If you have hemorrhoids, you may feel uneasy about seeing a doctor for treatment. That's understandable, but there's no need to feel embarrassed about this common rectal problem.
At UPMC, we treat hundreds of people with hemorrhoids every year. Our specialists are experts at putting you at ease. There’s no reason to live with the discomfort of hemorrhoid symptoms when quick relief is available.
On this page:
What Are Hemorrhoids?
Doctors define hemorrhoids as swollen, inflamed veins in the rectum and anus. You may also hear them called piles. Some people refer to them as varicose veins in the rectum.
These enlarged veins can cause itching, bleeding, discomfort, and pain. While not usually serious or life-threatening, hemorrhoids can be uncomfortable and bothersome.
What are the types of hemorrhoids?
There are two types of hemorrhoids.
Internal hemorrhoids
These hemorrhoids develop inside your rectum. You usually can't see or feel them.
When these hemorrhoids become enlarged, you may have painless rectal bleeding. You may notice bright red blood on toilet paper or in the toilet bowl.
Swelling of internal hemorrhoids may cause them to prolapse (slide out) during a bowel movement.
External hemorrhoids
These hemorrhoids form in the skin around the anus, on the outside of your body. They can cause itching and discomfort.
One type of external hemorrhoid is a thrombosed hemorrhoid. It has multiple blood clots that you can see and feel under the skin around your anus. It can cause severe pain.
How common are hemorrhoids?
Hemorrhoids are very common for both men and women. In fact, they affect about one in 20 adults in the U.S. About half the people over age 50 have hemorrhoids.
What causes hemorrhoids?
Hemorrhoids develop when there is increased pressure on the lower rectum. The pressure causes the veins in the rectum and anus to swell and stretch.
Causes include:
- Constipation.
- Obesity.
- Pregnancy.
- Sitting on the toilet for long periods of time.
- Straining during bowel movements.
- Weakening of surrounding tissues due to aging.
Hemorrhoid risk factors
It’s possible to develop hemorrhoids if you have no risk factors whatsoever. But certain conditions make them more likely to occur.
Risk factors for hemorrhoids include:
- Aging.
- Being overweight or obese.
- Chronic health conditions like inflammatory bowel disease (IBD).
- Eating a low-fiber, high-fat diet.
- Family history of hemorrhoids.
- Having chronic constipation.
- Lifting heavy weights at the gym or work.
- Pregnancy.
- Prolonged periods of sitting.
- Sedentary lifestyle with little exercise.
Complications of hemorrhoids
Hemorrhoids are usually not serious, and complications are rare. They don’t lead to more serious issues, like colon cancer.
However, it's possible to experience the following:
- Chronic bleeding, which can lead to anemia.
- Infection.
- Inflammation.
- Severe pain.
- Strangulated hemorrhoids, which can happen when internal hemorrhoids slide out through the anus and have their blood supply cut off by anal muscles.
How can I reduce my risk of hemorrhoids?
You may not be able to completely prevent hemorrhoids from developing, especially as you get older.
But you can reduce your risk of hemorrhoids if you:
- Avoid sitting for long periods.
- Don’t strain on the toilet.
- Drink plenty of water.
- Eat a high-fiber diet.
- Exercise regularly.
- Maintain a healthy weight.
What Are the Signs and Symptoms of Hemorrhoids?
Hemorrhoid symptoms can be mild or severe. Some hemorrhoids don’t cause any symptoms at all.
Symptoms of internal hemorrhoids
If you have internal hemorrhoids, you may not have a visible lump or any pain.
But you may notice:
- A prolapsed hemorrhoid — A hemorrhoid that has slid through your anal opening. Prolapsed hemorrhoids can cause discomfort and pain.
- Bleeding with a bowel movement — You may have bright red blood on toilet paper, on your stool, or coloring the toilet bowl. The amount of blood loss is usually small.
- Feeling that the rectum isn’t completely empty after a bowel movement.
- Mucus discharge from the rectum.
Symptoms of external hemorrhoids
The signs of external hemorrhoids are somewhat different from internal hemorrhoids.
They can cause:
- A hard, tender lump near the anus — This happens when a hemorrhoid becomes thrombosed, or it develops one or more blood clots. A thrombosed hemorrhoid can cause severe pain and swelling.
- Anal itching — You may have more itching if you’re not able to cleanse the area well after a bowel movement.
- Anal pain— Especially when you’re sitting down.
When should I see a doctor about my hemorrhoid symptoms?
You should see a doctor if you have:
- A great deal of pain from your hemorrhoids.
- Changes in your bowel habits or stool consistency, along with hemorrhoid symptoms.
- Hemorrhoid symptoms that don’t improve after about a week of home care.
- Rectal bleeding — May be from hemorrhoids, but it could be from other, more serious conditions, including:
- Anal cancer
- Colorectal cancer
- Crohn’s disease
- Ulcerative colitis
How Do You Diagnose Hemorrhoids?
