Hemorrhoids

What are hemorrhoids?

Hemorrhoids are swollen blood vessels inside your rectum (internal hemorrhoids) or on your anus (external hemorrhoids). Sometimes a hemorrhoid may prolapse, which means it extends out of your anus.


What increases my risk for hemorrhoids?

  • Frequent or prolonged straining during bowel movements: This may happen if you have constipation or diarrhea.

  • Increased pressure in your abdomen: You may have increased pressure in your abdomen if you are pregnant or have recently had a baby.

  • Weak skin around the rectum and anus: This may be caused by rectal surgery, anal sex, or loss of muscle tone as you age.

What are the signs and symptoms of hemorrhoids?

  • Itching around your anus

  • Pain inside your rectum or around your anus

  • Bright red blood in your bowel movement, on the toilet paper, or in the toilet bowl

  • Tissue bulging out of your anus

  • Discharge of a thick fluid from your anus

  • Incontinence (poor control over urine or bowel movements)

  • Inflammation around your anus

How are hemorrhoids diagnosed?

Your caregiver will ask you about your symptoms and if you have other health conditions. He may also ask about your diet and your bowel movements. Your caregiver will then look at your anus to check for swollen blood vessels. Your caregiver may do tests to look for other causes of rectal bleeding. You may need the following:

  • Digital rectal exam: Your caregiver will put a gloved finger inside your anus to feel for hemorrhoids.

  • Anoscopy: This test helps your caregiver look inside your anus and rectum. A short plastic or metal tube is put into your anus and up into the rectum.

How are hemorrhoids treated?

  • Medicines:

    • Topical medicine: This may come as pads, creams, ointments, or lotions. This medicine may help decrease pain and swelling.

    • Stool softeners: This medicine makes it easier for you to have a bowel movement. You may need this medicine to treat or prevent constipation.

  • Surgery: You may need surgery or a procedure to shrink or remove your hemorrhoids. Your caregiver may insert a long, thin tube with a small camera on one end to see the hemorrhoids better.

What are the risks of hemorrhoids?

Treatment for hemorrhoids may cause pain, infection, or incontinence. Treatment can also cause liver problems, heavy bleeding, and difficulty getting an erection. Surgery may cause scarring or damage to the tissue in your anus or rectum. Without treatment, your hemorrhoids may become bigger or more painful. You may develop a blood clot. The clot may travel to your heart or brain and cause life-threatening problems, such as a heart attack or stroke.

How can I manage my symptoms?

  • Decrease constipation: Eat foods that are high in fiber and drink more liquids. This will help soften your bowel movements.

  • Ice: Ice helps decrease swelling and pain. Ice may also help prevent tissue damage. Use an ice pack or put crushed ice in a plastic bag. Cover it with a towel, and place it on your hemorrhoid for 15 to 20 minutes every hour as directed.

  • Heat: Heat may help to decrease pain. Take a warm bath or a sitz bath. A sitz bath is a pan of warm water that fits on the toilet bowl. Ask how often to use a sitz bath.

  • Keep your anal area clean: Gently wash the area with warm water daily. Soap may irritate the area. After a bowel movement, wipe with moist towelettes or wet toilet paper. Dry toilet paper can irritate the area.

How can I help prevent hemorrhoids?

  • Bowel habits: Do not strain to have a bowel movement or sit on the toilet too long.

  • Exercise: Exercise may make it easier to have a bowel movement. Ask your caregiver about the best exercise plan for you.

  • Drink plenty of liquids: Ask your caregiver how much liquid to drink each day and which liquids are best for you. This may decrease constipation and reduce the need to strain to have a bowel movement.

  • Eat foods high in fiber: Fruits, vegetables, whole grains, and other high-fiber foods may help prevent hemorrhoids. Ask your caregiver if you should change your diet.



  • Avoid anal sex: It can weaken the skin around your rectum and anus.

When should I contact my caregiver?

Contact your caregiver if:

  • You have frequent and painful bowel movements.

  • You see blood in the toilet bowl or on the toilet paper after a bowel movement.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • You have severe pain in your rectum or around your anus.

  • You have bleeding from your anus that does not stop.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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