Hemorrhoids are swollen but normally present blood vessels in and around the anus and lower rectum. These blood vessels stretch under pressure, forming hemorrhoids. The increased pressure and swelling may result from straining to move the bowel. Other factors that contribute to the formation of hemorrhoids include pregnancy, heredity, aging, and chronic constipation or diarrhea. Hemorrhoids are either inside the anus (internal hemorrhoids) or under the skin around the anus (external hemorrhoids). Hemorrhoids are very common in men and women.  About half of the population have hemorrhoids by age fifty.

Symptoms

Many anorectal problems, including fissures, fistulae, abscesses, or irritation and itching have similar symptoms and are commonly incorrectly referred to as hemorrhoids.

Although many people have hemorrhoids, not all experience symptoms. The most common symptom of internal hemorrhoids is bright red blood covering the stool, on the toilet paper, or in the toilet bowl. Symptoms of external hemorrhoids include painful swelling or a hard lump around the anus. Excessive straining, rubbing or cleaning around the anus may cause irritation with bleeding or itching. This may produce a vicious cycle of symptoms.

What Causes Hemorrhoids?

Hemorrhoids are caused by increased pressure to the blood vessels around the anus and lower rectum. This pressure can be caused by a variety of factors.

During pregnancy, the pressure of the fetus in the abdomen and hormonal changes can cause hemorrhoids. The severe pressure placed on the blood vessels during childbirth also causes hemorrhoids. Hemorrhoids caused by pregnancy are usually a temporary problem.

Straining too hard to move the bowel is a common cause for the formation of hemorrhoids.  A low-fiber diet, inadequate fluid intake, and lack of exercise all contribute to hard stools that cause excessive straining and pressure.

Diagnosis

A thorough evaluation and proper diagnosis by the doctor is important any time bleeding from the rectum or blood in the stool lasts for more than a couple of days. Bleeding can be a sign of any number of more serious conditions.

The doctor will examine the anus and rectum to look for swollen blood vessels that indicate hemorrhoids. The doctor may also perform a digital rectal exam to feel for abnormalities.

To rule out other causes of bleeding, the doctor may examine the entire colon with a diagnostic exam called a colonoscopy.

Treatment

Medical treatment of hemorrhoids is initially aimed at relieving symptoms. Sitting in a warm tub or sitz bath for several times a day with plain, warm water in ten minute intervals is one way to relieve symptoms. Ice packs can also be used to reduce swelling.  Application of a hemorroidal cream or suppository to the affected area can be used for a limited time.

Treatment of hemorrhoids is also aimed at preventing future occurrences. Increasing fiber and fluid intake helps to soften the stool. Softer stool reduces the straining needed to move the bowel and lessens the pressure on the blood vessels that become hemorrhoids. Good sources of fiber are fruits, vegetables, and whole grains. An over-the-counter fiber supplement can also be useful.

In some cases, a referral for surgical treatment may be needed.

Points to Remember

• Blood vessels in and around the anus and lower rectum can stretch and swell resulting in hemorrhoids.
• About half the population have hemorrhoids by the age of fifty.
• A low-fiber diet, inadequate fluid intake and lack of exercise contribute to the formation of hemorrhoids.
• A doctor should be consulted anytime bleeding occurs for more than a couple of days.
• Increasing fiber and fluid intake, as well as getting more exercise can help to prevent future occurrences of hemorrhoids.

Disclaimer: The contents of this site are for informational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this site.