeding up healing: (Hemorrhoid pain management and healing methods)

If you are experiencing persistent pain from a thrombosed hemorrhoid, your physician may elect to remove the hemorrhoid containing the clot. The procedure entails a small incision under local anesthesia as an outpatient procedure.

Severe hemorrhoids may require special treatment, much of which can be performed on an outpatient basis. Those procedures include:

  • Ligation (rubber band procedure) – tying off the hemorrhoid with a small rubber band to cut off its blood supply. The hemorrhoid and the band fall off a few days later and the wound usually heals a week or so after that. This procedure sometimes produces mild discomfort and bleeding and may need to be repeated for a full effect.
  • Injection and Coagulation relatively painless and cause the hemorrhoid to shrivel up.
  • Hemorrhoid stapling – this is a technique that uses a special device to internally staple and remove internal hemorrhoidal tissue. This procedure is generally more painful that rubber band ligation and less painful than hemorroidectomy.
  • Hemorrhoidectomy – surgery to remove the hemorrhoids. It is needed when…
    1. Clots repeatedly form in external hemorrhoids
    2. Ligation fails to treat internal hemorrhoids
    3. The protruding hemorrhoid cannot be reduced
    4. Persistent bleeding occurs

How long do hemorrhoids last?

This depends on the severity of the hemorrhoid. However, in most cases, if behavior and dietary medications are made the hemorrhoids symptoms should be eliminated in two to seven days. If this new modified behavior is continued any bulge or lump will be eliminated in four to six weeks.       

What makes hemorrhoids worse?

  • Continuing the behavior that caused them in the first place
  • Prolonged sitting or standing. This may cause blood to pool in the anal area and increase pressure on the veins
  • Frequent heavy lifting or holding your breath when lifting heavy objects

Should I go to the doctor for hemorrhoids?

You should always keep your doctor appraised of any ailment or change in your health. Consulting a doctor on what may seem like a “mild” hemorrhoid is still wise. However, if you experience any of the below you should contact your doctor right away:

As stated above, some common symptoms of hemorrhoid may be a precursor of other serious underlying health problems such as colorectal cancer. Call your doctor if you have symptoms like these:

  • If you have increased pain
  • Recent changes in your bowel movement frequency
  • Recent changes in stool shape (long and stringy)
  • Stools are black or tarry
  • A lump or bulge that is not tender and does not go away develops at the anal opening.
  • You have a history of colon, rectal, or anal cancer
  • There is excessive bleeding or change in blood color

If you have hemorrhoids, call your doctor if:

  • Rectal pain lasts longer than 1 week after home treatment.
  • Pain or swelling is severe
  • Tissue from inside the body bulges from the anus and does not return to normal in 48 hours
  • A lump inside the anus becomes bigger or more painful.



Updated: August 21, 2015 — 12:12 am

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