Hemorrhoids: A Common Ailment with Frequent Questions
Medically reviewed on Jan 9, 2018 by L. Anderson, PharmD.
What Are Hemorrhoids?
It's a difficult topic, but one that's so common it deserves some coverage.
Hemorrhoids are swollen, inflamed and often painful veins in the rectum or anus. Older adults are usually affected, and an increased pressure in the veins of the anus may lead to or worsen the condition.
Hemorrhoids can occur inside the rectum (internal hemorrhoids) or near the anal opening (external hemorrhoids). When a hemorrhoid pushes through the anal opening, it is known as a protruding or prolapsed hemorrhoid. External hemorrhoids can form swollen and painful blood clots.
Are Hemorrhoids Common?
Hemorrhoids have been reported to occur in roughly 1 in 20 people in the U.S. Plus, about half of adults older than age 50 have hemorrhoids. In fact, a few years back, the search term "hemorrhoids" was the number one health topic searched on Google, highlighting its impact.
Although hemorrhoids can be painful and irritating, they are not usually a serious condition. Straining during bowel movements is the most common cause of hemorrhoids, with rectal bleeding as the most common symptom.
Increased anal pressure in pregnancy, diarrhea, constipation, excessive sitting or inactivity (for example - long hours at the computer), and being overweight can all increase the risk for hemorrhoids.
What Are the Symptoms of Hemorrhoids?
Painful bowel movements, itching, hard lumps, rectal bleeding, and swelling are common symptoms of hemorrhoids. Internal hemorrhoids can lead to bleeding from straining and constipation, and may push through the anal opening.
Blood clots may also form in hemorrhoids. Bleeding hemorrhoids usually leave a bright red color on the toilet paper, in the stool or in the toilet bowl. If you see blood after a bowel movement or develop severe pain, contact your doctor to rule out a more serious condition.
Are There Different Types of Hemorrhoids?
Hemorrhoids may occur on the inside or outside of the anal opening. Internal hemorrhoids occur just inside the anus at the beginning of the rectum and cannot usually be seen or felt by a doctor during a regular exam. These internal hemorrhoids may push though the anus and result in external hemorrhoids.
External hemorrhoids occur at the anal opening and may protrude outside of the anus. Both hemorrhoid types can occur at the same time. Be sure to visit your healthcare provider for a diagnosis, especially if bleeding occurs.
Can You Prevent Hemorrhoids?
Lifestyle changes can help to prevent hemorrhoids. Avoid sitting for prolonged periods of time; take a break at least every two hours. Eat foods high in fiber, such as fresh fruits, vegetables and whole grains, or use a fiber supplement. Drink plenty of water and get regular exercise.
If needed, stool softeners or laxatives can be used short-term for constipation and may help to prevent the development of hemorrhoids. If constipation is a chronic problem, see your doctor.
Visit the Drugs.com Over the Counter (OTC) database to find remedies for constipation.
OTC Treatments For Hemorrhoids
Treatments for hemorrhoids such as creams, ointments, sprays and suppositories can be purchased at the pharmacy. These products may contain a local anesthetic for pain, a corticosteroid for itching, or a topical vasoconstrictor to decrease swelling.
Common brands include Preparation H, Americaine, and Tronolane - although store brands or generics are available and will cost less. Talk to your healthcare provider if you need OTC creams or suppositories for longer than one week or if there is rectal bleeding.
What Else Can Be Done to Help Relieve Hemorrhoids?
OTC remedies won't cure hemorrhoids, but can offer relief. Other options include soaking in a warm sitz bath of water (avoid a bubble bath, however). Moist towelettes specifically made for hemorrhoids can be used after a bowel movement to help relieve irritation.
Avoid straining during a bowel movement; adding fiber to the diet can help alleviate straining. Also, check any medications to see if constipation is a side effect, and ask your doctor about it.
If these actions do not seem to relieve your symptoms, it may be time to visit with your healthcare provider to discuss other options.
What if the OTC Remedies Aren't Helpful for My Hemorrhoids?
If an OTC hemorrhoid treatment is not effective, and the hemorrhoid causes significant pain or bleeding, you may need a minimally invasive procedure to shrink or remove the hemorrhoid.
Clot removal, rubber band ligation, coagulation, and sclerotherapy (solution injected to shrink hemorrhoid) are all options. These procedures are usually performed as outpatient surgery, and may only require a local anesthetic.
For larger hemorrhoids, a hemorrhoidectomy may be suggested, which is a surgical procedure used in more extreme cases.
Which Surgical Procedures Are Used for Hemorrhoids?
Rubber band ligation is the most common procedure for internal hemorrhoids and is effective in about 75 percent of patients. A rubber band is placed on the hemorrhoid to cut off the blood supply, and in a few days the hemorrhoid tissue dies and falls off.
A hemorrhoidectomy can be effective in up to 95 percent of patients for treatment of hemorrhoids, but is usually reserved for larger internal hemorrhoids. Your physician will be able to examine you and tell you about your best options.
What's the Bottom Line on Hemorrhoids?
Prevention is key here. Staying at a normal weight, avoiding long periods of sitting, not straining during a bowel movement, and extra fiber in your diet can help to prevent hemorrhoids. If you see blood during a bowel movement, contact your doctor to rule out any more serious concerns.
Consider using over-the-counter remedies and warm sitz baths for minor symptoms, but don't hesitate to seek out advice from your doctor, too. Remember, hemorrhoids are a common topic in healthcare worth discussing with your provider. Don't let it embarrass you - as you are not alone in dealing with this health topic.
Finished: Hemorrhoids: A Common Ailment with Frequent Questions
- Brown SR. Haemorrhoids: an update on management. Therapeutic Advances in Chronic Disease. 2017;8(10):141-147. Accessed 1/9/2018 at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5624348/.
- Enlarged Hemorrhoids. PubMed Health. Accessed 1/9/2018 at https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024809/
- National Digestive Diseases Information Clearinghouse (NDDIC). Hemorrhoids. Accessed 1/9/2018 at https://www.niddk.nih.gov/health-information/digestive-diseases/hemorrhoids
- The Top Search Terms of 2012: Hemorrhoids, Herpes, and Heartburn. Accessed 1/9/2018. Health.com.
- Hemorrhoids. Mayo Clinic Disease Reference. Drugs.com. Accessed 1/9/2018 at https://www.drugs.com/mcd/hemorrhoids