A doctor can usually diagnose hemorrhoids with a visual exam.
If your hemorrhoids are painless but bleeding, your doctor may use an anoscope to examine them. An anoscope is a short tube used to view the rectum.
To rule out a more serious problem like colorectal cancer, your doctor may order a colonoscopy.
What to expect during your visit
Your doctor will ask you about your medical history. They will have you describe your symptoms and how long you’ve been having them.
They will ask you about your:
- Chronic or current medical conditions.
- Eating routine.
- Enema use.
- Laxative use.
- Toilet habits.
Your doctor will perform a physical exam, checking for:
- Anal fissures or tears.
- External hemorrhoids.
- Leaking stool or mucus.
- Lumps, masses, or swelling around the anus.
- Muscle tone in the anus.
- Prolapsed internal hemorrhoids.
- Skin tags (extra skin left after a blood clot in an external hemorrhoid dissolves).
How Do You Treat Hemorrhoids?
There are several different ways to treat hemorrhoids.
At-home treatment for hemorrhoids
You can try treating hemorrhoids at home before seeing a doctor. You may be able to get quick relief from a combination of the following methods.
You can:
- Drink more water.
- Eat more fiber.
- Limit your time on the toilet.
- Move your body more often.
- Sit in a sitz bath (tub of warm water).
- Take fiber supplements.
- Take over-the-counter (OTC) pain relievers.
- Use stool softeners.
Medicine to treat hemorrhoids
For mild cases of hemorrhoids, your doctor may recommend using creams, suppositories, ointments, or medicated pads. These over-the-counter methods can provide quick relief in many cases. You can purchase them in most drug stores or online.
Nonsurgical procedures to treat hemorrhoids
Your provider may use one of the following nonsurgical methods to treat hemorrhoids. These minimally invasive procedures can take place in a doctor’s office, outpatient center, or hospital.
- Electrocoagulation — Doctors send an electric current into the internal hemorrhoid. It causes scar tissue to form, cutting off the blood supply and shrinking the hemorrhoid.
- Infrared photocoagulation — Doctors direct infrared light at an internal hemorrhoid. The heat causes scar tissue to form, and the hemorrhoid shrinks.
- Rubber band ligation — Doctors place special rubber bands around the base of the hemorrhoid, cutting off its blood supply. The banded section falls off in about a week, and scar tissue forms over the remaining tissue. (You should never attempt this procedure by yourself.)
- Sclerotherapy — Doctors inject a solution into an internal hemorrhoid. The solution forces scar tissue to grow, which cuts off the blood supply to the hemorrhoid. It eventually shrinks and falls off.
Surgery for hemorrhoids
If other treatments don’t work, you may need a surgical procedure to treat hemorrhoids.
Your doctor may recommend:
Hemorrhoid stapling
A surgeon uses a stapling tool to remove internal hemorrhoid tissue and pull a prolapsed internal hemorrhoid back into the anus. You will have some form of anesthesia for this procedure.
Hemorrhoidectomy
During a hemorrhoidectomy, a surgeon removes an external or prolapsed internal hemorrhoid by cutting off the skin and removing the clotted hemorrhoid. This surgery is an option if your hemorrhoids don’t respond to other treatments. You’ll receive either general or local anesthesia for the surgery.
Is hemorrhoid treatment right for me?
If your hemorrhoids bleed or cause moderate pain, you should seek treatment.
At-home treatments may be enough for milder cases. If you have severe pain or bleeding, however, you will need medical treatment.
How long does it take to recover after a hemorrhoidectomy?
After surgery to have a hemorrhoid removed, you will likely go home the same day. If there are any complications, you may need to stay in the hospital overnight.
You will have some pain after the local anesthetic wears off. Your doctor may recommend taking acetaminophen (Tylenol) or ibuprofen (Advil or Motrin) to relieve the discomfort. You shouldn’t take aspirin, as it can promote bleeding.
You should avoid strenuous activity the day after the procedure. A small amount of bleeding and discharge is normal. Your doctor may recommend a sitz bath at least 12 hours after surgery.
You can return to most activities in about a week. It will take two to four weeks for complete healing. Anal hygiene is important, so you should wash after bowel movements and soak in a sitz bath or the tub daily.
Why Choose UPMC for Hemorrhoid Care?
Although hemorrhoids are rarely dangerous, they can affect your quality of life. For many people, they create significant discomfort. Here are some reasons to trust the colon and rectal specialists at UPMC with your care.
- We are specialists — Our colon and rectal care team provides expert diagnosis and personalized treatment for hemorrhoids.
- We offer a range of treatment options — Whether you need surgical or nonsurgical care, we will work closely with you to find the best treatment option for your specific condition.
- We understand that you may feel self-conscious — At UPMC, we offer compassionate, understanding care. Our doctors treat many people with hemorrhoids and are experts at putting you at ease.
